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Plasma Physics Lab |
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Regions 1, 3, |
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faculty, library staff, retirees |
faculty, library staff, retirees |
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Michelle Hund |
Beth Calamia |
Bobbie Forcier |
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The annual Open Enrollment period -- October 25 through November 12, 1999 -- is the time for all eligible employees to reevaluate their health care plan coverage for themselves and their families for the year 2000. During open enrollment, faculty and staff have the opportunity to
• add or remove dependents from health care or vision care plan coverage,
• change coverage from one health care plan to another,
• waive health care or vision care plan coverage, or
• enroll in a health benefit expense account (HBEA) or dependent care expense account (DCEA) for 2000.
No action is necessary by participants in the Preferred Provider Organization Plan (United HealthCare), Point of Service Plan (Oxford), HMOs (Horizon HMO Blue, Aetna US Healthcare NJ/PA) or Vision Care Plan who do not wish to make any changes.
All current participants in a health benefit expense account (HBEA) or dependent care expense account (DCEA) who wish to continue their coverage must reelect coverage for 2000. Expense account elections for 1999 will not carry over for 2000. Employees interested in enrolling in these plans for the first time must also enroll during the Open Enrollment period.
All changes made during the Open Enrollment period will be effective January 1, 2000. The elections made during Open Enrollment must remain in effect through December 31, 2000 unless a qualifying family status change is experienced.
Anyone considering a change in health care plan coverage should review the informational materials that have been sent to their campus address. Information and forms are also available on the Open Enrollment Web site (www.princeton.edu/hr/oe) and at the Office of Human Resources (Clio Hall on main campus, Lyman Spitzer Building at PPPL).
During the open enrollment period, October 25 through November 12, 1999, retirees may move from the Premium Plan to the Standard Plan or remove dependents from the plan. No other changes in plan coverage are allowed.
Two additions provide convenience and savings for retirees.
Beginning January 1, 2000, retirees will be able to use a Retail Prescription Discount Card. Currently, retirees pay the full retail price at the pharmacy and then submit prescription receipts to Aetna US Healthcare for reimbursement under their medical plan.
With the Retail Prescription Discount Card, retirees will have the opportunity to fill a prescription at the retail pharmacy using their card to receive a discounted rate of up to 20 percent. Prescription receipts are then submitted to Aetna as usual; the annual deductible must first be met, and then reimbursement is at 90 percent.
The Retail Prescription Discount Card will be mailed by Merck-Medco in mid-December.
The University has also arranged for the Medicare Direct program. This program provides for automatic submission of claims by Medicare to Aetna US Healthcare. With this service, retirees and their dependents who are Medicare eligible will no longer have to submit their claims to Aetna once they have been reimbursed by Medicare, thus relieving them of one additional step in the reimbursement process.
Last year there was no change in plan rates. Although the costs for retiree coverage in 2000 are projected to increase significantly, the University will continue to absorb a good portion of the increase. As a result, the rates charged to retirees are increasing overall by 7.5 percent. Copayments for the mail order portion of the prescription drug plan will increase slightly to $5 for generic drugs and $15 for brand name drugs.
Two special information sessions have been scheduled for retirees in early December. At these sessions the changes noted above will be discussed, and retirees will have the opportunity to learn more about the use of the Retail Prescription Discount Card and the Medicare Direct program. These sessions will be held in the People's Liberation Hall in the Third World Center on December 7 from 10:00 to 11:00 am and on December 9 from 2:00 to 3:00 pm.
Employees who would like PPO Plan coverage or a waiver of health care plan coverage for 2000 and have access to the Web can take advantage of the new Web Enrollment System. This provides a secure, convenient alternative to completing forms manually. With this system, employees can also elect or terminate vision care plan coverage or elect coverage under an expense account. Employees should make a final election decision and link to Web Enrollment via the Open Enrollment Web site at www.princeton.edu/hr/oe. A Net ID and password are necessary to gain access to the system.
Last year the University discontinued the indemnity plan and offered a self-insured Preferred Provider Organization (PPO) Plan using United HealthCare's network of providers and negotiated discounts. The new PPO plan had expanded benefits financed through the network's negotiated discounts. While medical costs have continued to increase significantly on the national level, rate increases for the year 2000 for Princeton employees will increase only modestly.
Employee contribution increases for the PPO Plan and the self-insured Point of Service (POS) Plan administered through Oxford are less than the University's overall projected health plan cost increase for the year 2000, because the University is absorbing a larger share of the cost increase. For employees in these two plans, the overall increase is about 5.5 percent. The rate of increase or decrease varies according to the type of coverage (e.g., employee only, employee and spouse). Employee contributions for the three HMOs will decrease overall for the year 2000. The rate of decrease depends on the individual HMO chosen and the type of coverage (employee only, family, employee and spouse).
Copayments for prescription drug coverage under the PPO and POS Plans are increasing for the first time since these plans were established in 1994 and 1995. The Comparison Chart on page 8 gives specifics of the new deductibles and copayments for the year 2000.
Rates for the Vision Care Plan through Vision Service Plan (VSP) have not changed for 2000.
Anyone currently enrolled or considering an enrollment in the POS Plan (Oxford) should be aware of the following limitations that will become effective January 1, 2000.
• Oxford will no longer accept Out-of-Network claims filed for services received overseas. Coverage while traveling overseas will be reduced to emergency/urgent care only. If you plan a leave of absence that takes you overseas, you will have the option of electing coverage under the PPO Plan or the Catastrophic Plan; however, coverage for all other overseas travel, including business-related travel, will include emergency/urgent care only. If you choose to move to one of these health care plans while on leave, you must remain in that plan for the duration of the calendar year in which you return from leave.
• Oxford will no longer administer the nonnotification/noncompliance fee of $500. As a result, any instance of a failure to precertify a procedure or failure to comply with Medical Management will result in denial of coverage for those services.
There are a number of sources of information available that can assist employees in selecting the health care plan or coverage that meets their personal and family needs. Information is available electronically, in print and in person.
Use the Web. Visit the Open Enrollment Web site at www.princeton.edu/hr/oe for descriptions of the different plan features, rates for 2000 and links to the various health care providers.
Enroll on the Web. This new system provides a secure, convenient alternative to completing forms manually. This option is available for those who would like PPO Plan (United HealthCare) coverage in the year 2000 or those who wish to waive coverage.
Review Open Enrollment mailing. Use the Open Enrollment Coverage Statement to review your current health care plan coverage. Review the information in the Open Enrollment Guide (new this year), which provides comprehensive information on the different plan features as well as plan and rate changes effective January 1, 2000.
Attend a meeting. This year the traditional Information Fair will provide you with the opportunity to enroll -- either traditionally or on the Web -- immediately. Representatives fromthe health care plan companies and Human Resources will be available to provide materials, answer questions and assist you in completing the forms necessary for enrollment. Meetings will take place on October 27 (PPPL, Lyman Spitzer Building, Main Lobby) from 9:00 am to 1:30 pm and on October 28 (Main Campus, Whig Hall, Senate Chamber) from 9:00 am to 3:00 pm.
Visit a site. You can visit one of the following locations to pick up forms and information: Clio Hall, E-Quad, Helm Building, Firestone Library, Macmillan Building, Robertson Hall, Lewis Thomas Lab, PPPL Lyman Spitzer Building.