The public sector union health insurance coalition, which includes the IFO, successfully concluded bargaining over health insurance benefits for 2018 and 2019, with no increases to any co-pays or co-insurance amounts, maximum out of pocket costs, or the amount employees pay as a deductible. The coalition was able to make some improvements in the health and dental plans, and pending legislative approval, improvements go into effect on January 1, 2018. We will send additional updates as the legislature takes action on these items.

Open Enrollment News
This year’s Open Enrollment for health and optional insurance coverages for 2018 will be October 26 – November 8, 2017.

Of interest, there will be a one-time window to elect the Short-Term Disability benefit during this year’s open enrollment. All faculty who do not currently have short term disability coverage may elect the coverage during this year’s open enrollment without evidence of insurability.

Health Insurance Coverage
The health plan benefit has been enhanced in several significant ways. There will no longer be a co-pay when faculty use a convenience clinic or the online service Virtuwell – faculty will be able to access these services without incurring a co-payment fee that is usually associated with a non-preventive office visit.

In addition, the parties have agreed to enter into a Value Based Insurance Design (VBID) pilot program that is aimed at improving the health of state employees and dependents who have chronic health conditions. The pilot will begin on January 1, 2018, and will cover those who have been diagnosed with Type I or Type II diabetes (excluding gestational diabetes).

As part of the new program, faculty and dependents age 18 or older who have been diagnosed with diabetes or are prescribed an antidiabetic medication will be automatically enrolled in the pilot program, and will be able to purchase their diabetes-related prescription drugs (including drugs for cholesterol, hypertension and depression) at a reduced co-payment amount. Also, participants in the program will not be charged a co-payment under Benefit Levels 1 and 2 for physician visits (co-payments will be reduced for physician visits under Levels 3 and 4) and deductibles will be waived for these services. There will be no co-insurance and the deductible will be waived for diabetes-related medical testing at allBenefit Levels, and the co-insurance for diabetic medical supplies will be reduced to 10% at all Benefit Levels.
Faculty will a see a relatively modest increase of 4.5% in the cost health insurance premiums for the 2018 plan year, which means that a faculty member’s share of the monthly premium for single coverage will increase (from the current amount of $30.66) to $32.04 per month and the share of monthly premium for dependent coverage will increase (from the current amount of $209.20) to $218.61 per month.

Prescription Drug Coverage
SEGIP’s contract with Navitus is coming to a close at the end of 2017. After a competitive bidding process for a replacement, SEGIP selected CVS Caremark as the new pharmacy benefit manager as of January 1, 2018.

Dental Insurance Coverage
For the first time in many years, there will be major improvements in our dental plan as of January 1, 2018. Sealants will be covered as a preventive and thus there be no co-pay for sealants. Orthodontia benefits will become available to all participants, meaning there will no longer be an age limit for orthodontia benefits. Implants have been added as a covered benefit, at 80%. All dental benefits that are currently paid at only 50%, such as prosthetics and orthodontics, will be paid at 80%. And finally, the annual maximum amount that is paid by you dental insurance will increase (from the current maximum of $1,500) to $2,000 per year (excluding orthodontia; orthodontia benefits will remain at the current $2,400 lifetime maximum benefit).

In part to cover the cost of plan improvements, dental insurance premiums for single coverage will increase (from the current amount of $5.00 per month) to $13.50 per month, and a faculty member’s share of the monthly premium for dependent dental coverage will increase (from the current amount of $33.00) to $38.98 per month.

Disability Insurance
Short term disability coverage will be included in open enrollment this year, to be effective beginning January 1, 2018. This means that all faculty will have a one-time opportunity to be able to enroll in or increase short term disability coverage without evidence of insurability.

In addition, the parties have agreed to a change in eligibility to apply for short- and long-term disability for faculty with contingent appointments who obtain probationary status. This means that faculty with a fixed term appointment who are hired into a probationary appointment will receive an open enrollment for both long term and short-term disability, i.e., faculty will be able to enroll in short and long-term disability coverage without providing evidence of insurability.

If you have any questions, please contact me. We are proud of new benefits and keep health care costs down for you and your family. Our involvement is dependent upon the support and advice of our members. If you are not a member, and wish to support this important work you can become a member here.