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November 20, 2013

Nov. 25 is deadline to select, change benefits for 2014

The University’s open enrollment period—the annual opportunity for faculty, staff, and residents to review and make changes to their benefits plans for the coming calendar year—ends Monday, Nov. 25.

Benefits-eligible employees may change their University health care or dental plan coverage to a different plan or administrator; elect health and dental coverage if not currently enrolled; increase or add group life insurance coverage and beneficiaries; and elect new contributions to a flexible spending account (FSA) or health savings account (HSA).

The University will continue to offer the current four health care plans and two dental plans to employees. No action is required for those who do not wish to make changes to their health care or dental plans. However, if you will be covered by a University health care plan or dental plan in 2014, you are required to certify that each of the dependents on your plan meet the University’s health program eligibility requirements. You must certify your covered dependents during open enrollment through the HRMS even if you are not making any changes to your coverage.

If you wish to participate in the health care FSA, the dependent care FSA, or HSA for 2014 you must enroll again, even if you are participating during 2013.

Key changes for 2014

There are several key benefits and coverage changes planned for this year:

  • New levels, means of calculating out-of-pocket maximums. In compliance with the Affordable Care Act, all plans except the HSAeligible plan, prescription drug copays will now count toward your out-of-pocket maximum as will visits to your primary care physician and specialists under the copay plan (but not your plan’s deductible). Because of this, out-of-pocket-maximum limits have changed for all affected plans.
  • Higher HSA contribution limits. The 2014 contribution limit for the University’s health savings account has increased to $3,300 and $6,500, respectively, for single and family coverage.
  • Pharmacy coverage changes. Pharmacy benefits will be administered by the third-party administrator (Aetna and Excellus) you choose for your health plan. All members will receive new health plan ID cards for both medical and pharmacy.
  • Pediatric vision coverage expanded. In compliance with the Affordable Care Act, University health care plans have added an additional five percent coinsurance (for in-network eyewear for dependents 18 and younger). The coinsurance kicks in after the $60 per year allowance has been satisfied. A separate claim must be submitted to your plan administrator (Excellus or Aetna) to process the coinsurance benefit.
  • University introduces new behavioral health services program. Beginning Jan. 1, Behavioral Health Partners, a general adult psychiatry outpatient practice offered through the Medical Center’s Department of Psychiatry, will offer mental health services—including individual therapies and medication consultation and management of anxiety, stress, and depression. No referral is needed. Regular full- and part-time faculty and staff age 18 years and older enrolled in a University health care plan, as well as non-Medicare eligible retirees enrolled in a University health care plan, may qualify. Spouses, domestic partners, and dependent children of active employees or non-Medicare eligible retirees who are age 18 and older and enrolled in a University health care plan may also be eligible. Behavioral Health Partners does not provide pediatric services to covered dependents under the age of 18. For all plans but the HSA-Eligible plan, these services are offered at no out-of-pocket cost. Learn more about the new service at
  • A reminder about the copay plan. The University’s copay plan, for the second year running, will have a hybrid design, now featuring deductible, coinsurance, and an out-of-pocket maximum for all in-patient, out-patient, and emergency services. Copays will continue to apply to PCP and specialist office visits.

A complete overview of the plans and changes for 2014 are available at

2014 health care premiums

The University offers four self-insured health care plans and two dental plans. According to the Benefits Office, the premiums are below market rates. With many local private health care plans expected to see a double-digit percent increase in premiums, the 2014 University health plan rate increase— 4.5 percent—remains relatively low. The increase will be shared by both the employee and University contribution, so that the University continues to pay, on average, 80 percent of the premium, and employees pay 20 percent. There is no rate increase to the University’s Tradition and Medallion Dental plans for 2014.

The University’s four health plans offer different cost structures tailored to match individual health needs of faculty, staff, and residents, including preventive care covered at 100 percent if conducted in-network. While a primary care physician is not required, the Office of Human Resources strongly encourages you to choose one. A list of Strong Health physicians accepting new patients can be found at www.urmc.rochester. edu/primary-care. University Health Service is also accepting new patients.

Need help selecting the optimal plan?

Online help sessionsThe Office of Human Resources offers a variety of online and personal tools to help employees evaluate the plans and make knowledgeable decisions when it comes to health and benefits options:

  • Visit to see the 2014 Medical Plans At-AGlance chart and the 2014 health care and dental premiums rate sheet.
  • Computer access and assistance completing the open enrollment process online is available through Nov. 25 at the Medical Center (Nesbitt G-7545). See the schedule, above.
  • Health care plan comparison presentations on Nov. 20, 21, and 22 will help give employees a clear picture of how each plan works best according to their needs. Once 2014 Open Enrollment ends on Nov. 25, employees cannot make changes to benefit elections (except HSA contribution amounts), unless experiencing a qualifying event.

Ready to get started?

Open enrollment is conducted online through the HRMS website ( with a NetID, or over the phone with ASK-URHR (be sure to have your six-digit employee ID handy).

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