Getting Ready for Open Enrollment 2020

Open Enrollment is right around the corner and it is a great time to review your benefits. How often did you go to the dentist this past year? Are you filling maintenance prescriptions that might be cheaper through mail order? Did you complete your two-step wellness incentive tasks? These are questions to consider when thinking about next year’s benefit elections.

IMPORTANT: All Open Enrollment meetings will be virtual this year!

Due to COVID-19, System Benefits Administration has made the decision to conduct virtual open enrollment meetings by Webex Presentations throughout the month of July. A calendar is posted on the Open Enrollment website and below with information on how to attend your virtual Open Enrollment meeting. Please record this information in advance so you are ready to either call in or log into your meeting by computer.

Here are plan updates for September 1:

  1. The A&M Care full-time premiums are remaining the same for the 5th year in a row; however, other plan premiums, including part-time premiums and the graduate student plan premiums, are changing. Please review the premium sheets found on the A&M System Benefits Open Enrollment website.
  2. Family, group, and marriage counseling will now be covered by the A&M Care, J and 65+ health insurance plans.
  3. A new coverage tier is being added to the A&M Care 65 Plus and A&M Care Plans. Blue Cross and Blue Shield of Texas-designated Blue Distinction Centers have a proven record of delivering specialty care and results. Blue Distinction Center care includes the following categories: bariatric surgery, cardiac care, knee/hip replacement, spine surgery, and transplants. This tier will be covered at 90% coinsurance for inpatient services. The benefits of the Blue Distinction Centers are available to 65 PLUS plan members, but there is no plan savings since, in most cases, Blue Cross and Blue Shield pays what Medicare does not pay for inpatient hospitalizations.
  4. Polycarbonate lenses and standard anti-reflective lenses are now covered in full for participants and dependents enrolled in the vision plan.
  5. The vision premium will have a small increase $.60 per month for employee only and $1.72 for employee and family and include the above additional coverage.
  6. Every 6 years, the A&M System Benefits Administration office is required to bid the insurance plans. This year, during the Request for Proposal process, a new Life Insurance carrier was selected. The Hartford will be the new carrier for FY21, however, there will be no plan changes.
  7. The MDLIVE Virtual Visits copay will decrease from $20 to $10 for the A&M Care, J, and 65 Plus plans. Virtual Visits is a way to conduct doctor’s or behavioral health appointments for non-emergency conditions by phone, video, or the MDLIVE app 24/7. To register for MDLIVE, go to MDLIVE.com/bcbstx and enter the information found on your ID card.
  8. Dependent Life Insurance Plan B has been split into Spouse Life B and Child Life B. This change has not changed the coverage amount and slightly lowered the premium for some enrollees. The premium is now: Spouse Plan B – $1.05; Child Plan B – $0.32 (for one or multiple children).
  9. The Healthcare Flexible Spending Account maximum annual election will increase from $2,700 to $2,750.
  10. The credit hour requirements for voluntary graduate students will be changed from 6 to 5 hours. Continuation coverage for the Graduate Student employee Plan (Grad Plan) will be reduced from 6 months to 3 months.
  11. During a recent records audit, we determined there is no provision to name an alternate beneficiary for Dependent Life Insurance. The beneficiary is the employee or retiree, and if deceased as well, the benefit will go to the estate.
  12. Livongo for diabetes and hypertension, Omada for pre-diabetes and pre-hypertension, and Hinge Health for musculoskeletal conditions are being added as Blue Cross and Blue Shield partner programs. These programs are based on eligibility or diagnosis, and include digital tools to assist with these chronic conditions such as a scale or virtual therapy courses. There will be more information provided about these programs after September 1.

 

Virtual Open Enrollment Calendar and Meeting Presentation Schedule

July 1 – July 31

Below you will find the morning, afternoon, and Retiree Meeting presentation schedules. If your campus or agency meeting is shown on the calendar in the AM, use the AM Presentation schedule for reference. You may join the Webex at any time during the meeting to listen to the vendor presentation for which you are most interested. Click the calendar above, and click on your campus or agency name to quickly get to the Webex meeting for your event. You may also drop off the meeting at any time. You will need the Webex information below to dial in. You may also have received this information from your benefits office via email invite. Please record this information ahead of your meeting.

Call-in Information: 1.855.282.6330 (toll free)
Password: benefits

Access Codes:

TAMIU:  145 341 0876
TAMUCC: 145 785 9574
TAMU-HSC: 145 382 8386
TAMU-K: 145 824 7915?
TAMU (7/13): 145 609 6860
TAMU (7/14): 145 315 7150
TAMUS: 145 679 8555
AgriLife: 145 158 5324
TEEX/TFS/TTI: 145 241 9072
TEES/COE: 145 679 3032
Retiree Meeting: 145 623 6773
WTAMU:145 385 2677
PVAMU: 145 500 0676
TAMUSA: 145 440 6709?
TAMUCT/TAMUT: 145 959 8925
TAMUC: 145 261 3887
Tarleton: 145 863 7222

Fighting Rising Healthcare Costs through Programming

Inflating healthcare costs have been a trending topic in medical, insurance, and employer conversations for many years. Despite high spending on healthcare in the United States, the life expectancy average is 78.8 years compared to a range of 80.7 to 83.9 in 10 other high-income, industrialized countries. Americans pay almost four times as much for pharmaceutical drugs as citizens of other developed countries, according to the Journal of the American Medical Association (JAMA). And, only 90% of the U.S. population has health insurance1.

Attributing to the increasing costs are a surprisingly small group of high cost claimants for most employer populations. A study by the Employee Benefit Research Institute (EBRI) found that generally, “20 percent of those insured by employer-based health benefits in the U.S. account for 80 percent of total spending on health care service” with a mere one percent accounting for 28 percent of total spending.

The study examined 5.8 million, employer-insured individuals that spent $38 billion on healthcare services in 2017 and found that the two percent of the population consistently spending the highest amount for healthcare services in 5 years accounted for 19 percent of total spending in 2017. The individuals had similar characteristics such as the presence of certain medical conditions like diabetes, hypertension, back problems/connective tissues problems, and respiratory diseases, and in most cases the claimants were the spouse of the insurance policy holder2.

Based on this data, it is not surprising to find the A&M System insured population of over 50,000 individuals mirrors these trends. Reports from Blue Cross and Blue Shield of Texas, the health insurance carrier for the A&M System, show that 5 percent of the current health plan population is diabetic (2,241 members), 15% of the current health plan population has hypertension (6,384 members), 20% of the current health plan population has both diabetes and hypertension (8,625 members), and 21% of the current health plan population has a musculoskeletal condition involving the back, knee, hip, neck or shoulder (12.932 members)3.

MyEvive also reported concerning health numbers on the MyEvive health survey that was applied as a wellness incentive credit activity in 2019. 58% of about 15,000 people completed the Heath Assessment and of those respondents, one-fifth self-diagnosed as having hypertension. 39% of respondents identified as having two or less of the indicators of metabolic syndrome, 4% said symptoms of a chronic condition held them back from doing day-to-day activities, and 24% would like to know more about nutrition.4 The infographic below provides more data about the A&M System population and its engagement with activities on the MyEvive checklists.

How A&M System Benefits Administration is responding
The EBRI confirms that cost-sharing is simply not enough to combat the rising costs of healthcare2. Industry experts encourage employers to help employees tackle conditions before they become high cost claimants through wellness programming. In 2018, the A&M System expanded its incentive-driven Wellness Program from employees completing a wellness exam for credit as had been the case for the last 4 years, to completing both the annual exam and the assessment survey. This encouraged employees to access MyEvive, which houses a plethora of benefit program resources, reminds employees about preventive screenings, chronic condition management, and other gaps in care. It also identified areas in the program which could be improved, such as an increase in access to nutritional resources and stress management.

In 2019, the program was again expanded to include more options and programs available to the A&M System-insured population, outside of preventive screenings. Employees were encouraged to take Well onTarget self-management courses, engage with Naturally Slim, or use a virtual service for behavioral health management.

Because the insurance plan has seen favorable results from these efforts and all-time high preventive screening adherence rates, premiums are remaining steady for full-time employees in FY2021, for the 5th year in a row. That is extremely uncommon in the medical insurance community today, with the exponential rising cost of healthcare. The wellness program is again expanding to include preventive skin care screening, nutritional counseling, and flu shots, combined with a new approach brought to us by some new vendor partners. The A&M System and Blue Cross and Blue Shield of Texas have partnered with Omada, Livongo, and Hinge Health to address chronic condition management for diabetes, hypertension, and musculoskeletal conditions in the A&M System insured population. These partners simplify treatment by using digital education and technology, making their programs easy-to-follow and more engaging for eligible individuals.

It is too early to tell if these continued efforts will drive costs down, but all signs point to “yes”. A&M System Benefits Administration continues to adjust wellness programming and insurance plan design to meet the needs of its insured population while maintaining a robust benefit package for everyone enrolled.

 

1- JAMA. “Health Care Spending in the United States and Other High-Income Countries.” https://jamanetwork.com/journals/jama/article-abstract/2674671
2-https://www.ebri.org/docs/default-source/ebri-press-release/pr-1254-highcostclaims-24oct19.pdf
3-This data is based on claims and provided to the A&M System Benefits Administration Office as aggregate, demographic data to protect the privacy of individuals according to HIPAA laws.
4-This data is based on aggregate data from an anonymous survey and individual details are not shared with A&M System Benefits Administration according to HIPAA laws. MyEvive Annual Report.

Two-Step Wellness Program Reminder

Two-Step Wellness Program Reminder

When logging into MyEvive, employees and covered spouses may see up to 7 health and wellness activities on their MyEvive Personalized Checklists (PCL). These may include your annual wellness exam, nationally-recommended preventive screenings, registration in various benefit programs, self-paced wellness courses, and more. They are personalized based on general demographic information and recommendations from the United States Preventive Services Task Force. Some items, like Naturally Slim, show up for everyone by default because System Benefits Administration does not receive personal health data to know who may or may not be eligible to participate. You can choose any two activities to complete for the incentive credit for FY21. Credits are applied to the next plan year for tasks completed in the current plan year*.

Completing any two steps on your PCL will ensure that you have the lowest rate for your health insurance premiums. Be sure to complete these activities by August 31, the extended deadline, and allow some time for processing! Retirees and graduate student employees enrolled in the Graduate Plan already receive the lower premium and do not need to participate. The Blue Cross and Blue Shield-Well onTarget Health Assessment and your annual wellness exam will still count as the alternative to using the MyEvive portal.

*Those who had not yet completed the HA and Wellness Exam to receive credit for FY20 can still complete these two tasks to receive their credit for the remainder of this fiscal year. If one of those checklist items was completed in FY19, you must then complete one more task to equal two tasks in the current plan year to receive the credit for FY21. The checklists will restart in FY21, with no partial completion accepted; simply complete two tasks in FY21 for credit in FY22.

Some new wellness tasks will be replacing some existing ones at the start of the new plan year so be looking for those!

Navia Flexible Spending Account Updates

Due to COVID-19, the IRS has allowed some changes to the Flexible Spending Account process for the rest of the plan year:

  • Mid-year election changes for health care and dependent day care FSAs for the remainder of the 2020 plan year will be allowed with or without a qualifying Life Event. This change allows participants to enroll, drop, decrease or increase their election. Contact your Benefits Office if you would like to make a change to your monthly deduction, and it will become active the following month. Participants may not decrease their health care FSA election beyond the amount that they have already been reimbursed.
  • The FSA Grace Period for expenses incurred and charged towards a participants’ FY2020 account(s) has been extended through December 31, 2020. Previously the grace period ended on November 15 of the following fiscal year.

Expanded Debit Card Usage*

Participants with Navia Dependent Day Care Accounts can now use the Navia Benefits debit card to pay for day care expenses. Participants will be able to swipe their debit card to pay eligible providers directly, rather than submitting claims and waiting for reimbursement. The addition of the debit card makes paying for daycare simple, quick, and efficient. This is a permanent change.

Day Care debit cards were activated in June for:

  • Participants who already have a Navia Benefits debit card, their Day Care FSA funds were automatically made available on the card on the release date, and
  • Participants who do not have a Navia Benefits debit card who should have automatically received a card at their address on file.

If you don’t have a Navia debit card and would like to request one, log in to your Navia account at https://naviabenefitsolutions.com.

*The Navia Benefit card may be declined at some daycare providers because they are not an approved vendor.

Grandchild Dependent Annual Re-certification

According to Texas Insurance Code Section 1251.151, in order to be considered an eligible dependent, your grandchild(ren) must be claimed as a dependent on your income tax return. If you are an employee or retiree covering your grandchild as a dependent, you should have received information regarding the re-certification of your grandchild. Be sure to submit your Certification Form along with documentation to your Human Resources Office. Accepted grandchild documentation is a copy of the portion of your most recent income tax return that states you are claiming your grandchild as a dependent. You may redact (cross out) any proprietary information. Contact your human resources office if you have any questions. You have until August 31 to submit your documentation.

Need a New ID Card?

Misplacing your insurance ID cards can be a pain when trying to go to an appointment or get a prescription! You can follow the steps for each insurance plan below to get a new ID card, and then keep them all in one place. MyEvive also has the ability to save images of multiple ID cards, so all you need is your phone and the MyEvive app the next time you need your card. 

Blue Cross and Blue Shield of Texas
1. Log in to your Blue Access for Members account at https://bcbstx.com/tamus
2. From your dashboard, click the image of the ID card on the left hand side.
3. You can print a paper copy of your ID card, or order one from this page!
4. If ordered, a new ID card will be mailed to the address on file within two weeks.

Express Scripts
Retirees on the 65 plus plan and their spouse will have separate ID Cards.
1. Log into your Express Scripts account.
2. Select the Account tab from the main menu.
3. Click Member ID Card.
4. Download your card from this screen.

Superior Vision
Although you are not always required to present your vision ID card, it is good to keep for your records.
1. Go to Superiorvision.com and select “Member Log in” in the top right.
2. Log in using your username and password.
3. From the home page, select Print ID Card from the menu.

All of these accounts can also be linked to MyEvive with single-sign-on capability! This means, once you log in through MyEvive once, you can go straight into your vendor account from the MyEvive app.