Changes to Health Care Plans for 2014
October 9, 2013
Cynthia Nickoloff
There are several changes to the college health care plans for 2014, which employees must elect during October 2013 and which become effective January 1, 2014. Most changes affect employees enrolled in Plan A鈥攖hose in the faculty, A&PS, and confidential groups鈥攂ut the staff in the Department of Human Resources urges all employees to closely read the details of their plans, which can found in the employee group-specific letters on the .
Here is an overview of what is changing for 2014:
Increases in Cost
For Employees on the A Plan (Faculty, A&PS and Confidential)
Medical Premiums
鈥 Premium percentages have increased for the first time in 11 years (January 1, 2003) to help share the increasing costs of healthcare between employer and employees
鈥 Two new premium categories鈥攑rimary and secondary鈥攈ave been added, and are described below in greater detail.
Physician Office Visit Copays
鈥 office visit co-pays have increased to help share the increasing cost of health care.
Deductibles
鈥 deductibles have increased to help share the increasing cost of health care
Out of Pocket Maximums
鈥 drug co-pays and office visit co-pays will now count towards the maximum out-of-pocket limit to comply with the Affordable Care Act (91直播鈥檚 bargaining unit health plans were already compliant). These maximums have increased to reflect the inclusion of co-pays.
For Unionized Employees
All negotiated costs for 2014 can be found in your applicable union contracts.
For All Employee Groups
鈥 Cigna Dental premiums have increased
Two New Categories of Coverage
For Employees on the A Plan (Faculty, A&PS and Confidential) and OCOPE Members
The rising costs of health insurance in general has necessitated two new categories of health coverage鈥攑rimary and secondary鈥攆or those employees electing family or employee plus spouse/domestic partner coverage.
The less costly of the categories is secondary coverage, which pertains to those employees whose spouses/domestic partners/families have other medical coverage.
Primary coverage means an employee鈥檚 spouse/domestic partner/family鈥檚 only medical coverage is through the 91直播 College health plan. If your spouse or domestic partner鈥檚 only medical coverage is through the 91直播 College health plan, you are required to complete a Spousal Coordination of Benefit Form each year鈥攖his form can be found on the .
Note: Employees with 91直播 College family plans whose domestic partners/spouses are also college employees, and who are without other coverage, qualify for secondary coverage premiums and are not required to complete a Spousal Coordination of Benefit Form.
Step Therapy鈥擟IGNA Pharmacy Management
For Employees on the A Plan (Faculty, A&PS and Confidential)
Starting in January 2014, CIGNA Pharmacy Management will offer Step Therapy for certain medical conditions such as high blood pressure, asthma, depression, and several others. Step Therapy is a prior authorization program that requires that certain prerequisite medications, typically generics or low-cost brands, are used before other more costly medications are covered. Note: at any time, your physician can request authorization to continue coverage for a step therapy medication for medical reasons. To determine if your medication is included in the program, log to myCigna.com. Click on the CIGNA Prescription Drug List and enter the name of your medication(s). An 鈥淪T鈥 designation will appear next to your drug if it is included in the Prescription Step Therapy program.
Increase in Cost. Increase in Flex Spending Allocation?
Employees who use the Flexible Spending Account (FSA) option may want to take note of the increases in health coverage premiums when calculating their 2014 FSA allocations. And, in light of these increases, those who have not used a Flex Spending Account in the past may want to consider doing so in 2014. Employees may review eligible expenses and online claim reimbursement instructions in the 2014 FSA Enrollment Guide, which is available on the . Employees should note that contributions into the FSA fund for 2014 must be used by March 15, 2015, otherwise they lose the money in the fund.
Details on all 2014 college health care plans are available in the employee group-specific letters posted on the .
An opportunity to obtain more information about the college鈥檚 health plans and benefits, the Benefits Fair, takes place Wednesday, October 16, in Carnegie Hall鈥檚 Root Room from 8 a.m. to 3:30 p.m.
You may also direct questions to Human Resources鈥 Compensation and Benefits Administrator Awura Ferguson Osei at 440-775-8430 or awura.ferguson.osei@oberlin.edu.
Open enrollment for 2014 ends Friday, October 31, 2013.