Benefits update
Key changes | Dental | Prescriptions | Retirees | More information
Open enrollment gives employees opportunity to evaluate
coverage
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Some highlights are described on this page. Open enrollment packets will be mailed to the homes of all regular faculty and staff around Oct. 27. Employees should carefully review the "Open Enrollment Guide" to obtain more detailed information.
In brief: Key changes for 2001
• Health care premiums paid by employees (using pre-tax dollars) will increase an average of 6.1 percent in 2001, depending on the plan and level of coverage selected.
• A new optional employee-pay-all dental plan will be available through Horizon Blue Cross, Blue Shield of New Jersey.
• Merck-Medco will be the vendor for the prescription drug plans for both United HealthCare and Oxford Health Plans.
• Deductibles and co-payments for the PPO and POS prescription drug plans will increase (co-payments for the HMO plans also will increase). A three-tier co-payment schedule will be introduced for the Merck-Medco prescription drug plan. The comparison chart on the following page gives specifics of the new deductibles and co-payments.
• Crosby Benefit Systems Inc. will replace Aetna as the administrator of the University's flexible spending accounts.
• Rates for the lump sum option of the Supplemental Life Insurance Program will be reduced by 15 percent.
• The survivor income benefit option of the Supplemental Life Insurance Program will be eliminated, effective Jan. 1, 2001. Current participants in this option can purchase lump sum insurance without providing evidence of insurability.
• Additional benefits have been added to the vision service plan with no increase in premiums.
Committee approves optional employee-pay-all dental
plan
This past summer, the Benefits Committee asked the Offices of Risk Management and Human Resources to identify a dental plan that would provide high quality dental care, a competitive level of benefits and affordability.
The successful result of this search is that the University is now able to provide two different plans, both offered by Horizon Blue Cross, Blue Shield of New Jersey: Horizon Dental Choice (HDC) and Horizon Dental Preferred Provider Organization (PPO) Access Plan.
• HDC is an HMO, and benefits must be rendered by your HDC primary dentist or authorized by HDC to be provided by a specialty dentist.
• Horizon Dental PPO Access Plan benefits must be provided by a Horizon Dental PPO network dentist. The Horizon Dental PPO Access Plan has more than 2,000 dentists in New Jersey.
HDC and PPO Access Plan highlights:
• No annual deductible.
• Most preventive and diagnostic care (routine exams, cleanings, X-rays) covered in full.
• Basic and major treatments provided by a general in-network dentist (root canals, oral surgery, periodontics, endondontics) substantially discounted.
• Orthodontia (children to age 19) provided at a contracted rate (HDC) or discounted rate (PPO).
Participation in the Horizon Dental Choice or Horizon PPO Access Plan is optional. The cost associated with participating in the plan is fully paid by the employee on a pre-tax basis. The cost of this program is competitive with dental plan costs that are employer subsidized.
Employees who are considering enrolling in the dental plan should plan to attend one of the presentations by Horizon that are scheduled during the open enrollment period. They should also carefully review the roster of dentists who participate in Horizon Dental Choice and Horizon PPO Access Plan before enrolling, since the number of dentists who participate in the local Princeton area is limited. For those who live elsewhere in Mercer County and beyond, there is greater choice. There are also a number of dentists who participate in the Horizon PPO Access Plan in Pennsylvania and New York.
A representative from Horizon Dental Services Inc. will be on campus to make presentations in the coming weeks. These times are in addition to the presentations that will take place at the Benefits Fair Wednesday and Thursday, Nov. 8-9 (see the related story on this page regarding sources of information):
Monday, Oct. 30, 2 p.m. E-Quad (Convocation Room C17)
Friday, Nov. 10, 2 p.m. Frist Campus Center Level B (Multipurpose Room C)
Tuesday, Nov. 14, 9 a.m. Frist Campus Center Level B (Multipurpose Room C)
Tuesday, Nov. 14, 11:45 a.m. Princeton Plasma Physics Lab (Gottlieb Auditorium)
Thursday, Nov. 16, 3 p.m. Princeton Plasma Physics Lab (Gottlieb Auditorium)
Revisions affect prescription plan
In an effort to better manage significant increases in prescription drug costs while assuring access to the appropriate quality of care for employees, the University is making three important changes in the prescription drug program in 2001.
• Merck-Medco will be the single provider for the United HealthCare (PPO) Plan and Oxford Health Plans (POS).
Previously, Oxford administered its own prescription coverage. However, a recent benefit review indicated that cost savings could be achieved by having a single provider of prescription drug coverage for both plans. Merck-Medco, which has been the provider for those participating in the United HealthCare PPO Plan, was selected to administer both plans. Details will be provided in the open enrollment packets.
• Three levels of co-payments have been established for the Merck-Medco prescription drug plan.
The University Benefits Committee also modified the current plan design to provide three rather than two levels of co-payments: the lowest co-payment is for generic drugs; a mid-level co-payment is for brand name drugs that have no generic equivalent, such as Claritin (these drugs are known as Single-Source Drugs); and a higher-level co-payment for brand name drugs that have generic equivalents, such as Zantac (these drugs are known as Multi-Source Drugs). Previously, the plans did not distinguish between Single- and Multi-Source Drugs. By law, generic equivalents must have the same active ingredients and same chemical composition as the brand name drug.
• Co-pays have been increased to the industry standard for all health care plans.
The University has changed its co-payment ratios to follow industry-standard ratios. For the Merck-Medco plan, this means that the co-payment for a generic drug purchased through mail order (for up to a 90-day supply) will be $12 or twice the co-payment level of the retail co-payment (for a 30-day supply) which will be $6.
All of the above changes are necessary to maintain the existing level of prescription drug cost sharing (80/20) between the University and members of the faculty and staff.
Retirees take note
To reflect medical inflation, premium rates for the retiree health plan the Princeton Health Care Plan will increase 10 percent effective Jan. 1, 2001, for those who pay premiums. Co-payments for the mail order drugs also will increase; the deductible and co-insurance for retail drugs will remain the same. Retirees should continue to use their retail discount cards when purchasing drugs at their pharmacy.
Need more info? Check out these sources
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 in print, online and in person.
In print
Review the 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," which provides comprehensive information on the different plan features as well as plan rate changes effective Jan. 1, 2001.
Online
Use the Web. Visit the open enrollment Web site at <http://www.princeton.edu/hr/oe> for descriptions of the different plan features, rates for 2001 and links to the various health care providers, which include directories of health care professionals and facilities that participate in the particular health care plan.
Please note: Enrollment in health care plans via the Web is not available this year. During a trial run last year, a number of areas that needed correction were identified to ensure accurate recording of the data. Direct enrollment on the Web will be available again for 2002.
In person
Attend a meeting. The Benefits Fair is scheduled for: 9 a.m. to 3 p.m. Wednesday, Nov. 8, in the Multipurpose Room on Level B of the Frist Campus Center; and 11 a.m. to 3 p.m. Thursday, Nov. 9, in the Lyman Spitzer Building at the Princeton Plasma Physics Lab. This event will provide you with the opportunity to obtain more information about the different health care plans and to meet with their representatives. This year, there also will be special presentations on the new dental plan (Horizon Blue), the new administrator for the flexible spending accounts (Crosby), the enhanced vision service plan, and the prescription drug plan. Benefits administrators from human resources also will be available to answer your questions and assist you in completing your enrollment forms.
Visit a site. You can visit one of the following locations at any time to pick up forms and informational materials: Clio Hall (lower level), E-Quad (main lobby), Firestone Library, Frist Campus Center, Helm Building, Macmillan Building and New South.
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