Plan Enhancements & Changes 2013
/ Medical Plan Premiums /Vision & Hearing / Health Care Flexible Spending Account / Save a Copay® /
Medical Plan Premiums
The cost for coverage under the POS II Plan will increase for 2013. Premiums for the High Deductible Health Plan (HDHP) will remain the same as in 2012. Please see specific rate information and plan highlights on pages 7 and 8 of the 2013 Re-Enrollment Newsletter.
With the increase in premiums for the POS II Plan, it may be the perfect time to consider enrolling in the HDHP. The HDHP allows you to pay lower premiums and have money from the College deposited in to a Health Savings Account (HSA) for you.
To learn more about how a HDHP with a HSA works, plan to attend one of the drop-in or informational sessions. Aetna representatives will also be available at the Employee Benefits & Work/Life Fair on November 1st to answer your questions.
Changes to the Vision and Hearing Care Plan
New lower premiums!
Beginning January 1, 2013, the College’s vision coverage will be switched to Davis Vision. First Ameritas will continue to administer the hearing care benefit through SoundCare.
What you need to know…
You will need to enroll in the Vision and Hearing Care (VHC) Plan during re-enrollment even if you are currently enrolled in the College’s Vision and Hearing Care Plan. If you do not elect coverage during the reenrollment period, your VHC benefits will end December 31, 2012.
You will still have two ID cards for the Vision and Hearing Care Plan. Effective with the new year, you will have a Davis Vision ID card for your vision plan benefits and a SoundCare ID card from First Ameritas for the hearing care plan.
Davis Vision benefits are easy to use. Members can access care through the Davis Vision network of independent, private practice doctors (optometrists and opthamologists) or select retail partners such as Empire Vision, Walmart or Sterling Optical.
To access a list of providers:
- Visit http://www.davisvision.com and select 'Open Enrollment' from the 'Members' menu at the top of the page
- In the 'Open Enrollment' box, enter Client Code '2423' and click 'Submit'
Review the Summary of Benefits listed in the newsletter for more details about the plan. You are also encouraged to stop by one of the informational sessions listed on the Informational Sessions page.
Benefits under the Hearing Care Plan will remain the same.
The Amount You Can Contribute to a Health Care Flexible Spending Account (HCFSA) is Decreasing
As a result of the Patient Protection and Affordable Care Act of 2010 (PPACA) upheld by the U.S. Supreme Court, effective January 1, 2013, a $2,500 cap will apply to contributions made to health care FSAs. A married couple may contribute up to $5,000, if they are both eligible to participate in a plan. The limit on FSAs for dependent care expenses remains at $5,000.
Save a Copay® Program—Additional savings on generic drugs
Members who switch to certain preferred generics from selected brand-name drugs will make no copayments
for 6 months after they make the change.
- Aetna will notify you if you are eligible to participate in the program, so there is no enrollment process.
- Members have to use a participating retail or mail-order pharmacy to participate in the Program.
- At the end of the initial 6-month period, you will be responsible for paying the lowest applicable copay for your prescription drug.
- You will have to meet your medical plan deductible before you can benefit from the Save a Copay Program.
The Save a Copay Program includes:
- ACIPHEX (heartburn)
- LIPITOR (cholesterol-lowering)
- LUNESTA (sleep aid)
- MAXALT (migraines)
- And many other brands
Here’s an example of how Save a Copay works:
Mary is covered by a three-tier pharmacy benefits/insurance plan with copays of $10 (generic drugs), $30 (preferred brand-name drugs) and $50 (non-preferred drugs). She is currently taking the nonpreferred brand-name drug ACIPHEX. By switching to a generic preferred alternative — like prescription omeprazole or lansoprazole — she could save $420 in the first year after she switches!*
* Savings in the first year are based on the copay amounts for brand-name drugs and generic preferred drugs as outlined in the example above. Calculations assume waiver of the $10 generic copay for 6 months, 12 fills a year for up to a 30-day supply of medication received from a participating retail pharmacy. Savings may vary if medications are received from a mailorder pharmacy.
