Transcript Texas A&M System Benefits Administration

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
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Benefit Changes for 9-1-12
• Tobacco User Additional Premium
• Consolidation of Health plans
• Dependent Audit
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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.
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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
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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
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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
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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/sit
e/openenrollment?accessCode=TAMRXB
EN14597
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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.
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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
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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
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Thank You!
Ellen Gerescher
System Benefits Administration
[email protected]
979.458.6330
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