This fall brings positive news for employees in the University of Virginia Health Plan: For starters, all preventive exams will becovered at 100 percent – no co-payment – in 2013. Covered employees will also get reduced co-payments or have deductibles waived for certain services when using U.Va. providers, under changes to the Health Plan that take effect Jan. 1.

To see how the changes in policies, from premiums to prescriptions, will affect them, employees should carefully review the benefits website. Employees click on their employment category and then “U.Va. Health Plan” to access a list of benefits changes, including premiums, prescriptions and cost-sharing, dental benefits and dependent eligibility requirements.

The University’s annual open enrollment period, for reviewing and making changes to benefits, is from Oct. 29 to Nov. 16.  This is the third year employees in the Academic Division will use Benefits@UVa to make benefits selections during open enrollment (Medical Center employees use online Self-Service). Employees who do not elect any changes will remain in whichever U.Va. Health Plan program (high- or low-premium) they are currently enrolled in.

The employee portion of premiums for the low-premium plan will remain the same. The rates for the high-premium plan will increase modestly (ranging from $2 per month for single to $12 per month for family). Eighty percent of U.Va. employees subscribe to the high-premium plan, which generally has a higher monthly premium but lower out-of-pocket expenses, while those in the low-premium plan pay a smaller premium but may incur higher out-of-pocket costs for certain services.

The University continues to cover 90 percent of out-of-pocket expenses and 80 percent of premiums for the U.Va. Health Plan, resulting in a 70/30 split of overall costs between the University and employees. 

Other parts of the benefits plan that can be changed during open enrollment:

• Dropping ineligible dependents or a former spouse
• Making changes to Davis Vision care
• Opening or changing a tax-deferred savings plan
• Enrollment in Flexible Spending Accounts (enrollment required annually)

Incentives for Using U.Va. Doctors and Facilities

The 2013 plan continues incentives introduced last year, halving co-payments when employees use U.Va. providers for office visits in primary care, obstetrics and gynecology, mental health and specialty care services.

Employees also have the option of choosing U.Va. for inpatient and several outpatient services – with cost-sharing reductions.  Co-payments for in-network office visits outside the U.Va. Health System will stay the same.

“There are many employees who have never tried the U.Va. Health System’s doctors and services.  We’d like to encourage employees to use U.Va., which provides outstanding community care,” said Anne Broccoli, U.Va.’s director of benefits.

“We recognize it’s a personal relationship between patient and health care provider,” she added. “Still, it’s a robust benefit.”

One of the Health System’s recent additions, Care Connection, aims to provide prompt service to employees making medical appointments with the U.Va. Provider Network. Call Care Connection at 434-243-3675.

Help with Quitting Smoking

Along with routine preventive exams being covered at no cost to employees, programs for quitting tobacco use will be expanded, co-payments will be waived for tobacco cessation drugs approved by the U.S. Food and Drug Administration, and those drugs will be supported for longer periods of time.

Starting in January 2014, the U.Va. Health Plan will discount premiums for non-tobacco users. Advance notice is being given so employees and their adult dependents can stop sooner and verify their tobacco-free status for at least 12 months by 2014.

Changes in Co-Pays and Deductibles

While high-premium enrollees will see lower co-payments if they use U.Va. providers for inpatient hospital and transplant services, outpatient hospital and procedures, acute care for mental illness and home health services, co-payments will be higher for other non-U.Va. in-network providers.   

Employees in the low-premium plan will also have an incentive for using U.Va. for inpatient hospital and transplant services, outpatient hospital and procedures, acute care for mental illness and home health services: The deductible associated with those services will be waived.

Employees can see a specific breakdown of the changes on the Open Enrollment presentation, available on the Open Enrollment pages.

Employees enrolled in the Davis Vision plan, which is distinct from the Aetna Vision Discount Program, will see some modest premium increases and are automatically re-enrolled unless they make a change during open enrollment.

Changes to Prescription Drug Coverage

Changes are also being made to the prescription drug program, beginning with its name: CatalystRx is now Catamaran.

Starting Jan. 1, medications will be placed in three tiers, a common practice in the industry. If a medication will be changing tiers, and therefore cost more, Catamaran will be notifying individuals specifically affected with a letter to their home address.  .

Employees can find specific medicines and their designations and costs in a new drug formulary list online on the Open Enrollment website.   

Cost-sharing will be reduced for those who use U.Va.’s Barringer Pharmacy. The U.Va. pharmacy is open weekdays from 8:30 a.m. to 5 p.m., and pick-up is available until 5:30 p.m. Patients can email questions or requests for information to BarringerPharmacy@virginia.edu and can order refills online.

In addition, employees in the HealthyRx program, Aetna’s disease management program that focuses on specific conditions, such as asthma or hypertension, will see cost reductions.

Flexible Spending Limits Change

Another benefit that helps with health care costs, the tax-free Flexible Spending Account, is again available and must be renewed each year. Under the plan, employees can divert some of their pay into pre-tax health-care spending accounts. Because of a change in federal regulations governing the accounts, the maximum amount that can be deposited into a medical Flexible Spending Account is $2,500.

Employees can also set up or renew a Flexible Spending Account for dependent care.

Get Help at Benefits Day

This year’s Benefits Day will be held Nov. 7 in the Newcomb Hall South Meeting Room from 9 a.m. to 1 p.m. Every hour on the hour, small-group sessions will be held with Human Resources staff explaining the benefits changes. Vendor representatives also will answer questions.

The Medical Center Benefits Day will be held Nov. 8 from 8 a.m. to 3 p.m. in the University Hospital’s pedestrian link by Primary Care.  

For additional help, click here for a user guide, tutorial and other information, or contact the HR Service Center at 434-982-0123 or email AskHR@virginia.edu.