Highlights of Changes for 2008
Medical plans
M-Plan HMO
- M-Plan has made a business decision to discontinue their HMO product effective December 31, 2007. Current members may enroll in another plan during Open Enrollment. If no action is taken, the member will be automatically enrolled in the Blue Preferred Primary POS Plan effective January 1, 2008.
IU PPO $900 Deductible
- Separate out-of-pocket deductible and copay limits will be added, equal to the in-network deductible and copay limits.
IU PPO-Plus
- No new enrollments will be accepted into this plan for 2008. This plan will be discontinued effective December 31, 2008. Although current participants can continue enrollment for 2008, they are encouraged to review this plan’s costs compared to the IU PPO $900 Deductible and Blue Preferred Primary POS plans which are more cost effective.
IU PPO Plus and IU PPO $900 Deductible
- Mental health coverage will be enhanced for chronic and behavioral conditions with additional coverage for medically necessary services.
Blue Preferred Primary POS – no plan changes
IU Dental Plan
Coverage will be enhanced by increasing the annual per person benefit limit from $1,000 to $1,200.
DEPENDENT Eligibility for Medical and Dental Plans
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Dependent eligibility will be modified to include coverage for an employee’s unmarried child until the end of the month in which the child reaches age 24, so long as the child can be claimed as a federal tax exemption by the employee or employee’s registered domestic partner.* Child is defined as biological or adopted child, or the legal ward of the employee, employee’s spouse, or registered domestic partner.
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The university will require the employee to certify that the employee or domestic partner can claim the child as an IRS tax exemption. Generally, the child must live with the employee at least half the year, not provide more than half of his or her own support, and, if age 19 or older for any part of the year, be a full-time student. Children age 19 or older who are not full-time students may still be a tax exemption under certain IRS support and income limits if they are not the tax exemption of any other person. Special IRS rules apply to children of divorced or separated parents. Employees who are uncertain of their child’s tax exempt status should check with a tax advisor or IRS Publication 501 (available at www.irs.gov/pub/irs-pdf/p501.pdf). Enrolling an ineligible child can result in termination of coverage, additional cost to the employee, and meaningful tax consequences.
Personal Accident Insurance (PAI)
There will be no plan changes in the coverages under the Personal Accident Insurance plan and the premiums will remain the same.
(Enrollment in this optional insurance plan is only available to newly hired employees and during Open Enrollment each year. It covers death and injuries caused by accidents that occur on or off the job, at home, and while traveling.)
M-Plan HMO Participants
M-Plan participants can locate in-network providers (physicians, hospitals, medical professionals, pharmacies, etc.) using the online drop-down menu of the Anthem Provider Directory tool at providerdirectory.anthem.com/ or by calling 800-345-2460.
- PPO $900 Deductible Plan select Anthem Blue Access.
- Blue Preferred POS Plan select Blue Preferred HMO/POS/EPO.
2008 Medical Premium Rates (Monthly)
13.4 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 13.4 percent. IU contributions for dental coverage will increase by 4.3 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. |
| |
Total Monthly Premium |
% of Change(1) |
Employee Contribution(2) |
Difference
2007 to 2008(3) |
| IU PPO–Plus |
| Employee Only |
$572.39 |
17.7% |
$156.60 |
$36.74 |
| Employee/Child(ren) |
$1,133.79 |
17.7% |
$410.29 |
$84.60 |
| Employee/Spouse |
$1,388.67 |
17.7% |
$509.67 |
$104.46 |
| Family |
$1,576.76 |
17.7% |
$631.81 |
$124.89 |
| IU PPO $900 Deductible |
| Employee Only |
$349.83 |
14.5% |
$1.00 |
$0.00 |
| Employee/Child(ren) |
$697.80 |
14.5% |
$1.00 |
$0.00 |
| Employee/Spouse |
$853.05 |
14.5% |
$1.00 |
$0.00 |
| Family |
$968.77 |
14.5% |
$23.82 |
$11.24 |
| Blue Preferred Primary POS |
| Employee Only |
$373.39 |
11.4% |
$1.00 |
$0.00 |
| Employee/Child(ren) |
$739.63 |
11.4% |
$16.13 |
-$10.10 |
| Employee/Spouse |
$905.90 |
11.4% |
$26.90 |
-$11.53 |
| Family |
$1,028.60 |
11.4% |
$83.65 |
-$6.81 |
(1) Represents the increase of total premiums from 2007 total premiums.
(2) Employee contributions are lower for Support and Service Staff employees with an annual salary of less than $27,186.
(3) Represents the change in employee contribution from 2007.
More details of employee contribution amounts, including dental coverage and additional IU subsidy for lower salaries, will be included with Open Enrollment materials. |
Important Notice Required by Federal Law
Medicare Prescription Drug Coverage
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 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.
Preferred Providers and Customer Service Contacts
IU PPO-Plus and IU PPO $900 Deductible
Medical - Anthem
Member Services: 800-345-2460
www.anthem.com (select Anthem Blue Access)
BlueCard network providers outside Indiana: 800-810-2583
www.bluecares.com
Prescription - Anthem/NextRx
Member Services: 800-345-2460
www.anthemprescription.com
Mail Order Services: 800-962-8192
Mental Health - IU Psychiatric Management
Member Services: 800-230-4876
Blue Preferred Primary POS
Medical/Mental Health - Anthem
Member Services: 800-345-2460
www.anthem.com
(select Blue Preferred HMO/POS/EPO)
BlueCard network providers outside Indiana: 800-810-2583
www.bluecares.com
Prescription - Anthem/NextRx
Member Services: 800-345-2460
www.anthemprescription.com
Mail Order Services: 800-962-8192
IU Dental Plan
CIGNA
Member Services: 888-336-8258
www.cigna.com/dental
Tax Saver Benefit Plan (TSB)
The Nyhart Company
Member Services: 317-803-7750 or 800-284-8412
iutsb.nyhart.com/
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