SMU’s 2014 Open Enrollment period began Saturday, Oct. 12 and ends Thursday, Oct. 31, 2013. The Open Enrollment period is the only opportunity for SMU employees to make changes to benefits elections for the coming year, except for qualified life event changes.
For 2014 open enrollment, you must take action if:
- You want to make changes to your current coverage, including adding or dropping dependents.
- You want to participate in one or both of the Flexible Spending Accounts (FSAs) or the Health Savings Account (HSA) in 2014. You must re-enroll in the FSAs or the HSA even if you participated in 2013.
If you do not make any changes during open enrollment, your 2013 elections will continue for the upcoming calendar year, except for contributions to the FSAs and the HSA.
In 2014, significant provisions of the Patient Protection and Affordable Care Act (ACA) require changes that may affect you:
- Beginning Jan. 1, 2014, all U.S. citizens will be required by law to have health insurance.
- If you do not have health insurance in 2014, you will pay a penalty to the federal government. The penalty is the greater of $95 (up to three per family, or $385) or 1 percent of your income.
Your health insurance coverage options for 2014 include:
- An employer-sponsored health plan like SMU’s or a spouse’s employer health plan.
- A health plan available through the Health Insurance Marketplace.
All of the SMU Health and Wellness Plan medical options meet or exceed the government’s “minimum essential value” criteria. As a result, SMU’s benefits-eligible faculty and staff members and their eligible dependents will not be eligible for a premium subsidy in the Health Insurance Marketplace.
SMU will continue to offer the $1,000, $2,000, $2,500 and $5,000 deductible options. Medical premiums for all University plans except the $5,000 deductible plan will increase 5 percent – half the national healthcare inflation average of 10 percent.
Specialist office visit and emergency room copays will increase in 2014. The Primary Care Physician (PCP) copay of $25 and the Urgent Care Center copay of $35 will remain the same.
Changes in copay will vary depending on the medical plan you choose for 2014:
- For the $1,000 or $2,000 deductible plans, the copay for specialist office visits will increase from $40 to $75. The emergency room copay will increase from $100 to $300.
- For the $2,500 deductible plan, copays do not apply until the deductible is met. The copay for specialist office visits will increase from $40 to $75. The emergency room copay will increase from $100 to $300.
- The $5,000 deductible plan has no copays. All covered services apply toward the deductible.
Express Scripts will continue to administer SMU’s pharmacy plan in 2014; however, CVS and Walgreens pharmacies will no longer be in the retail pharmacy network available to SMU faculty and staff members.
Participating pharmacies have agreed to offer greater prescription discounts to remain in the retail pharmacy network, including Costco, Kroger, Sam’s Club, Target, Tom Thumb and Wal-Mart, as well as several independently owned stores.
The Express Scripts web portal, Express-Scripts.com/SMU, enables faculty and staff members to get retail and mail-order pricing information for prescription medications.
SMU has provided on-campus health screenings for a number of years. Beginning in October 2013, those screenings will be replaced by a more comprehensive preventive health check-up provided by Catapult Health. The preventive health check-up will continue to be free for all faculty and staff members.
The Catapult Health check-up takes about 45 minutes and includes these elements:
- Private 20-minute check-up with a health technician
- Lab-accurate finger-prick blood test that measures cholesterol, triglycerides and blood glucose
- Biometric values measurements including blood pressure and waist circumference
- Private 10-minute consultation with a nurse practitioner
- Review Personal Health Report and develop a Personal Action Plan
- Review listing of programs SMU makes available to help you improve identified health risk factors
In addition, the University will offer the opportunity to participate in Healthy Outcomes, a voluntary pilot program created to reward healthy behavior by encouraging us to become more aware of our health status and take action to improve it, if needed.
SMU uses a secure online open-enrollment application available through Access.SMU. To make your benefits elections for 2014:
- Enter your Access.SMU user ID and password as you normally would to review your pay statement.
- Click Benefits in the Employee Self-Service navigation on the right, then choose Benefits Enrollment to access your personalized Open Enrollment record.
- Be sure to read all instructions carefully before making elections for 2014.
More information on vendors and plan changes will be available at SMU’s 2013 Human Resources Fair, 10:30 a.m.-1:30 p.m. Thursday, Oct. 18 in the Hughes-Trigg Student Center Ballrooms. Vendor representatives will be on hand to answer questions about your options.
In addition, SMU Human Resources has scheduled a series of information sessions Thursday, Oct. 17 to Monday, Oct. 28 designed to help faculty and staff members better understand the medical plans and other resources available to them. RSVP online for the “How To Be a Better Healthcare Consumer” session of your choice.