|
Highlights of Changes for 2007
IU Dental Plan
- Coverage will be enhanced by removing the age limit for reimbursement of sealants for teeth; current age limit is 14.
Medical plans
- IU PPO-Plus and IU PPO $900 Deductible plans prescription drug changes:
- The threshold for determining ‘high cost’ brand (Tier 3) prescriptions will increase from $60 to $65. As a result some prescriptions will move to the lower Tier 2 copay.
- Mail order (up to a 90-day supply) copays will increase to the amounts shown below.
Member Mail Order Prescription Copays |
|
2006 |
2007 |
Generic/Tier 1 |
$12 |
No change |
Brand/Tier 2 |
$34 |
$36 |
Brand/Tier 3* |
$70 |
$75 |
* includes speciality drugs
- IU PPO $900 Deductible Plan
- Coverage of urgent care facilities and providers will be subject to the deductible and 10 percent coinsurance.
- M-Plan HMO – no plan changes
- Blue Preferred Primary POS – no plan change
2007 Medical Premium Rates (Monthly)
6.8 Percent Average Increase in Premiums
As a result of the weighted increase in medical premiums, IU contributions for medical coverage will increase by up to 6.8 percent. IU contributions for dental coverage will increase by 6.0 percent. Employee contributions equal the difference between the total premium for the respective plan and IU contributions, with a minimum employee contribution of $1 per month.
Employee contributions equal the difference between the total premium for the respective plan and IU contributions. IU contributions are the same across all medical plans, with a minimum employee contribution of $1 per month. |
| |
Total Monthly Premium |
% of Change(1) |
Employee Contribution(2) |
Difference
2006 to 2007(3) |
| IU PPO–Plus |
| Employee Only |
$486.52 |
6.09% |
$119.86 |
$4.49 |
| Employee/Child(ren) |
$963.70 |
6.09% |
$325.69 |
$14.53 |
| Employee/Spouse |
$1,180.34 |
6.09% |
$405.21 |
$18.21 |
| Family |
$1,340.21 |
6.09% |
$506.92 |
$23.66 |
| IU PPO $900 Deductible |
| Employee Only |
$305.45 |
7.88% |
$1.00 |
$0.00 |
| Employee/Child(ren) |
$609.27 |
7.88% |
$1.00 |
$0.00 |
| Employee/Spouse |
$744.83 |
7.88% |
$1.00 |
$0.00 |
| Family |
$845.87 |
7.88% |
$12.58 |
$8.52 |
| M-Plan HMO |
| Employee Only |
$379.27 |
7.00% |
$12.61 |
$1.37 |
| Employee/Child(ren) |
$714.02 |
7.00% |
$76.01 |
$5.92 |
| Employee/Spouse |
$873.95 |
7.00% |
$98.82 |
$7.61 |
| Family |
$991.99 |
7.00% |
$158.70 |
$11.63 |
| Blue Preferred Primary POS |
| Employee Only |
$335.33 |
4.78% |
$1.00 |
$0.00 |
| Employee/Child(ren) |
$664.24 |
4.78% |
$26.23 |
-$10.49 |
| Employee/Spouse |
$813.56 |
4.78% |
$38.43 |
-$12.44 |
| Family |
$923.75 |
4.78% |
$90.46 |
-$11.13 |
(1) Represents the increase of total premiums from 2006 total premiums.
(2) Employee contributions are lower for Support and Service Staff employees with an
annual salary of less than $26,520.
(3) Represents the change in employee contribution from 2006.
More details of employee contribution amounts, including dental coverage and additional IU subsidy for lower salaries, will be included with Open Enrollment materials. |
Benefits Change Connection
 www.indiana.edu/~uhrs/bcc
University Human Resource Services (UHRS) has a new, task-based Web site that enables employees and Retirees to enroll in and change certain benefit plans. The Benefits Change Connection provides necessary step-by-step information and resources an employee needs to make decisions about and to successfully complete many benefit enrollment tasks. Many forms that were previously hard copies only are now available as interactive, Web forms. And processes such as initiating a Change of Status, can now be submitted electronically. The types of tasks employees can perform include:
- Request changes to benefit plans following life event changes (marriage, birth of a child, change in residence, etc.)
- Enroll in a benefit plan or change coverage in an existing plan that does not require an official Change of Status (life insurance and
retirement/investment)
- Enroll in IU Fee Courtesy Plan benefits
This service complements eBenefits, a self-service tool available through OneStart that UHRS announced in June.
Important Notice Required by Federal Law
Prescription Drug Coverage and Medicare
Employers, like Indiana University, are required to provide notice to employees about Medicare prescription drug coverage each year. Medicare prescription drug coverage is now available to everyone with Medicare. This coverage is referred to as Medicare Part D.
The prescription drug coverage in IU-sponsored employee medical plans—IU PPO-Plus, IU PPO $900 Deductible, Blue Preferred POS, and M-Plan HMO—is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage. For this reason, IU plan participants will not pay a penalty to enroll in Medicare coverage later—as long as their Medicare prescription plan enrollment takes place within 63 days of ceasing IU-sponsored coverage. (This rule is similar to the current rule about enrolling without penalty in Medicare Part B.)
If a Medicare-eligible individual goes 63 days or longer without prescription drug coverage that’s at least as good as Medicare’s prescription drug coverage—monthly Medicare premiums will go up. The amount of increase will be at least 1 percent per month for every month for which there was no coverage. For example, if a Medicare-eligible individual goes nineteen months without coverage, the premium will always be at least 19 percent higher than what most other people pay. This higher premium will be in effect as long as Medicare coverage is in effect. In addition, after a 63-day lapse of coverage, the individual may have to wait until the next November to enroll in Medicare.
Go to www.indiana.edu/~uhrs/benefits/needknow.html to learn more about Medicare part D coverage.
Next article: Clery Act Notice
|
