Once a year, full-time employees have the opportunity to make changes in medical, dental, and Personal Accident Insurance coverages and to enroll in the university’s Tax Saver Benefit (TSB) and Wellness HRA Plan pre-tax reimbursement accounts. This year, employees will have a new opportunity: to participate in the IU HDHP PPO & Medical Savings Plan. See separate article in this issue.
If an employee does not take any enrollment actions during Open Enrollment, participation in medical, dental, and Personal Accident Insurance will remain the same at the 2009 contribution rates. If an employee does not enroll in a TSB reimbursement account or the Wellness HRA, he/she will not be a participant in 2009.
Participation in the university’s TSB Plan requires enrollment each year to take advantage of pre-tax reimbursement of health and dependent care expenses. Employees do not need to be enrolled in an IU-sponsored medical or dental plan.
The Open Enrollment period takes place during November of each year, with enrollment changes becoming effective on January 1. This is an opportunity to:
- Select a different medical plan or drop a plan.
- Add or drop dependents.
- Add or drop dental coverage.
- Add, drop, or change Personal Accident Insurance.
- Allocate contributions for pre-tax reimbursement of health care and/or dependent care expenses (TSB).
- Complete a tobacco-free affidavit to participate in the Wellness HRA.
An Open Enrollment packet with additional information and enrollment forms will be sent to full-time employees in mid-October through campus mail. The deadline for submitting forms is November 14, 2008.
Eligibility provisions for enrolling dependents in IU-sponsored medical and dental plans are available at www.indiana.edu/~uhrs/benefit/needknow.html.
7.47 Percent Increase in Medical Premiums
For 2009, there will be a 7.47 percent weighted average increase in medical premiums for the university’s medical plan options. There will also be a 3.6 increase in dental premiums. These are adjustments in total premiums. Employee contributions will increase or decrease based on the difference between total premium and the university’s contribution amount, with a minimum employee contribution of $5 per month for employee-only coverage and $10 when one or more family members are covered. For 2009, the university will contribute up to the following amounts for medical and dental plan coverages:
2009 University Contributions
For Fiscal Year 2008/2009, it is estimated that Indiana University will contribute a total of $146 million for employee health care coverages.
Highlights of Changes for 2009
- As announced last year, this plan will be discontinued effective December 31, 2008. Current enrollees will be defaulted to the Blue Preferred Primary POS plan effective January 1, 2009, unless the employee selects a different plan.
IU PPO $900 Deductible
- The Organ and Tissue Transplant maximum will increase to $2 million.
- Prescription copays will increase to $8 generic/$20 low-cost brand/$40 high-cost brand for retail and $20/$45/$90 for mail order.
- Medical annual out-of-pocket copay maximums will increase to $1,500 per individual and $4,000 per family for in-network services with a separate out-of-pocket maximum for out-of-network services. In order to facilitate comparison of plans, the out-of-pocket maximums will be restated to include copays and the deductible, that is: $2,400 ($900 deductible plus $1,500 in copays) for individual coverage, and $6,700 ($2,700 deductible plus $4,000 in copays) for the family out-of-pocket maximum.
Blue Preferred Primary POS
- The Organ and Tissue Transplant maximum will increase to $2 million.
- The lifetime maximum of $5 million per member for medical coverage will be eliminated.
- Prescription copays will increase to $20 generic/$45 formulary/$90 non-formulary for mail order.
- Medical copays will increase to $25 for office visits and $100 for outpatient services.
- Medical annual out-of-pocket maximums will increase to $5,000 per family for in-network services and to $10,000 per family for out-of-network services.
IU HDHP PPO & Medical Savings Plan
- This is a new plan option effective January 1, 2009, that includes both medical coverage and a unique tax-advantaged savings account for medical expenses, as provided by IRS regulations. See page 2 for an overview.
- Health Risk Assessment and 24-hour Nurse Line
- These new features are being added for all IU-sponsored medical plans and are provided through Clarian Health: an online Health Risk Assessment and phone access to a registered nurse for health-related questions 24 hours a day, 7 days a week.
IU DENTAL PLAN
- Coverage will be enhanced by adding coverage for dental implants.
PERSONAL ACCIDENT INSURANCE (PAI)
- Premiums will decrease 20 percent for employee coverage and 15 percent for family coverage.
Enrollment in this optional insurance plan is only available during Open Enrollment each year. It covers death and injuries caused by accidents that occur on or off the job, at home, and while traveling.
As an incentive for the non-use of tobacco and to promote a healthy life, the university provides the IU Tobacco-free Wellness Program which includes these two distinguishable plans:
- Tobacco Cessation Plan
- Wellness HRA (Health Reimbursement Arrangement) Plan
Tobacco Cessation Plan
This plan covers the cost of a Tobacco Cessation Plan with Free & Clear, Inc. Quit for Life™ cessation program. The benefit is available to all full-time Academic and Staff employees and their family members 18 or older even if they are not enrolled in an IU-sponsored medical plan. The plan is fully paid by the university. To enroll individuals may call 866-784-8454 (1-866-QUIT-4-LIFE) or visit www.freeclear.com.
Free & Clear’s Quit for Life™ program includes an individualized cessation plan. The program offers an assigned Quit Coach, phone counseling sessions designed to set and reach a quit date, nicotine replacement therapy as needed, and one year of follow-up phone and Web assistance to help participants stay “quit.”
Wellness HRA Plan
Visit the Wellness HRA Plan Web page at www.indiana.edu/~uhrs/benefits/hra.html to read and understand this plan’s criteria and provisions before enrolling.
The Wellness HRA Plan is available for full-time employees who sign an affidavit (provided in the Open Enrollment packet) indicating their non-use of tobacco. Employees who are not tobacco-free at the time of Open Enrollment may still enroll (during Open Enrollment only) by agreeing to certain criteria.
The Wellness HRA is an employer-paid account set up under Internal Revenue Service regulations that allow preferential tax treatment for contributions. The account is funded entirely by the university. Neither IU contributions to nor reimbursements from an HRA are considered taxable income to the employee.
Contributions of $10 per month will be made for those employees who sign the affidavit. See the HRA Web page for details about reimbursements and allowable expenses.
Account balances up to a $240 maximum will carry over into the next year. Employees who fail to reenroll for 2009 will forfeit any remaining 2008 balance. See the HRA Web page for details about submitting and receiving payment for claims.
It is important for employees who are enrolled in the Wellness HRA Plan and the TSB Plan and/or IU HDHP PPO & Medical Savings Plan to understand the order in which claims will be reimbursed, as well which claims can be paid from an account. This information is available in Open Enrollment materials and on the Web.
- Eighty percent (80%) of all smokers have their first cigarette before age 18 and 90 percent of all smokers begin before age 20.
- One third of all smokers began before the age of 14.
- Each day, approximately 3,900 young people between the ages of 12 and 17 years initiate cigarette smoking in the United States.
- Between one half and one third of youth who try a cigarette will go on to become a daily smoker.
- Each day an estimated 1,500 young people become daily cigarette smokers in this country.
- Within days or weeks of first cigarette use, symptoms of nicotine dependence may appear.
- In 2002, 33 percent of middle school students and 57 percent of high school students reported having tried smoking at least once in their lives.
American Legacy Foundation (February 2008)