A 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.
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.
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.
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.