The clock is ticking on this year’s 2015 benefits enrollment period, and with only 10 days left, it’s time to make a decision about the coverage you want for you and your family.
Enrollment ends on Friday, November 14. If you want to change plans or coverage levels, or if you want to participate in the Flexible Spending Account, you’ll need to elect your benefits during the enrollment period. If you don’t actively enroll during that time, your current medical, dental and other benefits will automatically carry over next year. Flexible Spending Account participation does not carry over from one year to the next, so you will need to reenroll.
Here are some questions and answers that hopefully will help you make the best decisions about your health insurance.
Where do I get more information about benefits?
Visit www.texaschildrens.org/mybenefits to learn more about your 2015 benefit options.
I need help selecting a plan. What resources are available?
You have access to Decision Direct, an interactive tool designed to help guide your decisions around which plan might work best for you and your family. Decision Direct is available at www.decisionsupportsuite.com/texaschildrenshospital.
Is the most expensive medical plan the best plan available?
Not necessarily. What’s “best” is based on the amount of coverage you and your family actually need. For example, if you enroll in the EPO or PPO option next year but don’t use a lot of health care services or take a lot of prescription medications, you may pay for more coverage than you need. The key is to consider your “total” medical plan costs for next year. That’s how much you contribute from your paycheck and how much you anticipate spending throughout the year combined.
Is one medical plan option better than another?
No. One medical plan option isn’t necessarily “better” than another. They’re designed to give you choices so you can find the option that makes sense for your and your family’s situation. Remember to take your total costs into consideration, which includes what you pay out of your paycheck and what you pay out of your pocket when you receive care (deductibles, coinsurance, copays). For example, if you select the EPO or PPO, you’ll pay more up front in payroll contributions and generally pay less during the year when you need care. With the CPP, you’ll pay less up front in payroll contributions and generally pay more when you need care during the year (but can use money in your HRA).
Are the same services covered by all the medical plan options?
The services that the CPP, EPO and PPO cover through BCBS are identical. They are just covered at different levels. You can find specific plan coverage details in your enrollment guide.
How does the CPP work?
The CPP saves you money up front with lower payroll contributions. You must meet an annual deductible for medical and prescription drug expenses before the plan begins to pay benefits. You will have an HRA account you can access to help satisfy out-of-pocket expenses such as the deductible, coinsurance, and/or other eligible expenses. Once you meet the annual deductible, you pay 20 percent of in-network medical and prescription drug costs until you reach the annual out-of-pocket maximum. Then the plan pays 100 percent of eligible expenses for the rest of the plan year. You have the option to open a Flexible Spending Account (FSA) along with your HRA, into which you can deposit $2,500 out of your check to help pay for your expenses. If you do open an FSA, using your debit card will allow those funds to be used first to pay for services to meet your deductible before the funds will be paid out of your HRA.
How does the CPP encourage informed and smart health care behavior?
Low payroll contributions on the front end and higher deductibles on the back end help you think before you use health care services – like deciding whether to go to an Urgent Care Clinic rather than the Emergency Room (ER) for a sinus infection. This type of plan promotes better decision-making around health care use, which in turn drives down costs.
I want to improve my health in 2015. What other programs are being offered?
You can kick-start your healthy 2015 by receiving your annual physical at the Employee Medical Clinic. Preventive care is covered by all three medical plans at no cost to you and subsequent visits are only $10! Employee Health and Wellness can also support you in achieving your well-being goals through various wellness programs including tobacco cessation programs, chronic condition management, health coaching, and engaging wellness activities. An exciting new offering is that tobacco cessation prescriptions and over the counter treatments are now covered at 100 percent with a prescription. Contact the Employee Medical Clinic at Ext. 4-2150 for a same-day appointment and wellness program details.
