[Chronicle]

Nov. 10, 1994
Vol. 15, No. 6

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    Open Enrollment: Only chance this year to make changes in benefits

    Open Enrollment for changes in various benefit plans will be held on weekdays from Thursday, Nov. 17, through Tuesday, Nov. 22. During the Open Enrollment period, employees may change health and dental plans, add eligible family members to health and dental plans, and set up a Flexible Spending Account for 1995. Changes in health-plan and dental-plan enrollment will take effect Jan. 1, 1995.

    Open Enrollment will be held in Swift Commons during the following times: Thursday, Nov. 17 9:30 a.m.-4:30 p.m. Friday, Nov. 18 9:30 a.m.-1:30 p.m. Monday, Nov. 21 12:30 p.m.-4:30 p.m. Tuesday, Nov. 22 9:30 a.m.-4:30 p.m.

    Health-plan premiums

    "The University's goal in managing health coverage over the past decade has been to contain the cost of an excellent set of choices," said Henry Webber, Associate Vice President for Administration. "The 1995 health-plan premiums and coverage options reflect that ongoing effort."

    In order to achieve this goal, the University adopted in 1990 a set of principles to guide the structure and pricing of health options. These principles are as follows:

    _ All employees enrolled in a health plan should contribute toward the cost of that coverage.

    _ Employees who select a more expensive plan should pay a greater percentage of the total cost of that coverage than those who select a less-expensive plan.

    _ The University should offer at least one plan that provides comprehensive coverage at low cost.

    Pricing changes since 1990 have included the re-establishment of employee premiums for participation in the HMO plans and the introduction of salary-graded employee premiums for all plans. The University has also contracted with the EPIQual Preferred Provider Network to negotiate discounts with a set of Chicago-area physicians and hospitals for employees enrolled in the indemnified plan. In 1994, the University merged its two indemnified plans into a single plan, the Maroon Plan, and increased the incentives for participants to select EPIQual hospitals and physicians. All of these changes were based upon the recommendations of the Committee on University Benefits, chaired by William Pollak, Associate Professsor in the School of Social Service Administration.

    The University expects to contribute an average of 85 percent of the cost of all health plans in 1995, according to Webber. "For the second consecutive year, employees in the lower two salary tiers who select either of the two lowest-cost options, Humana Premier HMO Plan and HMO Illinois, will see no increase in premiums." He noted that the maximum monthly premium increase from 1994 to 1995 for any employee enrolled in Humana Premier HMO Plan and HMO Illinois is $2 for single coverage and $6 for family coverage.

    1995 Health-Plan Premiums The following table displays 1995 monthly health-plan premiums for full-time employees. Tier I Tier II Tier III Tier IV Humana Single $7 $13 $18 $21

    Family $23 $35 $47 $55 HMO Ill. Single $9 $13 $18 $21

    Family $24 $36 $48 $56 UCHP Single $15 $23 $28 $32

    Family $44 $64 $73 $82 Maroon Single $36 $46 $60 $73

    Double $68 $83 $99 $122

    Family $90 $112 $133 $163

    The 1995 salary tiers will be as follows: Tier I Under $25,000 Tier II $25,000-$44,999 Tier III $45,000-$66,000 Tier IV Over $66,000 Health-plan changes

    Health-plan changes for 1995 include the introduction of the Humana Premier HMO Plan. Under this plan, Humana will offer, in addition to its current facilities, the option of selecting a doctor from a network of physicians who practice in non-Humana facilities but have contracted with Humana to treat patients. "If you were previously enrolled in the Humana Staff Model Plan, no change is required if you wish to maintain coverage under the Humana Premier HMO Plan at your current Humana center," said Robert Riesman, Director of Staff Benefits.

    Other changes include an increase in the prescription co-payment for University of Chicago Health Plan (UCHP) subscribers to $5 per prescription. In the Maroon Plan, the EPIQual preferred-provider network now includes 49 hospitals and 5,200 physicians in the Chicago and Northwest Indiana area. Lutheran General Hospital has joined University of Chicago Hospitals, Northwestern Memorial Hospital, Rush-Presbyterian-St. Luke's Medical Center, Children's Memorial Hospital, Ingalls Memorial Hospital and Palos Community Hospital as members of the hospital network. Participating physicians now include the University of Chicago Physicians Group, the Northwestern Medical Faculty Foundation and Rush Medical Associates.

    User's guide

    As part of this year's Open Enrollment, the University is distributing a User's Guide to Health Plans at the University. This new resource is designed to serve both as a "buyer's guide" in selecting a health plan and as an "owner's manual" in using the plan. The booklet contains a revised health-plan comparison chart, as well as a map displaying the locations of hospitals affiliated with each plan. "I encourage faculty and staff members, and their families, to use these materials to get the most out of the dollars they and the University spend on their health care," Webber said.

    Dental coverage

    In addition to health coverage, employees may also choose dental coverage under the First Commonwealth plan. This option offers comprehensive coverage through over 900 private-practice dentists for commonly needed dental procedures. Plan features include no annual deductibles and no annual limitation on coverage, although co-payments are required for services other than covered preventive and diagnostic procedures.

    Premiums for the First Commonwealth plan will increase slightly in 1995. Monthly premiums for calendar year 1995 are as follows: Single $10.75

    Single plus one $19.80

    Family $26.25 If an employee enrolls in the First Commonwealth dental plan for 1995, the enrollment will remain in effect through Dec. 31, 1995. If an employee is currently enrolled in the First Commonwealth dental plan and wishes to discontinue coverage, he or she must terminate the coverage by completing a termination form during Open Enrollment.

    Flexible Spending Accounts

    Employees who wish to contribute either to a Health Care Flexible Spending Account or to a Dependent Care Flexible Spending Account during 1995 must complete an enrollment form during Open Enrollment. A Flexible Spending Account enables employees to use pretax dollars to pay for certain medical, dental and dependent-care expenses, in compliance with IRS regulations. Employees with questions about Open Enrollment may contact a Benefits Counselor by phone at 702-9634, by e-mail at benefits@uchicago.edu, or by stopping in the Benefits Office in Ingleside 103.