Benefits Update UWSA

1
Benefits Update - UWSA

• Topics
• Proposed Legislation to Extend ARRA Premium
  Subsidy - Nicole
• Adult Children Eligibility Emergency Rule - Beth
• Domestic Partner Requirements for Optional Plans
• Optum Continuants - Beth
• Reminders - Beth         
•  Enrollment Period End Dates
• Anthem DentalBlue Employees must remain in plan
  for full year
• Navitus web site

2
Benefits Update Beth Ritchie

• Adult Childrens Eligibility for Health Insurance
  to Age 27
• The Office of the Commissioner of Insurance has
  issued an emergency administrative code to
  clarify an adult dependent child loses
  eligibility for health insurance at the earliest
  of the following
• The end of the month in which the adult child
  turns age 27
• The end of the month in which the adult child
  marries
• When the child is eligible for health insurance
  through his/her own employer that has a lower
  employee cost less than the cost to provide
  coverage through a parents plan.

3
Benefits Update Beth Ritchie

• Adult Childrens Eligibility for Health Insurance
  to Age 27
• This is a change from the earlier direction to
  compare the cost of the health insurance coverage
  to the adult child through his/her own employer
  to the fair market value of the coverage through
  his/her parent.
• Because of the change, covered employees may
  enroll eligible adult children for health
  insurance (and Epic, Anthem DentalBlue and VSP)
  through the end of 2009 for coverage effective
  1/1/10.

4
Benefits Update Beth Ritchie

• Adult Childrens Eligibility for Health Insurance
  to Age 27
• Unintended consequence This change has created
  an enrollment problem for adult children who
  would have lost eligibility for coverage at the
  end of 2009 had the coverage to age 27 mandate
  not been passed and
• who are eligible for state group health because
  they are eligible WRS employees but
• did not enroll in health insurance due to
  coverage under a parent's policy through the
  state

5
Benefits Update Beth Ritchie

• Adult Childrens Eligibility for Health Insurance
  to Age 27
• There will be a one-time exception whereby any
  adult children insured on their parent's policy
  will have an enrollment opportunity through their
  own WRS employer for coverage effective January
  1, 2010.

6
Benefits Update Beth Ritchie

• Domestic Partner Affidavit for Optional Plans
• Discussion of domestic partner affidavit when the
  employee chooses to enroll partner in optional
  plans only.
• If the employee has family state group health
  insurance in force when the ETF domestic partner
  affidavit is submitted to ETF, the partner must
  be added to the family coverage.

7
Benefits Update Beth Ritchie

• Optum Continuants
• Enrollment Deadlines

8
Benefits Update Beth Ritchie

• Anthem DentalBlue
• Starting for 2010, once enrolled, the employee
  must remain in the plan for the full year.
• Employees who want to drop their current coverage
  must submit an application to cancel coverage.
  We want the applications to cancel by December 1
  to avoid refunds.
• Employee can re-enroll at the next open
  enrollment. The three-month waiting periods will
  have to be met again.
• Preferred PPO will have coverage for implants.
• No dependent status questionnaire will be sent.

9
Benefits Update Beth Ritchie

• Navitus
• Navitus Health Solutions has introduced a new,
  secure section on their web site called
  "Navi-Gate(r) for Members".  Information that was
  formerly available through the Navitus.com public
  web site are now accessible only through
  "Navi-Gate(r) for Members".
• This includes formularies, Prior Authorization
  (PA) forms and prescription drug benefit
  information.

10
Benefits Update Beth Ritchie

• Navitus, cont
• Members must register and create their own secure
  login to access the "Navi-Gate(r) for Members"
  site.
• In order to register, members will need both a
  valid e-mail address and their Navitus
  identification number, which can be found on
  their Navitus ID card.
• Members who do not have a valid e-mail address
  can obtain pharmacy benefit information by
  calling Navitus Customer Care at 1-866-333-2757.