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During this fall's open enrollment, benefits-eligible Vanderbilt employees must select a new health plan option.
Unlike recent years, employees won't be able to 'default' to last year's choice because the University's contract with current plan providers expires Dec. 31.
Three new plans, as well as the addition of vision benefits, will be offered at open enrollment.
The cost to employees for the new plans is still being finalized. Information packets outlining the new health plan benefit options will be mailed to employees Sept. 26. Open enrollment will be held Oct. 1-16, and the Benefits Fair is set for Oct. 10-12.
“There are changes for 2007 that will allow faculty and staff more choice,” said Jane Bruce, director of Benefits. “We will offer some options that we haven't had before and we hope people are pleased with the new options available.”
As usual, in addition to health and vision coverage decisions, employees will also use the open enrollment period to select the following year's dental, accidental death and dismemberment and short-term disability insurance plans.
The University is making changes to health plan options as the three-year contract with BlueCross and CIGNA is ending Dec. 31. Having solicited bids from insurance companies who could administer the health plan options, University officials decided to offer new options. The Office of Benefits Administration worked in conjunction with Vanderbilt's Health Care Cost Containment and Benefits committees to develop benefit plans that serve the diverse needs of the faculty and staff, officials say.
Health plan options
There will be three options for health coverage in 2007. Aetna will administer two of the options: Aetna Standard, a preferred provider organization (PPO); and Aetna Choice. BlueCross will administer one option: BlueCross Advantage P, also a PPO.
The plan design of the two PPOs will be somewhat familiar to Vanderbilt faculty and staff. Aetna Choice is a newer plan design, one that uses a health reimbursement account.
“Many companies are moving toward plans that put some of the decision making back into the hands of the employee,” said Kevin Myatt, associate vice chancellor and chief Human Resources officer. “Our Aetna Choice offering is designed to do just that. We hope a number of our faculty and staff will be well served by enrolling in this option.”
Officials have not yet finalized for release the exact dollar figures employees would pay for each plan, but the monthly rates for two of the 2007 options are expected be lower than what faculty and staff are accustomed to paying for the existing PPOs.
Details include:
• The new BlueCross Advantage P option is the most expensive, but brings with it advantages, including the lowest coinsurance rates, the extension of the 'at-Vanderbilt' rate to select community pediatricians who have admitting privileges at Vanderbilt, and no deductible at Vanderbilt.
• The new Aetna Choice option has different characteristics from previous offerings. The monthly cost to employees is in the middle of the range of 2007 options. Aetna Choice will bring with it a health reimbursement arrangement (HRA) of $500 for the individual tier or $1,000 for the other coverage tiers. The HRA is a Vanderbilt-funded pool that pays for the first $500 (or $1,000) of covered expenses and helps the employee meet the deductible ($2,500 for individual tier and $5,000 for other coverage tiers). If the deductible is met at any point during the year, the Choice option would then pay 80 percent of health care expenses, not to include prescription drug costs.
“One of the advantages of the Choice option is that preventive care visits — both at Vanderbilt and in-network — are covered at 100 percent,” Bruce said. “The Choice option will require careful consideration, as it is much different from what we have offered before.”
• The new Aetna Standard option offers the lowest monthly payroll deduction and will be the 2007 default plan. Aetna Standard will offer the same $15 at-Vanderbilt preventive and office visit co-pay as BlueCross Advantage P. This option includes a deductible for the at-Vanderbilt rate, so hospital inpatient and outpatient treatments would be subject to an individual deductible of $200 and a deductible of $400 for the other coverage tiers.
The Office of Benefits Administration will present descriptions of the health plan options and other changes for 2007 benefits during Open Forums that will be scheduled starting in early September.
The new optional vision plan will be through a company called VSP (www.vsp.com), with enrollment available at the same tier levels as health and dental — employee only; employee plus spouse/certified domestic partner; employee plus children; and family coverage. The plan will offer an annual vision appointment for $15 and eyeglasses or contacts at a $15 per year rate.
Also next year, a disease management program will be offered through ActiveHealth (http://activehealth.net/disease-management.php). Health plan participants who have complex and chronic conditions can participate in ActiveHealth's program to help focus on their overall health in a comprehensive, holistic manner. Individuals who have been diagnosed with diabetes, asthma, congestive heart failure, low back pain and other chronic conditions will be automatically enrolled, but will have the ability to opt out of the program.
What is NOT changing
Dental Plans — There will be no changes to the plan design for dental insurance. The two options, CIGNA Dental Care (the DHMO product) and CIGNA Dental PPO, will be offered. There are no changes to the rates for dental coverage.
Personal Spending Accounts — There will be no changes to the health care and dependent care personal spending accounts (PSAs) for 2007. Both will be administered by WageWorks as in 2006. Employees interested in enrolling in one or both of the PSAs must complete the enrollment form each year.
Short-term Disability — Offered through The Hartford. The online application process includes a brief medical questionnaire. Open Enrollment is also the time to drop short-term disability if an employee no longer wants the coverage.
— Information for this story was provided by Ginny McLean-Swartsell, Health Plan Communicator in Benefits Administration