Effective, informed health care consumerism credited for 2016 improvements
For the third year in a row, Purdue faculty and staff will have no increases in medical premiums. What’s even better is that Purdue will offer improved, enhanced versions of the same three medical plan options next year without changes in deductible or coinsurance.
“Purdue is dedicated to providing its employees with excellent benefits that meet their needs and those of their families,” said Eva Nodine, director of benefits in Human Resources. “In 2016, we are pleased to extend autism coverage to include Applied Behavior Analysis (ABA) therapy, enhance your vision benefits and provide preventive dental – all with no increase in cost to employees.
A recap of the 2016 program changes include:
- Autism coverage will be expanded to meet the Indiana Health Insurance Mandate for Autism Spectrum Disorders.
- Bariatric surgery will be covered if patient meets Anthem-specific minimum requirements.
- Individual out-of-pocket maximums ($6,850 for in-network and $13,700 for out-of-network) will be implemented for family-level coverage on the Purdue Health Plan Plus HSA 1 and Purdue Health Plan Plus HSA 2. No one person within family-level coverage will pay more than $6,850 of the $7,000 (for HSA 1) or of the $10,000 (for HSA 2) in-network out-of-pocket maximum. For out of network, no one person within family-level coverage will pay more than $13,700 of the $14,000 (for HSA 1) or of the $20,000 (for HSA 2) out-of-pocket maximum.
- Preventive dental through Delta Dental, including two cleanings, one fluoride treatment (up to age 19) and standard X-rays up to a $500 per person maximum will be included for all benefits-eligible employees who elect medical coverage. Dependents covered under a Purdue medical plan will also automatically receive this coverage. As part of the preventive coverage, all benefits-eligible employees covered on a Purdue medical plan, as well as their covered dependents, will receive Delta Dental discounts for all procedures done by an in-network dentist.
- Prescription drug coverage will see several changes affecting prior authorizations, drug quantity management, preferred formulary list and specialty drugs. Employees impacted by these changes will be contacted directly via letters to their homes. Additional assistance will be available to employees via the Center for Healthy Living’s pharmacist, Kamal Singh, PharmD, at no cost.
- Vision coverage allowance for frames and contact lenses will see a slight increase. Contact lenses allowance will increase from $120 to $130. Frame allowance will increase from $130 to $150. Coverage allowance increases to $200 for VSP featured frames, which are frames endorsed by VSP.
“Employees shared their requests for improved benefits coverage and positive additions to the plans,” said Nodine. “Those requests were heard, and due to how much our faculty and staff have embraced and supported the plans over the last two years, we were able to make significant improvements to all three plans. Their effective decision making and dedication as informed health care consumers has made this possible.”
According to Nodine, being able to not only keep premiums the same again but also adding in the improvements to the coverage is something we should be very proud of accomplishing. She credits employees for being wise health care consumers and doing an excellent job of “shopping” for health coverage using the Castlight tool. Using resources available at each campus, such as the Center for Healthy Living on Purdue’s West Lafayette Campus, to improve employee health also contributes to the enhancements we will see in 2016.
Providing on-site preventive care as well as care for chronic conditions and acute illnesses, the Center for Healthy Living plays an important role in employees’ health and wellness.
The Center provides numerous health management and wellness programs throughout the year at no cost to benefits-eligible faculty, staff and family members age 8 weeks and older who are covered on a Purdue health plan. Additionally, the Center offers health coaching and support for nutrition, stress management, physical activity and more.
“This smart consumerism, in conjunction with the change to Anthem as our medical vendor in 2014, has saved employees money and allowed the University to maintain stable premiums for three years in a row. We are working hard to improve employee wellness in 2016 and beyond to keep Purdue below the market trend.”
To help faculty and staff in their efforts to be wise consumers, Purdue will continue to offer Castlight and will once again provide the Truven Informed Enrollment tool so that employees can review their 2015 claims history and estimate which 2016 medical plan may be best for them.
Open enrollment begins Oct. 26 and ends at 6 p.m. Eastern Time on Nov. 13. No changes will be able to be made after this time unless there is a qualifying life event (change in family status).