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This presentation by Ellen Gerescher, Employee Benefits Manager, outlines significant updates to the A&M System's employee benefits for the 2012/2013 year. The presentation covers renewed contracts with BlueCross BlueShield and Medco, leading to lower costs and enhanced discounts. Key changes include the consolidation of health plans, the introduction of additional premiums for tobacco users, and an audit of dependents resulting in voluntary drops. The new A&M Care Plan will provide 100% preventive care and eliminate maximums for drug coverage, aligning with federal healthcare reforms.
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Benefits 2012/2013 - - An HR Liaison Presentation • June 2012 Ellen Gerescher Employee Benefits Manager A&M System Office
Contract Renewals • The System Benefits Office administers the System benefit plans and has fiduciary responsibility for sound management of the premium resources • Renewed contracts with both BlueCross BlueShield and Medco will result in significant savings • Lower administrative fees, greater network discount savings
Benefit Changes for 9-1-12 Tobacco User Additional Premium Consolidation of Health plans Dependent Audit
What constitutes a tobacco user? This can be defined many different ways. The A&M System will follow the standard used by the ERS in order to be consistent with other State entities. A tobacco user is someone who has utilized tobacco more than five times in the previous three months.
Two Years of Changes • Changes for 2011-12 • Merged two A&M Care plans into one plan • Changes for 2012-13 • Merging the Scott & White Health Plan into the A&M Care Plan
Behind the Consolidation • Larger, single risk pool eliminates selection bias and adverse selection • SWHP enrollment has decreased over the past several years • Costs have increased • Members aged • Costs for doctors outside the clinic increased • Plan design continued to mirror that of the A&M Care plan
Transitioning from Scott & White • While plan choice may be gone ---- physician choice remains • Decrease in monthly premiums • Virtually all S&W doctors are in the BlueCross BlueShield network • BCBS phone number for Scott & White members with questions: 1-866-231-5581
Transitioning (cont.) • The Scott & White pharmacies are in the Medco network • Medco website for information about coverage for specific drugs: http://www.medcohealth.com/consumer/site/openenrollment?accessCode=TAMRXBEN14597
New for the A&M Care Plan Starting August 1, your A&M UIN will be your BlueCross BlueShield ID Number, beginning with TXW (for employees) and ZGB (for retirees) – all existing members will get new ID cards Benefits Value Advisor – service that helps employees by locating providers, providing cost estimates, scheduling procedures, etc.
New for the Grad Plan • Expanded to be compliant with Federal Healthcare reform • No plan-year maximum for drug coverage • Preventive care provided at 100% • No pre-existing coverage limitation for members under age 19
Dependent Audit Approximately 10,000 employees with dependent medical coverage audited Approximately 750 dependents dropped; however many dropped voluntarily Audit continues for those with dependents on dental, vision and dependent life only
Thank You! Ellen Gerescher System Benefits Administration Egerescher@tamus.edu 979.458.6330