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

Express Scripts

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
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October 15, 2013|News, Save the Date|

SMU to use new pharmacy network in 2014

Benefits U logoImportant changes to SMU’s Health and Wellness Plan pharmacy network are coming in 2014 – “changes that should help the University group health plan and its faculty and staff members save more than $1 million on their prescriptions over the next three years,” says Jeff Strese, executive director of human resources.

Participating pharmacies have agreed to offer greater prescription discounts to remain in the SMU network, which serves all of the University’s medical plans. They include Costco, Kroger, Sam’s Club, Target, Tom Thumb and Wal-Mart, as well as several independently owned stores.

CVS and Walgreens pharmacies will no longer be part of Express Scripts’ SMU network. If you have recently filled a prescription at a CVS or Walgreens, you will receive a letter from plan administrator Express Scripts providing the locations of three network pharmacies closest to the pharmacy last visited.

Express Scripts logoExpress Scripts has created a web portal, Express-Scripts.com/SMU, that will allow faculty and staff members to compare prescription prices at more than 450 Dallas-Fort Worth area retailers. The site will be open during the University’s 2014 open-enrollment period, Oct. 12-31, 2013.

If you currently use CVS or Walgreens but want to take advantage of the new prescription discounts, you must transfer your prescriptions to a network pharmacy by Jan. 1, 2014. You can complete a transfer in one of three ways:

  • Take your prescription container to the new network pharmacy of your choice; they will contact your current pharmacy to transfer the prescription.
  • Call your new pharmacy and ask them to contact your current pharmacy for your prescription information.
  • Ask your doctor to call your new pharmacy with your prescription information.
  • Ask SMU’s Compass Health Pro, Jeremy Garrett, to do the work for you. He can research Express Scripts’ contracted rates at pharmacies near you after Jan. 1, when Express Scripts loads its online database of 2014 prescription pricing. Call after Jan. 1 with your Rx information at (800) 513-1667, ext. 726.

If you currently use a CVS or Walgreens pharmacy to fill prescriptions, you can continue to do so. However, you will pay the full retail cost without plan discounts, and the costs will not apply toward your medical plan deductible or out-of-pocket maximum.

After extensive analysis with Express Scripts, SMU’s Department of Human Resources learned that 99 percent of faculty and staff members currently filling prescriptions at a CVS or Walgreens pharmacy have access to an alternative network pharmacy within less than three miles of their current pharmacy location, says Sheri Starkey, director of total compensation and senior associate director of human resources.

“By asking some faculty and staff members to move to our new retail pharmacy network, all faculty and staff will benefit from the savings our plan will experience over the next three years,” she adds. “This change is one step we’re taking to ensure the continuation of a comprehensive and affordable benefit plan.”

The University’s mail-order prescription plan will remain unchanged.

More information on the new SMU pharmacy plan will be included in the 2014 open-enrollment packages, scheduled for delivery in early October 2013.

> Learn more about 2014 open enrollment at smu.edu/hr

Related:
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