Frequently Asked Questions
University of Puget Sound 2016 Health Care Plans
October 26, 2015
1. Who will be the insurance company for Puget Sound’s 2016 health care plans?
Our 2016 medical and dental plans will continue to be underwritten by Premera Blue Cross.
2. Will there be any changes to health care plans in 2016?
Yes.
Health Plan Offering Changes
In 2015, the university offered both high-deductible and low-deductible plans. Diminishing enrollment in the
low-deductible plan and significant increases in the cost of the plan, particularly for families, have rendered it
unaffordable. Effective January 1, 2016, the low-deductible plan will be discontinued. For those being
transitioned from the low-deductible plan to the high-deductible plan, you will see a decrease in the cost of
the premiums in all categories.
Network Change
Our PPO network is changing from Premera Heritage Plus to Premera Heritage Prime. Premera Heritage
Prime has negotiated better/deeper discount rates with in-network health care service providers and
provides a comprehensive network that includes almost all providers currently used by our faculty and staff.
To verify your providers are in the Premera Heritage Prime network, visit www.premera.com and use the
“Find a Doctor” tab. You can search (without logging in) by clicking on the orange “Search All Providers” link
in the Visitor block. Once you select the provider, look under the “Networks Accepted” to see if your
provider participates in the Premera Heritage Prime network.
For those individuals who are in active treatment at any provider not in the Premera Heritage Prime network,
there is transition of care available that may allow the provider to be covered as in-network for up to 6
months. Contact Kenni Simons in human resources (ext. 3296) for additional information.
Health Reimbursement Arrangement (HRA)/Flexible Spending Account (FSA) Administration
To improve service, the university will be changing our vendor from Connect Your Care to Navia Benefit
Solutions (formerly Flex Plan Services). Reimbursements will be mailed to your home or deposited directly to
the participants’ bank account, eliminating the problem of double payments experienced by many users of
Connect Your Care.
HRA Changes
The university will continue to contribute $750 per year for individual subscribers and $1,500 for a family into
your HRA. Reimbursements will now be expanded to include the medical deductible, coinsurance and
copayments, rather than medical deductible only.
FSA Changes
In addition to the change in vendor to Navia Benefit Solutions, the healthcare flexible spending account
maximum contribution will increase to $2,550 per year. There are no changes to the dependent care FSA.
3. What will the 2016 premiums be for the university-sponsored health care plans, and how do they
compare to 2015?
The table below includes 2015 and 2016 premiums for the high-deductible medical plan and the dental plan.
2016
Monthly Premiums
Total
F/S*
Share
PS*
Share
Medical Plan
(High Deductible HRA)
You
$665
$0
$665
You & Spouse/DP
$1,498
$624
$874
You & Child(ren)
$1,165
$248
$917
You & Family
$1,996
$830 $1,166
Dental Plan
You
$56
$56
$0
You & Spouse/DP
$112
$112
$0
You & Child(ren)
$127
$127
$0
You & Family
$183
$183
$0
*F/S = faculty and staff; PS = Puget Sound; DP = Domestic Partner
2015
Monthly Premiums
Total
F/S*
Share
PS*
Share
$572
$1,288
$1,002
$1,717
$0
$537
$214
$715
$572
$751
$788
$1,002
$56
$112
$127
$183
$56
$112
$127
$183
$0
$0
$0
$0
4. Why are medical premiums increasing?
Premiums are increasing for three primary reasons.
 Industry-wide increases in health care costs. These costs (also known as “medical trend”) reflect the
increase in the cost of services from one year to the next.
 Claims utilization. These are costs related to the number and size of health insurance claims within Puget
Sound’s plan during the last 12 months. Puget Sound continues to experience several large claims.
 Affordable Care Act regulatory mandates.
5. What is the university doing to address the 2016 premium increase?
In the face of substantial changes in the health insurance environment, Puget Sound remains committed to
making benefits available to faculty, staff, and their families and will invest approximately $6 million in
FY2016. The university will continue to fund:
 100% of premiums for faculty/staff enrolled in our medical plan;
 50% of premiums for children enrolled in our medical plan;
 25% of premiums for spouses/partners enrolled in our medical plan;
 A contribution to the health reimbursement arrangement (HRA) - up to $750 for those enrolled in
employee-only coverage and up to $1,500 for those enrolled in family coverage, not to exceed the
maximum medical deductible.
6. What can I do to contain my health care costs in 2016?
One of the most important steps you can take is to use in-network providers. Not only are the deductibles
significantly lower when providers are in-network, but Premera pays more once deductibles are met.
You may also consider contributing to the healthcare flexible spending account (HCFSA) through our vendor,
Navia Benefit Solutions. HCFSAs allow you to use pre-tax dollars to pay for out-of-pocket health care
expenses. Go to Navia’s website at www.naviabenefits.com for more information.
Use Premera’s tools to be a smart consumer:
Nurseline – available 24 hours a day, 7 days a week. Call a registered nurse for questions about symptoms,
care or medications.
Teladoc - gives you access to U.S. board-certified doctors 24 hours per day, 7 days a week through the
convenience of your phone or computer. It’s an affordable alternative to costly emergency room or urgent
care visits when you need care right away, or after hours.
Teladoc does not replace our primary care physician. It is an affordable option for convenient care. It is most
effective for when you need care now, if you’re considering the emergency room for non-emergency issues,
on vacation or away from home, or for short-term prescription refills. Teladoc doctors are just a call or click
away!
All Teladoc physicians are practicing pediatricians, internal medicine and family medicine physicians with an
average of 15 years experience. All are board-certified and licensed in your state. Teladoc doctors can treat
many medical conditions, including:
 Cold and flu symptoms  Sinus infection
 Rashes
 Ear Infection
 Bronchitis
 Urinary Tract Infection
 Pink Eye
 Cough
Visit the Premera website to compare the cost and quality of care from providers in your area. If your
physician recommends surgery or expensive tests, you can shop for care using Premera’s tools. Did you
know there is a large difference is cost between providers, even preferred providers? Find out!
Work with your provider – ask questions, be an active participant in your care.
7. Who can I contact if I have additional questions about Puget Sound health insurance plans?
Human resources can respond to questions regarding the university-sponsored health care plans. HR is happy
to meet with individuals and small groups throughout the open enrollment period and beyond. We may be
reached at:
 hr@pugetsound.edu
 253.879.3296
 Howarth Hall 016