Health Plan Offers Some New Benefits, Some Reduced Costs

October 30, 2008 — Each year, University Human Resources reviews and updates the University of Virginia Health Plan to meet current needs of staff and faculty. As a result of this year's review, the plan will offer several benefit enhancements, including wellness initiatives, coverage for acupuncture and half the cost of dental implants, said Susan Carkeek, vice president and chief human resource officer.

The challenge for the University, like other employers, is finding a way to offer attractive benefits while managing costs. Human Resources is working to keep cost increases in the health plan as low as possible, Carkeek said. She acknowledged that it is difficult for employees to face increases in health plan costs in years without salary increases.

This year's open enrollment period runs from Nov. 3 through Nov. 21. During that time, employees can choose between the low- and high-premium health plans, add or drop a spouse or dependent, or enroll in the Davis Vision Insurance Plan. They may set up a Flexible Spending Account for the first time or re-enroll for another year (re-enrollment is required on an annual basis).

U.Va. Health Plan Premiums

"This is a good time to consider the University's low-premium program — a solid plan for healthy individuals and families — because there will be no cost increases in those premiums," Carkeek said.

Monthly premiums in the low-premium program will remain the same (see chart below): $12 for a single employee, $47 for employee plus child, $54 for employee plus spouse, $116 for family, and $80 for double state (family coverage for husband and wife who are both U.Va. or state employees).

There will be increases in the high-premium program. The new premiums will be: $42 for single employee, $147 for employee plus child, $171 for employee plus spouse, $327 for family and $291 for double state.

Employees who wish to make changes must complete a program election form and/or a health plan application. These forms will be available online Nov. 3 at or from the benefits office. If employees don't make any changes, they will automatically stay in the same programs they're enrolled in this year, with the exception of Flexible Spending Account enrollment, as noted above.

Wellness Benefits

"I am pleased we will be able to offer employees some enhancements," Carkeek said. "We will be introducing several new components in a wellness program we are planning to roll out in 2009."

The program features discounts for memberships in Weight Watchers weight-loss program; walking and exercise classes and activities; and the "Quit For Life" smoking cessation program that augments existing prescription drug coverage with counseling sessions and nicotine replacement products.

If quitting smoking is an employee's goal, Free & Clear's "Quit for Life" program will be available for employees, spouses and dependents age 18 or older enrolled on the U.Va. Health Plan. It offers an individualized plan, coaching via telephone and free delivery of nicotine replacement patches or gum, which are also free. This year U.Va.'s health plan began to cover prescription medications for smoking cessation, such as Chantix, on the formulary brands list.

Alternative Medicine

Health plan enrollees will be covered for up to 20 acupuncture sessions per year with $30 co-payments. Acupuncture, an ancient Chinese healing technique, has gained scientific acceptance in the West and is widely practiced in the U.S. by thousands of physicians, dentists, acupuncturists and other practitioners. It is used for relief or prevention of pain and for various other health conditions.

Other new benefits include coverage of rental or purchase of a pain control method using a device called TENs, which delivers transcutaneous electrical nerve stimulation.

Prescription Drug Coverage

Employees will see a decrease in co-payments for generic medications, as shown in the chart below. The price for a generic drug, up to a 30-day retail supply, will be $6 — down from $9. The cost of a 90-day supply ordered by mail will decrease from $21 to $14. Co-payments for the two groups of preferred brand-name drugs, formulary and non-formulary, will increase slightly.

Some medications on the most expensive list of specialty drugs will be moved from the specialty list to the formulary brand list, significantly reducing their cost to employees. They include most HIV medications, hepatitis B and transplant medications.

The co-payments of specialty medications will not change in the coming year. They remain $25 for the generic, $50 for the formulary brand and $75 for the non-formulary brand.

Things to Consider

When deciding whether to elect the low- or high-premium for health benefits, or to enroll in the optional programs, employees should consider the following:
• their monthly cash flow
• average annual health costs
• their tolerance for unexpected expenses.

Carefully consider these factors when making benefits decisions, and remember that employees always have the option to review benefits and make changes next year.