Dialogue: Open Enrollment
Benefits Manager Tom Sherr answers questions on Open Enrollment for 2006
What is Open Enrollment?
It's the period of time when benefits-eligible employees may sign up for or change their benefits. Unless you are a new hire or have a life-changing event, such as getting married or having a child, this is the only time that you may make changes to your benefits.
What's new in benefits this year?
There are several enhancements to our employee benefits package this year, including:
A change from Tufts Health Plan to Blue Cross Blue Shield of Massachusetts (BCBSMA);
Three additional earned time days for most benefits-eligible employees;
Elimination of the waiting period for dental, disability and life insurance benefits;
Employer contribution of 10 percent toward short-term disability coverage;
An increase in the short-term disability weekly maximum from $1,000 to $1,500;
An increase in the amount of cash back when employees opt out of health benefits;
A change from a pre-tax to a post-tax disability offering;
An increase in the T-pass and bus pass subsidy from 35 to 40 percent;
An increase in tuition reimbursement; and
An increase in adoption assistance.
Why has Children's switched from Tufts to BCBSMA?
BCBSMA is known for consistently providing excellent member services. Their HMO Blue New England network offers access to 32,000 providers and 228 hospitals across New England, with significantly improved access in Rhode Island, Connecticut and New Hampshire. In addition, the BCBS National BlueCard PPO program offers seamless network benefits nationally and access to more than 650,000 preferred providers and 6,000 hospitals, providing better access for all of our employees and their dependents.
BCBSMA also has extensive resources, processes and systems to more efficiently process claims, resolve member issues, track payments and create more cost-effective utilization over time.
Are the BCBSMA plans similar to the Tufts plans?
We will offer three BCBSMA health plans that mirror the Tufts plans. In most cases, the BCBSMA plans offer identical benefits to those provided by Tufts. We are still offering an HMO Value Plan, an HMO Premium Plan and a Point of Service Plan identical to the Health Plans offered in 2005.
Will I have to pay more in premiums?
Health care premiums will increase by approximately 15 percent this year, but as many people know, the cost of health and prescription drug programs has steadily increased in the past several years. However, BCBSMA has numerous programs in place to manage claims costs and still provide a high level of care.
Is my doctor on the participating provider list?
Your current doctors are most likely part of the BCBSMA network. Go to www.bcbsma.com to double-check.
Do I have to change doctors?
You probably won't have to change doctors. But, in the unlikely event that your doctor doesn't participate in the network, you may want to consider selecting the Point of Service plan, which provides benefits for care received from non-participating providers.
I liked the Tufts "Optimal Me" program. Does BCBSMA offer any wellness plans?
BCBSMA offers a variety of disease management programs for illnesses such as asthma, diabetes, heart problems, and several stress management, healthy eating and exercise programs designed to keep you and your dependents healthy and happy.
Will my prescription costs stay the same?
Generally, your prescription drug co-pays will remain the same, with the exception of Tier 2 drugs on BCBS's formulary. In this case, the co-pay will be less than the current co-pay. In the event that a drug is considered "non-preferred," or Tier 3, and it was preferred, or Tier 2, under the Tufts plan, the co-pay would be more. In this case, we would recommend that you speak with your physician to determine if there are more cost-effective alternatives, like switching to a different medication.
Whom should I contact if I have
questions about my benefits?
You should contact a benefits representative in Human Resources at ext. 5-7790 or firstname.lastname@example.org.