June 2012

Benefits 2012/2013 - - An HR Liaison Presentation

Employee Benefits Manager A&M System Office

Ellen Gerescher

Contract Renewals

• The System Benefits Office administers the System benefit plans and has fiduciary responsibility for sound management of the premium resources

• Renewed contracts with both BlueCross BlueShield and Medco will result in significant savings– Lower administrative fees, greater network

discount savings

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Benefit Changes for 9-1-12

• Tobacco User Additional Premium• Consolidation of Health plans • Dependent Audit

What constitutes a tobacco user?

• This can be defined many different ways.  The A&M System will follow the standard used by the ERS in order to be consistent with other State entities.  A tobacco user is someone who has utilized tobacco more than five times in the previous three months.

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Two Years of Changes

• Changes for 2011-12– Merged two A&M Care plans into one plan

• Changes for 2012-13 – Merging the Scott & White Health Plan into

the A&M Care Plan

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Behind the Consolidation

• Larger, single risk pool eliminates selection bias and adverse selection– SWHP enrollment has decreased over the

past several years– Costs have increased

• Members aged• Costs for doctors outside the clinic increased

– Plan design continued to mirror that of the A&M Care plan

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Transitioning from Scott & White

• While plan choice may be gone ---- physician choice remains

• Decrease in monthly premiums• Virtually all S&W doctors are in the

BlueCross BlueShield network– BCBS phone number for Scott & White

members with questions: 1-866-231-5581

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Transitioning (cont.)

• The Scott & White pharmacies are in the Medco network

• Medco website for information about coverage for specific drugs: http://www.medcohealth.com/consumer/site/openenrollment?accessCode=TAMRXBEN14597

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New for the A&M Care Plan

• Starting August 1, your A&M UIN will be your BlueCross BlueShield ID Number, beginning with TXW (for employees) and ZGB (for retirees) – all existing members will get new ID cards

• Benefits Value Advisor – service that helps employees by locating providers, providing cost estimates, scheduling procedures, etc.

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New for the Grad Plan

• Expanded to be compliant with Federal Healthcare reform– No plan-year maximum for drug coverage– Preventive care provided at 100%– No pre-existing coverage limitation for

members under age 19

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Dependent Audit

• Approximately 10,000 employees with dependent medical coverage audited

• Approximately 750 dependents dropped; however many dropped voluntarily

• Audit continues for those with dependents on dental, vision and dependent life only

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Thank You!

Ellen GerescherSystem Benefits Administration

Egerescher@tamus.edu979.458.6330

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