health care

Premiums and plan options remain stable as SMU prepares for 2016 Open Enrollment, Oct. 12-31, 2015

Benefits U logoPremiums for medical, dental and vision coverage will remain unchanged as SMU kicks off its 2016 Open Enrollment period. University faculty and staff members will be able to make benefits changes for 2016 from Monday, Oct. 12 to Saturday, Oct. 31, 2015.

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.

> 2016 Key Benefits Changes from SMU HR

For 2016 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 2016. You must re-enroll in the FSAs or the HSA even if you participated in 2015.

If you do not make any changes during open enrollment, your 2015 elections will continue for the upcoming calendar year, except for contributions to the FSAs and the HSA.

In order to comply with the reporting requirements of the Affordable Care Act (ACA), a Social Security number (SSN) is required for every individual enrolled in the SMU Medical Plan. If you have a spouse or dependent child enrolled in the plan, it is important that you enter a SSN for each.

SMU will continue to offer $1,000, $2,000, $2,600 and $5,000 deductible options for 2016. Premiums for all University plans will remain the same as in 2015.

Effective Jan. 1, 2017, SMU will no longer offer the $1,000 deductible medical option. If you enroll in this option for 2016, you will need to choose a new option for 2017.

All copays will remain the same for all plans in 2016, including Primary Care Physician (PCP) and specialist office visits as well as emergency room and Urgent Care Center (UCC) visits.

> Find more information in SMU’s 2016 Benefits Guide

Prime Therapeutics, the University’s mail-order pharmacy provider, is integrated with BlueCross BlueShield of Texas. Plan members have one customer service number and one online portal (BCBSTX) for all medical and pharmacy information. SMU’s DFW-area network of retail pharmacies include, but are not limited to, chains such as Costco, CVS, Kroger, Sam’s Club, Target, Tom Thumb, Walmart and Walgreens.

In addition, many locally owned, independent pharmacies throughout the area, including compounding pharmacies, are included in the network.

Get your flu shot for free during SMU’s Fall 2015 clinics

Catapult Health will continue to administer wellness screenings for SMU employees. More information will be provided in the coming weeks.

SMU uses a secure online open-enrollment application available through My.SMU.edu. To make your benefits elections for 2016:

  • Enter your My.SMU.edu 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 2016.

You will receive a confirmation statement summarizing your 2016 benefits elections in early December 2015.

More information on vendors and plans will be available at SMU’s 2015 Human Resources Fair, 10:30 a.m.-1:30 p.m. Wednesday, Oct. 14 in the lower level of Hughes-Trigg Student Center. Meet representatives from BCBSTX, Prime Therapeutics, VSP, Transamerica and other vendors, and get your free flu shot.

> Check in at SMU’s 2015 HR Fair Wednesday, Oct. 14

SMU’s 2015 Open Enrollment set for Oct. 11-31, 2014

Benefits U logoA new pharmacy benefit administrator, restored prescription coverage with the CVS and Walgreens chains, and a new option for legal and identity protection are among the changes coming during SMU’s 2015 Open Enrollment. University faculty and staff members will be able to make benefits changes for 2015 from Saturday, Oct. 11 to Friday, Oct. 31, 2014.

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 2015 open enrollment, you must take action if:

  • You want to make changes to your current coverage, including adding or dropping dependents.
  • You want to enroll in LegalGUARD/PrivacyARMOR for 2015.
  • You want to participate in one or both of the Flexible Spending Accounts (FSAs) or the Health Savings Account (HSA) in 2015. You must re-enroll in the FSAs or the HSA even if you participated in 2014.

If you do not make any changes during open enrollment, your 2014 elections will continue for the upcoming calendar year, except for contributions to the FSAs and the HSA.

The University’s $2,500 deductible option will increase to a $2,600 deductible option to meet the Internal Revenue Service’s minimum deductible requirements for High Deductible Health Plans. The family deductible will increase to $5,200. SMU will continue to offer the $1,000, $2,000 and $5,000 deductible options.

Medical premiums for all University plans will increase 4.5 percent – less than half the national healthcare inflation average of 10 percent.

All copays will remain the same for all plans in 2015, including Primary Care Physician (PCP) and specialist office visits as well as emergency room and Urgent Care Center (UCC) visits.

> Find more information in SMU’s 2015 Benefits Guide, coming soon to smu.edu/hr

Prime Therapeutics will replace Express Scripts as SMU’s pharmacy benefit administrator in 2015. The University was able to negotiate an expanded network offering that will once again include CVS and Walgreens. In addition, preventive vaccines administered at an in-network pharmacy will be covered 100 percent with no copay, under all four medical options.

SMU’s DFW-area network of retail pharmacies will include, but not be limited to, chains such as Costco, CVS, Kroger, Sam’s Club, Target, Tom Thumb, WalMart and Walgreens. In addition, many locally owned, independent pharmacies throughout the area are included in the network.

Prime Therapeutics is integrated with BlueCross BlueShield of Texas. Plan members will now have one customer service number and one online portal (BCBSTX) for all medical and pharmacy information.

You will receive a new BCBSTX ID card in December. Please provide your new ID card to your pharmacy before they process any 2015 refills or new prescriptions. Let the pharmacist know that your plan has a new pharmacy administrator and ask that your record be updated. If you have auto-refills at your preferred pharmacy, please be sure the pharmacy updates your record right after the first of the year. You will continue to use your existing ID card for all prescriptions filled until Dec. 31, 2014.

Express Scripts will send mail-order prescriptions (with refills remaining) to Prime Therapeutics on or before Jan. 2, 2015. After this date, log on to MyPrimeMail.com or call the 24-hour automated PrimeMail Refill Center at 877-357-7463 to request refills.

NOTE: Express Scripts cannot transfer mail-order prescriptions for compound medications or controlled substances to Prime Therapeutics. You must request a new prescription from your doctor.

If you need a new prescription, ask your doctor to send a prescription electronically via e-prescribe or fax to 877-774-6360. You can also fill out the PrimeMail order form and mail your new prescription with your preferred method of payment.

> Learn more about Prime Therapeutics from their website

During Open Enrollment, full-time and part-time benefits-eligible employees will have an opportunity to enroll in the new LegalGUARD and PrivacyArmor plans for 2015. Although the plans are administered separately, they are available as a bundled arrangement for $27.45 per month. By bundling the plans, SMU is able to offer comprehensive legal and identity protection benefits for an affordable monthly premium.

The LegalGUARD Plan, administered by LegalEASE and underwritten by Nationwide, provides access to quality legal services and protection from the high cost of legal fees. LegalEASE also connects participants with the right attorney when a need arises.

The LegalGUARD Plan covers the plan member, his or her spouse or domestic partner, and unmarried dependent children up to age 19 (or up to age 25 if a full-time student).

The PrivacyArmor Plan, administered by InfoArmor, provides a comprehensive and proactive defense against identity theft, with a focus on identity monitoring. InfoArmor is capable of identifying anomalies indicative of fraudulent behavior up to 90 days sooner than credit monitoring.

The PrivacyArmor Plan covers the plan member and his or her spouse or domestic partner.

> Register for a LegalGUARD and PrivacyArmor info session

SMU uses a secure online open-enrollment application available through My.SMU.edu. To make your benefits elections for 2015:

  • Enter your My.SMU.edu 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 2015.

More information on vendors and plan changes will be available at SMU’s 2014 Human Resources Fair, 10:30 a.m.-1:30 p.m. Wednesday, Oct. 15 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 from Monday, Oct. 13 to Tuesday, Oct. 21 designed to help faculty and staff members better understand the medical plans and other resources available to them. Visit smu.edu/hr and tap “Educational Sessions” to RSVP online for the “Understanding Your Benefits: Every Choice Counts” session of your choice.

> Consult SMU’s 2015 Benefits Guide on the web, coming soon to smu.edu/hr

Related:
> Check in at SMU’s 2014 HR Fair Wednesday, Oct. 15
SMU’s Fall 2014 flu shot clinics now in session

Health care options in the spotlight at 2013 HR Fair

Stock image of 'Good Health, This Way' freeway signVendors from SMU’s medical plans will be on hand to discuss your health care options at the University’s 2013 Human Resources Fair Oct. 15.

You can learn more about the University’s health, savings and retirement plans during the fair, scheduled for 10:30 a.m.-1:30 p.m. in the Hughes-Trigg Student Center Ballrooms.

Flu shots will be available at the Memorial Health Center station, and SMU Recreational Sports therapists will be on hand to provide chair massages. In addition, Baylor Health Care System will offer bone-density screenings; no appointment is necessary.

Visitors can also check out Centennial Hall, the interactive exhibit in the Hughes-Trigg lower level featuring high points in SMU history and spotlighting faculty, staff, student and alumni excellence.

Visit SMU Human Resources online

SMU 2014 Open Enrollment takes place Oct. 12-31, 2013

Benefits U logoSMU’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.

> Learn more about the Health Insurance Marketplace at healthcare.gov

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.

> Find more information in SMU’s 2014 Benefits Guide

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.

> Read more about SMU’s new pharmacy plan for 2014

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.

> Read more about SMU’s Healthy Outcomes voluntary pilot program

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.

> Consult SMU’s 2014 Benefits Guide on the web

Related:
> New SMU health program pays incentives for wellness, prevention
SMU to use new pharmacy network in 2014
SMU’s Fall 2013 flu shot clinics begin Sept. 25

SMU’s 2013 Open Enrollment period runs Oct. 14-31

SMU Benefits U logoSMU’s 2013 Open Enrollment period begins Sunday, Oct. 14 and ends Wednesday, Oct. 31, 2012. 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 2013, there are several Patient Protection and Affordable Care Act (ACA) required changes that will affect you:

Women’s Preventive Health Services Covered at 100%
SMU will provide female plan participants with expanded access to recommended in-network preventive services, including contraceptives, without cost sharing.

Healthcare FSA Contribution Limit of $2,500
If you contribute to the Healthcare Flexible Spending Account (FSA), the maximum amount the IRS will allow you to contribute will be reduced from $5,000 to $2,500. This change in the law does not impact the Dependent Care FSA; you can still contribute up to $5,000 to this account.

Medicare Tax Increase – Highly Compensated Employees
Currently, the Medicare tax is 2.9%, with 1.45% withheld from the paycheck and the other 1.45% paid by SMU. Beginning Tuesday, Jan. 1, 2013, an extra 0.9% Medicare tax will be charged as follows:

  • For unmarried people, the extra 0.9% will be charged on wages above $200,000.
  • For married-filing-jointly couples, the extra 0.9% will be charged on combined wages above $250,000.
  • For those who are married filing separately, the extra 0.9% will be charged on wages above $125,000.

Medical premium increases for 2013 are due to the University’s medical claims experience and new requirements under the Patient Protection and Affordable Care Act (ACA). Premium increases will vary depending on which SMU Health & Wellness Plan you’re currently enrolled in and on what plan you choose next year. Premiums will remain the same for dental and vision coverage.

SMU will continue to offer the $1,000, $2,000, and $2,500 deductible options. In addition, the University is adding a fourth coverage option in 2013 – a $5,000 deductible option – in order to provide greater coverage choice. In some cases, the premium savings from switching to a higher deductible plan option can offset the higher deductible, or a large portion of it.

Find more information in the 2013 Benefits Guide, available at HR’s Benefits U page

For 2013 open enrollment, you must take action for the following conditions:

  • 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) in 2013. All faculty and staff members must reconfirm their participation in an FSA even if they participated in an FSA in 2012.
  • You want to participate in the Health Savings Account (HSA) in 2013. All faculty and staff members must reconfirm their participation in the HSA even if they participated in the HSA in 2012.

SMU uses a secure online open-enrollment application available through Access.SMU. To use the application:

  • 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 2013.

More information on vendors and plan changes will be available at SMU’s 2012 Human Resources Fair, 10:30 a.m.-1:30 p.m. Tuesday, Oct. 23 in the Hughes-Trigg Student Center Ballrooms. Vendor representatives will be on hand to answer questions about your options.

The Department of Human Resources has scheduled a series of sessions designed to help faculty and staff members make their medical-plan decisions for 2013. RSVP online for the session of your choice, or contact the Department of Human Resources, 214-768-3311.

Consult SMU’s 2013 Benefits Guide on the web

Memorial Health Center achieves national accreditation

SMU's Memorial Health CenterSMU’s Memorial Health Center has earned renewed accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC), says Patrick Hite, FACHE, executive director, Health Services.

To achieve its status as an accredited organization, the Health Center passed a series of nationally recognized standards for the provision of quality health care as set by the AAAHC. Almost 5,000 ambulatory health care organizations across the United States are accredited by the AAAHC.

“Accreditation underscores our long-standing commitment to providing the highest possible levels of quality care to the community we serve,” Hite says. “We are very pleased and proud to have achieved accreditation; we believe this has helped us improve the quality of patient care and that our patients are the ultimate benefactors from our participation in the accreditation program.”

Ambulatory health care organizations seeking accreditation by AAAHC undergo an extensive on-site, peer-based survey of their facilities and services. The types of organizations that can apply for such accreditation include single- and multi-specialty group practices, ambulatory and office-based surgery centers, college and university health services, managed care systems, dental group practices, community health centers, and occupational health centers.

The Memorial Health Center has been accredited since 1998. The most recent survey extends its accreditation through 2014.

> Visit SMU’s Memorial Health Center online
> Learn more about the AAAHC

Calendar Highlights: Apr. 19, 2011

MMU'A “duet” for peace: This week’s Stanton Sharp Lecture features Vanderbilt Professor of History Richard Blackett as he covers a more obscure fight for peace within America in “A ‘duet with John Bull’: African Americans and the Struggle to win British Support for the Union.” Blackett will discuss how African Americans during the Civil War used the momentum started from the emancipation of West Indies slaves in the late 1830s to further their cause to the British public and further the Union’s cause. The lecture is free and open to the public and begins at 6:30 p.m. Tuesday, April 19, in McCord Auditorium, 306 Dallas Hall. A reception precedes the lecture at 6 p.m. For more information, call 214-768-2967 or visit the Sharp Lecture Series website.

Bringing the hospital to you: A Mobile Mammography Unit (pictured) will be open for business 8 a.m.-4 p.m. Wednesday, April 20 in the East Campus Parking Lot Expressway Tower. For SMU employees covered by the Health and Wellness medical plan administered by Blue Cross Blue Shield of Texas, SMU will cover all routine annual mammogram charges for women age 40 and above. The cost of the mammogram will not be billed to your $500 preventive care benefit. Please have your insurance information available when you call. BCBSTX will process the claim and SMU will pay it at 100%. To pre-register for an exam, call 214-645-2560. (If you participate in any non-SMU-related insurance plan, inquire about other pre-billing arrangements when you pre-register.) The parking lot at Expressway Tower is in the final stages of being repaved; arriving early to get one of the few available parking spots or using the Mustang Express to travel from the main campus to the Tower is recommended.

Cal Jillson'Messing with Texas: The policies of the independent-minded Lone Star State will be discussed at an event co-hosted by the Cary M. Maguire Center for Ethics & Public Responsibility and the SMU Faculty Club. In “Lone Star Tarnished: A Critique of Texas Public Policy,” 2011 Public Scholar Lecturer Cal Jillson (pictured) will cover the reality behind Texas’s picture-perfect model of limited government, economic growth and personal freedom. Jillson is currently at work on a book covering the subject, entitled Lone Star Tarnished, which will compare the overall Texas model of government to recent and historical state government styles. The lecture begins at 5 p.m. Wednesday, April 20 at the Faculty Club. Wine and hors d’oeuvres will be served. All attendees should RSVP, as space is limited.

Research Spotlight: Breathe right for asthma relief

SMU's Alicia Meuret with an asthma study participantAs the health care reform debate turns to cutting costs and improving treatment outcomes, two SMU professors are expanding a study that shows promise for reducing both the expense and suffering associated with chronic asthma.

Thomas Ritz and Alicia Meuret, both of SMU’s Psychology Department, have developed a four-week program to teach asthmatics how to better control their condition by changing the way they breathe.

With the help of a four-year, $1.4 million grant from the National Institutes of Health, they plan to engage 120 Dallas County patients in four weeks of breathing training by the study’s projected end in July 2012. Their co-investigators include David Rosenfield, also of SMU’s Psychology Department, and Mark Millard, M.D., of Baylor University Medical Center.

More than 22 million Americans suffer from asthma at an estimated annual economic cost of more than $19 billion, according to the American Lung Association. The number of cases doubled between 1980 and 1995, prompting the U.S. Department of Health and Human Services to classify the disease as an epidemic in 2000.

During an attack, sufferers tend to hyperventilate, breathing fast and deep against constricted airways to fight an overwhelming feeling of oxygen deprivation.

Unfortunately, this makes the problem worse by lowering the body’s carbon dioxide levels, which restricts blood flow to the brain and can further irritate already hypersensitive bro nchial passages.

Patients who “overbreathe” on a sustained basis risk chronic CO2 deficiencies that make them even more vulnerable to future attacks. Rescue medications that relieve asthma symptoms do nothing to correct breathing difficulties associated with hyperventilation.

As part of SMU’s Stress, Anxiety and Chronic Disease Research Program, Ritz and Meuret use their biofeedback-based Capnometry-Assisted Respiratory Training (CART) to teach asthma patients to normalize and reverse chronic overbreathing. A hand-held device called a capnometer measures the amount of CO2 exhaled. Using this device, patients learn how to breathe more slowly, shallowly and regularly.

CART techniques could have a positive impact on quality of asthma treatment even as they reduce the need for acute care, Ritz says.

“The research shows that this kind of respiratory therapy can limit both the severity and frequency of asthma attacks,” he says. “That means fewer doctor visits and less frequent use of rescue medications, with the associated savings of both time and money.”

And for those who count any year without a trip to the emergency room as a year with a good treatment outcome, that means a higher quality of life, says Meuret, who lives with asthma herself.

“The training gives patients new ways to deal with acute symptoms, and that helps them to feel more in control,” she says.

Read more at the SMU Research blog

Above, SMU Professor Alicia Meuret (at right in photo) uses biofeedback data to demonstrate the relationship between oxygen and carbon dioxide levels in hyperventilation.

By | 2009-09-22T11:24:29+00:00 September 22, 2009|Categories: Research|Tags: , , , , , , , , |