Oct. 29

ISU Plan open change period is Nov. 2-20

by Paula Van Brocklin

ISU Plan participants will have a chance to review and change their health and dental benefits during an annual open change period, Nov. 2-20.

Differences in medical and prescription drug plans and some changes in employee's share of costs highlight benefit changes for 2010. While Iowa State's health care costs are rising more than 11 percent annually, the university limited its contributed health care increase to 5 percent for 2010. The university benefits committee recommended plan changes to bridge the difference, and to minimize the impact to employees in 2010.

Following is a look at what's changing, how to review your current elections and where to get more information. New benefits elections go into effect Feb. 1, 2010.

What's changing?

Wellmark Alliance Select (PPO plan)

  • Co-payments will increase from $10 to $20.
  • Within the PPO provider network, out-of-pocket maximums for all spouse, child or family plans will increase from $1,500 to $3,000, but out-of-pocket maximums for single contracts will remain $1,500.
  • Outside the PPO provider network, out-of-pocket maximums will increase from $1,500 to $3,000 for single plans, and rise to $6,000 for spouse, child and family contracts.
  • Beginning Feb. 1, 2010, the most one person in a family will pay for in-network eligible services is $1,500. After that, the other family members on the contract will share the remaining $1,500 out-of-pocket cost, for a maximum of $3,000. If a family member receives services outside the network, the most he or she will pay is $3,000. The other family members will share the remaining out-of-pocket cost, up to $6,000.

Wellmark Blue Advantage (HMO plan)

  • Co-payments for office exams will increase from $0 to $10. Chiropractic and acupuncture services will remain $10 per visit.

Medco prescription plan

  • ISU is enhancing clinical programs for certain medications to protect the health and safety of employees. This means some prior authorization may be required before Medco will dispense certain medications. For example, a doctor may prescribe a medication for a health issue not normally indicated for that condition, though it may work for you. Medco will not approve payment for the medication without first consulting with you and your doctor to receive authorization.
  • Co-payments for retail (your local pharmacy) purchases are not changing. They will continue to be $10 for generic, 30 percent for preferred brand-name drugs and 50 percent for non-preferred brand name drugs.
  • Mail-order generic prescriptions will continue to cost employees nothing. Mail-order preferred brand-name drugs will have a 25 percent co-payment, compared to 20 percent for 2009. For non-preferred brand names, the mail-order co-payment is 33 percent.
  • Out-of-pocket maximums for family contracts are increasing from $1,500 to $3,000. So, if one family member reaches $1,500 out-of-pocket, he or she will have no further costs for prescriptions the rest of the year. Other family members will have co-payments until the $3,000 maximum is met. Single contracts will continue to have a $1,500 out-of-pocket maximum.
  • Co-payments for preferred and non-preferred brand-name drugs will be capped. When purchased at a retail store, the maximum cost for a 30-day supply of a preferred brand-name drug will be $100; it will be $200 for non-preferred brand name drugs. For a 90-day supply, the maximum retail cost will be $300 for preferred drugs and $600 for non-preferred drugs.
  • Co-payments for mail-order preferred brand-name drugs will be capped at $250; the co-pay cap will be $500 for mail-order non-preferred brand-name prescriptions.

Credits will be called shares

Iowa State will continue to contribute to employees' benefits, but those contributions now will be called a share, not credits or premiums. The reason? Consistency and clarity.

"We hope [the change] will help the employee know the real cost," said Jane Walter, human resources specialist. For example, in 2009 a person with a single PPO may think he or she pays $452 each month when that individual really pays only $15.

Employees will continue to receive contributions from ISU toward their benefits when they do not elect certain coverage. For example, employees who choose not to purchase life insurance will have that share go toward their health or dental share, or to a flexible spending account.

How to make changes

Human resource services will send an e-mail to all ISU Plan participants and other eligible employees at the beginning of the open change period, alerting them that open change has begun. There will be no notification sent to employees' homes this year.

Beginning Nov. 2, ISU Plan participants may check their 2009-10 participation statement online by logging into AccessPlus (Employee > Benefits Info) to review their current elections. If you're happy with your selection and wish to make no changes, do nothing. The benefits you had in 2009 will carry over to 2010.

"But know that on Feb. 1, 2010, there are changes to some coverage of your plan," Walter said.

All new elections must be completed by 5 p.m., Nov. 20.

On Dec. 4, the 2010 confirmation statements will be added to AccessPlus (under Benefits Info) for most employees. You will have one week to review the statement, and to report any corrections or errors.

More information

If you need more information about the ISU Plan changes, you have multiple options this year.

  • Vendor fair, Nov. 3 (9 a.m.-3:30 p.m., Pioneer Room, Memorial Union). Stop by and meet with representatives from Wellmark, Medco, Delta Dental, Avesis (vision), John Hancock (long-term care) and Principal (life and long-term disability insurance). ISU Benefits staff also will be available to answer questions.
  • Web cast, Nov. 6 (10:15-11:15 a.m.). You'll be able to log in to the web cast at your desk (HRS will send an e-mail prior to the event with detailed instructions). HRS will provide an overview of this year's benefits changes, and you'll have a chance to ask questions in real time by typing questions into your computer.
  • Professional and Scientific Council benefits open forum, Nov. 11 (noon-1 p.m., Gallery, MU). Mike Otis, associate director of HRS, will address benefit changes and lead a Q&A session.
  • HRS web site. Check out the HRS web site for answers to your questions.
  • Personal appointments. Human resource specialists will be available for brief appointments at the beginning of the open change period.

"If everyone calls on Nov. 20 to get an appointment, it could be too late," Walter said.