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

Healthy Outcomes

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

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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

October 15, 2013|News, Save the Date|

New SMU health program pays incentives for wellness, prevention

Benefits U logoIn an effort to improve the health of SMU’s faculty and staff, while helping to control rising medical costs, the University is offering a voluntary health and wellness program with a $300 cash incentive for those who successfully complete the program.

Healthy Outcomes, a voluntary pilot program, is designed to reward healthy behavior and to acknowledge the crucial role of prevention in reducing the cost of health care, says Jeff Strese, executive director of SMU Human Resources. “We want to encourage employees to be aware of their health status and to take action, if needed.”

The program is a response to significant portions of the Affordable Care Act that go into effect Jan. 1, 2014. The healthcare reform law encourages better outcomes and lower costs by permitting employers to offer incentives to employees who take steps to become more aware of their health issues and reduce their known risk factors.

A key component of the program is a baseline check-up designed to identify specific health risks and help participants take steps to maintain good health or improve risk factors.

Catapult Health logoSMU has contracted with Catapult Health to administer the check-ups on campus. The 45-minute Baseline Check-up will measure blood pressure, height, weight, and waist circumference. The Check-up includes a finger-prick blood screening which will identify any risk factors associated with HDL cholesterol, triglycerides and blood glucose. You will also have a private consultation with a nurse practitioner to help you establish your health goals.

The Check-up meets the screening requirements for those participating in Wellpower and for those who wish to participate in the 2014 Deductible Discount Program.

The Healthy Outcomes Program is open to all SMU faculty and staff members enrolled in a SMU medical plan on January 1, 2014.

There are three steps to completing the pilot successfully and earning a $300 Healthy Outcomes Achievement Award:

  1. Complete a Baseline Check-up before Friday, Nov. 25, 2013 using Catapult Health or your primary care physician. During the Baseline Check-up, you will complete a Commitment Form to officially join the program.
  2. After your Baseline Check-up, your Achievement Period begins. You will have until Thursday, May 15, 2014 to meet your health goals based on your screening results:
    1. If you have no risk factors, your goal will be to maintain your good health by keeping your lab values in the normal range.
    2. If you have one or more risk factors, your goal will be to improve your lab values for each risk factor identified.
    3. Catapult will provide information about SMU’s wellness resources that may help you achieve your goals, or you may select a program of your choice and/or work directly with your primary care physician.
    4. If you are pregnant, you may download and complete a maternity waiver form found on the appointment scheduler website.
    5. If you have a medical condition that would impede your ability to meet the program goals, Catapult and your physician can work with you to develop an alternative program. Email Catapult to request a medical condition form to be completed by your physician.
  3. Complete the Results Check-up before Thursday, May 15, 2014 using Catapult Health or your primary care physician. The Results Check-up will include another finger-prick blood screening that will determine if you met your health goals during the Achievement Period.

Check-up results and information are protected by the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). SMU will not have access to your individually identifiable health information.

SMU will receive a list of names along with the Check-up date in order to properly credit participants with completing a screening for Wellpower and the 2014 Deductible Discount. If you volunteer to participate in the Healthy Outcomes program, your name will be released to SMU only if you qualify for the $300 cash incentive. SMU will not know if you volunteered for the program, but did not complete it successfully.

The on-campus Baseline Check-ups will begin Tuesday, Oct. 29 and continue through Friday, Nov. 15 on the main campus. The SMU-in-Plano campus will host the final day of Check-ups on Tuesday, Nov. 19, 2013. Make an appointment online at www.timeconfirm.com/smu or by calling (214) 269-1513 and following the automated instructions. The online and phone schedulers are both available 24/7.

The Check-up is open to all benefit-eligible staff and faculty. Spouses and family members are not eligible to participate at this time.

Additional information about how to use results from your own physician, screening/check-up locations, directions to schedule your appointment and more may be found on the SMU HR website.

Watch your mailbox for more information from SMU Human Resources.

Related:
> SMU to use new pharmacy network in 2014
SMU’s Fall 2013 flu shot clinics begin Sept. 25

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