Benefits Open Enrollment

Benefits Open Enrollment 2014
University of Georgia Human Resources Division
Action Required!
No changes in coverage or premiums for 2015
 Premiums increase 12%
University System of
Same vendor for FSAs and HSA
Open Access POS is now
Comprehensive Care plan
Add ABA Autism Therapy coverage
Premiums decrease 6%
Increase in-network deductible: Single /$500 Family/ $1500
Increase in-network out of pocket maximum: Single/$1250
Increase in-network specialist office visit co-pay by $10 from $20 to
HSA Open Access POS is now
Consumer Choice HSA
Add ABA Autism Therapy coverage
Increase in-network out-of-pocket maximum from $3,000
single/$6,000 family to $3,500 single/ $7,000/family
Increase in-network employee co-insurance from 15% to 20%
(employer co-insurance decreases from 85% to 80%)
Increase out of network deductible from $2,500 single/$5,000
family to $3,000 single/$6,000 family
Premiums increase by 32%
Plan Changes – BlueChoice HMO
Add ABA Autism Therapy coverage
Increase in-patient hospital services co-pay from $250 to $500
Increase primary care office visit co-pay from $20 to $30
Increase brand name prescription drug co-pay from $25 to $35
Increase specialist office visit co-pay from $25 to $50
Premiums increase 24%
Add 20% co-insurance to non-preferred brand name prescription drug
with a $45 minimum and $125 maximum cost share
Plan Changes – Kaiser HMO Plan
Add ABA Autism Therapy coverage
Increase emergency room co-pay from $150 to $250
Increase preferred brand co-pay from $25 to $35 and nonpreferred co-pay from $35 to $45 at Kaiser pharmacy
Premium increase of 4%
Why are the premiums going up for some of
the plans?
Good claims experience in previous years kept costs lower
System healthcare costs ran to a $17 million deficit last
Projected costs for 2014 are over budget
– Extra fees due to ACA
– Enrollment growth
– Higher than average claims experience
– Migration between plans
CVS Caremark replaces Express Scripts
CVS Caremark will be the Pharmacy Benefit
Manager for all the BCBS plans (excluding Kaiser
One of the largest networks in the country
You do not have to use CVS as your pharmacy
Open enrollment sessions for active employees
1:00 – 3:00am
9:00 – 11:00am
2:00 – 4:00pm
Masters Hall, Ga. Ctr.
Masters Hall, Ga. Ctr.
Masters Hall, Ga. Ctr.
University Chapel
University Chapel
Collaborate Sessions (non-Athens locations)
2:00 – 3:30 pm
10:00 – 11:30 am
Visit and select “Open Enrollment”
Tobacco Surcharge – Action Required!
Affordable Care Act
Employees averaging 30 hours a week are eligible for health insurance
(it’s not that simple)
Important dates
 Transition period
– May 1, 2014 through October 31, 2014
– Tracking temp employees working more than 30 hours per week
– Potentially benefits eligible in January 2015
 End of first 12-month reporting period
– May 1, 2015
What has been happening
 Identification of temps
 Interpretations of workplace situations
 Feeding work hours data to the USG
– Payroll hours for hourly temps
– Calculated hours from Percent Time for monthly temps
(50% time equates to 20 hours per week)
What is going to happen next
 The USG is going to review the data from the
transition period to determine who has
averaged more than 30 hours per week
 They will report back to us in late November
 We’ll review and reconcile their list
 Anticipate between 25-50 temps will be
designated as potentially benefits eligible
What is going to happen next
 USG survey of our methodology
 USG audit of our practices and results
 Potential changes to our recordkeeping
Recordkeeping Options
Temp faculty and staff employment agreement
Timesheets for both hourly and monthly temps
Electronic timekeeping application
–Expansion of Kronos
–Third party vendor compliance tool for UGA
–USG compliance tool
Graduate Research Assistants
 This has been one of the most debated groups
both within the USG and nationally
 Very difficult to distinguish between
“academic training” time and “work” time
 USG has decided to explore the possibility of
establishing a separate health insurance plan
for GRAs
 Early stages of development; more to come
Reference material
 The USG Employee Categories policy can be
found at:
 A separate UGA ACA Guidelines document is
being completed and will be available in