Health plan expands
coverage; monthly premiums up $1-$3
a national trend, the University's health plan will raise premiums
only slightly next year while greatly expanding the scope of benefits.
the first time, the plan will offer vision and orthodontic benefits,
as well as some coverage for complementary and alternative therapies.
The drug plan will no longer bar access to certain drugs. Premiums
will rise by only $1 per month for employee-only and employee-plus-one
Premiums for family and "double-state" enrollees will
rise by only $3 per month.
A nationwide survey reported that health insurance premiums for
large businesses -- those employing 1,000 or more -- are expected
to rise by 12.2 percent for active employees and 13.3 percent
for retirees still receiving benefits. Federal employees will
pay an average of 10.5 percent more.
Meetings to discuss benefit changes and additions to the
U.Va. health plan, effective Jan. 1, 2001
6 -- 10 a.m. Newcomb Hall South Meeting Room, third floor
8 -- 7:30 a.m. Medical Center, Primary Care, classrooms
Nov. 14 -- 3 p.m. Newcomb Hall South Meeting Room, third
17 -- 9 a.m. Darden School, classroom 40, lower level
Nov. 27 -- 3:30 p.m. Medical Center, Primary Care, classrooms
Nov. 28 -- 3 p.m. Newcomb Hall South Meeting Room, third
reservations are needed.
Way-Smith, the University's director of employee benefits, says
conservative management has softened the blow at U.Va, where increases
range from 1 percent to 7.7 percent.
"We have been slightly more successful at controlling costs
than was projected in the past couple of years," she said.
The savings, plus greater-than-required reserves, allowed the
plan to absorb most of the expenses associated with the new benefits
and drug cost increases, she said.
slight increase is] nothing people should count on happening [regularly],"
she warned. "It's not something that is going to be an annual
the open enrollment period beginning Oct. 30 and continuing through
Dec. 8, full information about changes to the health plan are
scheduled to be mailed shortly, Way-Smith said. The changes take
effect Jan. 1.
The plan includes a vision benefit through First American Vision
Services. Participating providers offer up to 20 percent off eye
exams, up to 50 percent off retail frames, 20 to 30 percent off
retail lenses, 20 percent off the initial set-up for contact lenses
and 50 percent off replacement contacts. In addition, there is
a 25 percent discount on laser eye surgery at TLC Laser Eye Centers
in Northern Virginia, plus up to $200 in travel expenses.
two-thirds of local opticians are expected to participate in the
plan, Way-Smith said.
The plan will offer a $1,000-per-person lifetime benefit for orthodontic
coverage. After paying a $50 deductible, employees and the plan
split evenly the next $2,000 in costs. The employee then picks
up all costs in excess of $2,050.
Acupuncturists and massage therapists will offer a discount to
plan participants through a complementary and alternative medicine
Dependents who receive immunizations and inoculations at their
out-of-town student health centers will be covered as if the shots
were given in a network physician's office.
An option is being added to chiropractic coverage, allowing employees
to visit a chiropractor within the network without a referral
from their primary care providers (with a $30 co-payment and an
80-20 split of additional charges).
are also changes in the existing benefits, chiefly in mental health
and drug coverage.
forget flexible accounts
The deadline for renewing or establishing a flexible spending
account is Dec. 8.
spending accounts allow employees to set aside a portion
of their paychecks before taxes to pay for dependent care
or certain out-of-pocket health care costs, such as deductibles
and co-pays. To establish an account, employees must complete
an application specifying how much they would like deducted
from their pay. They are then reimbursed for appropriate
expenses after filing claims.
left in the accounts at the end of the calendar year is
who are currently enrolled in the program must reapply to
continue particpating in 2001.
For information, call Ceridian Benefit Services at (888)
588-6852. Applications are available through the Human Resources
Web site at www.hrs.virginia.edu, by contacting Human Resources
at 924-4392, by e-mail at email@example.com,
or by fax at 924-4486.
applications should be sent to U.Va. Benefits Division,
914 Emmet St., P.O. Box 400127, Charlottesville VA 22904-4127.
mental health plan previously based its charges on whether the
participant was referred for health care by a physician, or was
self-referred. However, the plan was seeing substantial growth
in both costs and utilization of mental health services, Way-Smith
The new plan offers three options. The first option is entry into
the system through a referral. If referred by your primary care
physician, you pay $10 per visit; if referred by the Faculty and
Employee Assistance Program, the co-pay is waived altogether.
"We think it will help us to get people to the right providers
faster," Way-Smith said. "It may keep people out of
the system altogether if they can get the services they need at
retain the right to see mental health providers of their own choice,
either inside the network ($30 co-pay per visit) or outside (pay
half the cost). However, if participants choose the latter option,
they must make sure that the mental health professional submits
a treatment plan to QualChoice -- the plan's third-party administrator
-- for approval before the fifth visit. If there is no approved
treatment plan in place, the participant must pay all of the costs.
prescription drug benefit is being converted from a two-tiered
system to a three-tiered one -- covering generic, "preferred
brand" and "non-preferred brand" medications --
with the amount of the required co-payment dependent upon the
cost of the drugs selected. The purpose is to urge employees to
consider lower-cost drug options, Way-Smith said.
cost to the participant for a 30-day supply of a generic drug
purchased at retail will be $8 or less, compared to $12 for a
preferred brand and $25 for a non-preferred brand. There is a
substantial discount for mail-order purchases.
As has been previously, some very expensive drugs require pre-approval
changes in the drug benefits "actually bring us in line with
what other local plans are doing," Way-Smith said.
Resources will offer a series of information sessions on the benefit
changes. More information is also available through the Web at
or via e-mail at firstname.lastname@example.org.