As part of compliance with the Affordable Care Act (ACA), the A&M System Benefits Administration Office is required to request Social Security Numbers (SSNs) for covered dependents. This information will remain confidential. If you have dependents covered through your A&M System health plan for whom you have not provided an SSN or if you are unsure as to whether you have previously provided your dependent’s SSN(s), go online to Workday (https://sso.tamus.edu/) to check and enter an SSN. After logging into Workday, click on the Benefits Worklet. On the Benefits screen, select Change Dependents.
When logging into MyEvive, employees and covered spouses in the A&M Care Plans will see a variety 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. Items on your checklist are programmatically displayed based on age/gender, United States Preventive Task Force Guidelines on preventive screenings, and then educational wellness activities. Some items, like Naturally Slim, show up for everyone by default because System Benefits Administration does not receive personal health data to single out those services. 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*.
As we face the COVID-19 national emergency together, the safety and well-being of our employees, their families, and their communities is our top priority. That’s why we encourage you to delay any non-essential care you may have coming up, like biometric screenings and annual wellness exams. It can help lower the risk of spreading COVID-19 to others, and ensure that healthcare resources are there for the patients who need them the most. Accordingly, we extended the wellness incentive program completion date to August 31st, 2020. Please also note there are several checklist activities that can be completed virtually and we encourage you to participate in those programs to promote your health and wellbeing during this stressful time.
Completing any two steps on your PCL will ensure that you have the lowest rate for your health insurance premiums. 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 (BCBS HA) and your annual wellness exam will still count as the alternative to using the MyEvive portal. The BCBS HA may not be paired with an activity other than the wellness exam for credit.
*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 this fiscal year. You will then complete one more task to equal two tasks in the current plan year to continue receiving the credit in FY21.
The System Employee Benefits Advisory Committee met for the second time during FY20 on February 22, 2020. The current state of the benefit plans was discussed. Below are some highlights from the meeting:
- Health plan enrollment increased slightly as the number of employees and retirees overall has increased since last year. There are currently 30,738 covered employees and retirees, and 25,819 covered dependents. Total paid claims for the health plan are slightly higher than at the same time during FY19 and total $105.7M as of the end of December.
- System Benefits Administration is required to bid the health plan every 6 years. Requests for Proposals were submitted for two carriers, and Blue Cross and Blue Shield will remain the health insurance plan provider for FY21-FY27. Their bid offered significant savings in provider discounts over the next closest bidder.
- The Life Insurance and Accidental Death and Dismemberment Request for Proposals are currently under review by the A&M System. The finalist will be announced on April 22.
- MDLIVE, the virtual visit service that allows covered plan participants to talk to a doctor via video and phone, has been active for 18 months. We are performing better than book of business for utilization comparable to other higher education entities.
- Blue Cross and Blue Shield of Texas reported that cancer continues to be the System’s highest diagnostic category followed by musculoskeletal and circulatory conditions. Breast cancer is our highest-cost cancer and most prevalent with 7/1000 claimants per year. Cervical/colorectal cancer costs remain below benchmark, which is attributed to early detection from the preventive screenings. System Benefits Administration continues to use this data to strategically assess the employee wellness program and participation in preventive screenings.
- A&M System participants are above the BCBSTX benchmark on all preventive screenings (Colon, breast, wellness, well-baby, well-child, etc).
A&M System Benchmark Cholesterol 58.5% 37% Annual Wellness Exam 69% 39.6% Mammmograms 62.7% 45.6%
- Health plans are evolving towards a wellbeing management structure, which involves increasing targeted communications to raise awareness and boost utilization of existing programs.
- The biggest cost driver in student plans for last year across the country, as well as in our plan, was prescription drugs.
Coinsurance, a term found in every health insurance policy, is your out-of-pocket expense for a covered medical or health care cost after the deductible has been paid on your health care plan.
The insurance company generally pays more of the coinsurance, expressed as a percentage of the cost of service. Common divisions are 70/30, or 80/20, like the A&M Care Plan.
So if your medical bill is $1,400 and you have a $400 deductible, the portion of the bill to which coinsurance will apply is $1,000. For a plan with 20% coinsurance, you would pay:
$400 deductible + $200 (20% of remaining $1,000) = $600
Copayments do not go toward your deductible. In our A&M Care plan, most office visits have a copay that you pay without having to first meet your deductible. However, if you have in-office surgery that costs more than $500, expect to pay 20% of the cost after the deductible is met.
Did you know that many people with diabetes have to ration their insulin because they can’t afford to take it as directed? That’s why the A&M System and Express Scripts have partnered to bring down the cost of preferred insulin products for you and your family members living with diabetes.
Through the new Patient Assurance Program, eligible members will never pay more than $25 per 30-day supply of preferred formulary insulin products. That can mean more affordable access to insulin and fewer health emergencies. It’s already included in your benefit – so there’s no additional fee! Mail-order participants will continue to pay the standard, lower copay.
Questions about the Patient Assurance Program or your benefits? Contact Human Resources or Express Scripts at 1-866-544-6970 for more information or details about preferred medications.
Using Your Benefits While Traveling
The holidays are approaching and this is the most popular time of year for employees to travel. Make sure you are covered if you need medical care while traveling.
First– Save all of your information
Do you know your Group Number and Insurance ID by heart? No? That’s okay. The MyEvive app lets you save space in your carry-on and upload your insurance ID cards to your phone! Download it using the Employer Name: Texas A&M University System.
Medical and Prescription Drug
You should keep a list of your emergency contacts on hand, and save the Blue Cross and Blue Shield BlueCard customer service number: 1-866-265-1212. A Benefits Value Advisor can help you find in-network services in the region you are traveling. The BlueCard Program* helps Blue Cross and Blue Shield of Texas (BCBSTX) members get needed health care when you travel outside your plan service area.
If you need a prescription drug supply for a period longer than 30 but less than 90 days, have your physician write a prescription for the needed dosage and send it directly to Express Scripts (ESI) with one mail-order copayment (twice the retail pharmacy copayment).
- Your 90-day mail-order prescription should be sent to:
Express Scripts, Inc.
P.O. Box 650322
Dallas, Texas 75265-0322
Or, you may ask your doctor to call 1 888 327-9791 for instructions on how to fax the prescription to Express Scripts. Your doctor will need to use your social security number or ESI member ID number to complete the transaction. (Only doctors can fax prescriptions to ESI.)
If you have more than one prescription filled, send one copayment for each prescription. Be sure to start this process at least three weeks before your departure date. First-time orders arrive within 8 to 11 days. Refills usually arrive in less time – 7 to 9 days. The best time to reorder is when you have about a 14-day supply of your medication remaining. This will help ensure that the medication is received when it is needed.
The only thing worse than getting sick while traveling is losing your contact lenses. Pack at least two extra pairs of contact lenses while traveling so you have replacements. To locate a network provider in the area in which you will be traveling, or to get information on how the plan handles claims for services you receive while traveling, contact Superior Vision at (844) 549-2603.
Within the United States, you may use any licensed dentist for covered services. Generally, you will pay less out-of-pocket by using a PPO network. Delta Dental’s National Dentist Directory is online at www.deltadentalins.com.
*The BlueCard Program is not available for Medicaid and Medicare Advantage members