For 2005, there will be an 8.1 percent increase in the weighted average adjustment in medical premiums for the university’s four medical plan options. There will also be a 7.0 increase in dental premiums.

The above are adjustments in total premiums, and employee contributions will increase or decrease abased on the difference between total premium and the university’s contribution amount. For 2005, the university will contribute the following for medical and dental plan coverages:

Note: The university will contribute a greater amount for Staff in non-PA positions with a base salary of less than $25,000.

See the 2005 medical plan premiums and employee contributions chart for more information.

Highlights of Modifications
All Plans

• State Legislation May Affect Medical Care Benefits in 2005
  In early 2004, the Indiana state legislature passed a bill requiring the state to implement a prescription drug purchasing program for governmental entities, including state educational institutions. Although the law’s intent is for the provisions of the drug purchasing program to take effect on January 1, 2005, the state timelines for contracting and implementing the program have not resulted in any specific information at the time of printing this bulletin. Should the state finalize a contract that requires IU to participate, the university will notify employees as soon as possible. In this event, employees enrolled in PPO plans should expect the following: (1) mail order locations for purchasing drugs will change, (2) prescription benefits will include a formulary (a preferred list of drugs that determines the copay), (3) prescription management changes, (e.g., quantity limits, prior authorizations and other requirements that must be met before certain prescriptions will be covered), and in some cases, (4) changes in copays.

Note: The new state legislation will not affect the prescription benefits in M-Plan, and no major changes are anticipated in the Blue Preferred Primary POS plan prescription benefits as a result of the legislation.

IU Dental Plan

• No plan changes.

IU PPO-Plus

• No plan changes.

IU PPO $900 Deductible

• No plan changes.

M-Plan HMO

• Physical, speech, and occupational therapy services will have a copay of $15 per visit; the benefit limit on these services will change from 60 consecutive visits to 60 visits per condition per year.
• A $5 million maximum benefit per covered person will be added.
• Artificial insemination services will no longer be covered.
• Mental health and substance abuse services will no longer have a day-limit on inpatient stays.
• A new “OTC Select” prescription benefit will be added to cover certain over-the-counter drugs with a $4 copay when they are pre-authorized.

Blue Preferred Primary POS

• Prescription non-formulary brand copay will increase to $30 at retail and $60 through mail.
• Non-sedating antihistamines (Allegra, Zyrtec, Clarinex) will no longer be covered.
• This plan is now available in the Bloomington area; however, before enrolling–and due to network provider limitations and major plan differences–Bloomington residents will want to compare it to their current PPO plan to determine if it meets their needs. See the UHRS Web page for comparison information.

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