New, revised health care plans mean higher costs for faculty, staff

With the cost of providing health care benefits for employees on the rise across the nation [see Sept. 16-22, 2002 Register], faculty and staff can expect to pay more of the costs beginning in 2003, according to University officials. As such, employees eligible for health care benefits will have new options from which to choose during the annual open enrollment period Oct. 2-18. Changes made during open enrollment — generally the lone time of the year employees may modify their benefits package — will go into effect Jan. 1, 2003.

“Vanderbilt will continue to pay the great majority of health plan costs,” said Jerry Fife, interim chief human resource officer. “But faculty and staff will share some of the higher costs. Coverage will be more expensive in most cases. However, we have maintained a $15 co-payment for well care, which includes preventive care physicians office visits for such things as annual checkups, children’s immunizations, and mammograms.”

Higher Premiums
While medical plan premiums will increase for two of the three plans, the higher rates are modest compared to the millions of dollars in higher costs for the plans, according to Fife. More important than the dollar amount of the increases is the fact that Vanderbilt is freezing the premiums for the Vanderbilt Preferred plan, and introducing a single new low-cost option.

“The idea behind cost structure of all today’s options is to have people choose coverage based on plan benefits and networks,” said Fife. “That is what most people think is important, and this will help simplify the process of choosing a plan.”

New Plan — Blue Cross Select (S)
Along with changes to current plans, Vanderbilt will introduce a new, low-cost option for 2003, the Blue Cross Select (S) Plan. It will cost less in payroll deductions to participate in the plan, but participants also risk higher out-of-pocket expenses for medical services.

“Think of the new plan as a safety net,” said Fife. “It is an important choice. Everyone should have medical insurance. Most people will continue to want traditional coverage, and that is reflected in our continuing the existing choices. The S Plan is simply a new option.”

Costs can add up quickly. For example, after meeting a $300 annual deductible, S Plan participants will pay 40 percent of the cost of most in-network services. A $1,000 co-pay applies to each in-patient hospital stay, and there is a $100 deductible before prescription drug benefits take effect.

In the event of a serious illness, an S Plan participant could easily meet the plan’s $3,000 annual out-of-pocket maximum — which includes the participant’s 40 percent share, but not any deductibles or co-pays.

New Features in Existing Plans
Two of Vanderbilt’s existing health care plans — Blue Cross Preferred and United Healthcare — will continue, but with numerous new features. Physician office visits will cost from $20 to $30 in-network. Prescription drug costs will range from $15 for a generic to $45 for some brand-name medications. For most other care, participants will pay as little as 10 percent of costs for services from network providers, after a $300 annual individual deductible.

Each of the plans also features the freedom to go out of network for care, though it will cost considerably more. Going out of network will cost participants 40 percent of covered expenses — plus any excess amounts that are not covered, since out-of-network providers are not limited in how much they can charge.

Dental Plans, Other Changes
Although the dental plan names will change, coverage options will remain relatively unchanged for 2003. The Denticare/Preferred Plan will be the Legend Peak Plan (Peak). The Pro Three Plan will be the Fortis Freedom Advance Plan (Freedom).

FlexBen Corp., a new vendor, will process personal spending account and flexible reimbursement account claims.

“Vanderbilt is continuing to provide top-quality benefits for faculty and staff. However, it is more important than ever to make informed choices during open enrollment,” said Fife. “We would like for people to be satisfied when they choose and when they use their benefits.”

Open forums and a benefits fair is scheduled during Open Enrollment, which runs Oct. 2-18.

Posted 9/30/02 at 10 a.m.