Health care edition of Currents (.pdf)

FAQ: Health care plans

Do employees have to choose a new health care plan for 2011?

No. If you’re happy with your current health plan, no action is needed. The open-enrollment period provides you with a chance to change plans, if desired.

When is the open-enrollment period?

The University’s 2011 Health Care Program Open Enrollment will be held Thursday, Oct. 28, through Monday, Nov. 29, 2010.

How do I make changes to my current plan?

Make your 2011 health, dental, FSA, and HSA changes and elections online at www.rochester.edu/people during open enrollment.

What are the plans offered?

There are four health care plans for employees to choose from. The plans are designed to provide an equitable distribution of costs across all employee levels but also provide plenty of flexibility for people to find a plan that works well for them.

The four plans are Preferred Provider Organization (PPO), which include a a low deductible plan, a high deductible plan, a HSA-eligible account, and a copay plan.

Will I be able to use my doctor?

Yes. Aetna and Excellus will continue to be the University’s third-party administrators (TPA), and both offer national provider networks. Under the four options, you will have the freedom to visit any provider you choose, no matter which option you select. But if your doctor is a participating provider in Aetna’s or Excellus’s networks, you will generally save on out-of-pocket expenses. Visit Aetna’s Web site, www.aetna.com, and the Excellus Web site, www.excellusbcbs.com, to view the doctors and facilities that are participating in-network providers for each TPA.

Can I add my young adult child back as a dependent under my health care plan for 2011?

Under federal health care reform legislation, you can add your biological child, stepchild, adopted child, or foster child up to age 26 as a covered dependent if he or she does not have access to other employer health coverage (except another parent’s coverage). Though not covered under federal health care reform, you can also continue coverage for other recognized children (unmarried grandchildren, nieces, nephews, or other children) up to age 24 who live with you in a parent-child relationship, whom you claim as a federal tax dependent, and who does not have access to other employer health coverage. (You will need to complete a Dependent Verification Form to continue coverage for other recognized children. The form can be found on the Benefits Office Web site, www.rochester.edu/benefits.)

Do all employees—regardless of their salary—have to contribute the same amount under the plans?

The health care plan task force was careful to make sure that the costs of health care did not fall disproportionately on any single group of full-time employees. Full-time faculty and staff earning less than $44,100, for example, will pay less in payroll deductions and out-of-pocket costs, while those earning more than $110,100 will be required to pay more.

Are flexible spending accounts still available?

Yes, they are an option for those who want to set aside a fixed amount of pretax money to pay for eligible health care expenses. The accounts cover expenses in that calendar year.

What is the difference between HSA or FSA?

The University offers two types of spending accounts to help you save on taxes when you have eligible health care, dental, and/or dependent care expenses.

If you participate in a Flexible Spending Account, you choose how much to contribute for the plan year. Each pay period, your contributions are automatically deducted from your paycheck in equal amounts—before taxes—and deposited into your FSA. Then, when you incur an eligible expense, you get reimbursed from your account.

A Health Savings Account is like your own health care checking or savings account. You can make pre-tax contributions through payroll deductions to your HSA. How you use the funds is up to you—you can use them to pay for eligible health care expenses until you meet your deductible, or you can save them for future expenses. You will never pay federal income taxes on your HSA as long as you use the funds for qualified health care expenses. You can contribute to a HSA only if you enroll in the University’s HSA-eligible plan.

If I had a health care and/or a dependent care FSA or an HSA account in 2010, do I need to make an election in 2011?

Yes, even if you had a health and/or dependent care FSA or HSA account in 2010, you will need to make your 2011 contribution choice during open enrollment. Federal regulations require an annual election for the tax-free accounts. Carefully consider your anticipated 2011 FSA contribution needs—an FSA can’t be changed during the year without a qualifying event such as the birth of a baby, marriage, or death of a spouse. Also, any FSA funds can’t be rolled over to the next year. Funds not used in 2011 will be lost.

How can I estimate my health care expenses in the future?

To start the process of evaluating which plan will work best for your situation, you can access past claims online through Aetna or Excellus. The Benefits Office offers an online Health Care Cost Estimator, which can help employees calculate and analyze their expected costs under each plan. The tool is available at https://yourhealth.rochester.edu.

If I change my mind, can I switch plans?

Employees may change plans during the open-enrollment period that takes place each fall. In addition, changes to health care coverage are allowed within 30 days of a qualifying event—such as the birth of a baby, marriage, or death of a spouse.

What personal health and wellness programs does the University offer?

If you need guidance to make healthy changes or to help manage a chronic condition, the University has partnered with Carewise Health to offer personal wellness and personal health programs. The programs teach strategies to make appropriate lifestyle choices and changes to help you improve and manage your health and reduce symptoms related to chronic conditions. The personal health programs can help you manage asthma, diabetes, low back pain, heart disease, and more. The personal wellness program can help manage stress, tobacco dependency, weight, nutrition, and more.

Visit www.rochester.edu/working/hr/wellness to learn more.

Next page: Health Care Lingo