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Health benefits changes announced
Open enrollment period begins Monday

May 18, 2007
By Gina Calcamuggio

Starting July 1, Ohio University employees will see an increase in their share of health benefits coverage. The move, which marks the first time since 2003 the university has increased employee premiums, is in response to continuing increases in health-care costs for the university and projected budget shortfalls for the upcoming biennium.

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Several information sessions have been scheduled to answer employees' questions about the health benefits changes and open enrollment. Here is a list of those sessions.

Employees can learn more about open enrollment and benefits changes and review related information at www.ohio.edu/hr/

In an effort to help close projected budget gaps, the Budget Planning Council charged an 18-member, universitywide health benefits committee with finding ways to reduce the university's health-care expenses by $1.5 million while keeping the employee share manageable and competitive with other institutions. 

Current projections indicate the benefits program will cost the university $35.4 million this year, up 40 percent from the $25 million it cost in 2002. By fiscal year 2010, the university's share of the benefits budget is projected to grow by 20 percent, to $44.3 million.   

"We're doing this to avoid bigger cuts elsewhere in our budget," said Vice President for Finance and Administration Bill Decatur. "This helps us protect jobs and our core academic mission while still providing our employees with a very competitive benefits program."

Even with the increase, the amount Ohio University employees pay for coverage is among the most affordable for higher education institutions in the state and nation, according to independent benchmarking data collected from 160 colleges and universities nationwide by Mercer Consulting. For example, Ohio University employees with single and family plans pay no deductible for in-network coverage compared to a national higher education average in-network deductible of $417/single and $888/family; a Midwest average of $377/single and $825/family; and an Ohio public college and university average of $173/single and $435/family.

The upcoming changes will occur in six areas:

  • Employee premiums. Premiums still will be based on salary and family size. As a percent of total benefits costs, employee premiums will increase from 7.5 to 9.8 percent, keeping Ohio University well below national higher education averages, which Mercer's data indicated can range from 18 to 30 percent. For an employee earning $45,000 a year, these premium increases would equate to $6.20 more a month for single coverage, $12.41 additional for single plus one coverage and $18.61 more a month for family coverage. This is the first increase to employee premiums in four years.

  • Number of salary brackets. To provide greater equity in premium levels, nine brackets evenly distributing employees by salary range, will be used to determine premiums. Previously, there were only four groupings. Employees earning less than $30,800 will pay the lowest premiums and those earning more than $82,601 will pay the highest premiums.

  • PPO co-insurance maximum. Employees will continue to pay $15 for office visits. Benefits coverage for other procedures (X-rays, lab tests, etc.) will continue to be paid at 90 percent with employees paying 10 percent in co-insurance until they reach the co-insurance maximum, when most claims are paid at 100 percent. The co-insurance maximum is increasing from $500 to $750 for single coverage and from $1,000 to $1,500 for family coverage annually.

  • Mail order prescriptions. Co-pays for retail pharmacy-provided prescriptions will remain at current rates: $10 for generic, $20 for formulary and $30 for non-formulary. Co-pays for mail-order prescriptions will increase to $15 for generic, $30 for formulary and $45 for non-formulary.

  • Formularies. EnvisionRx will begin transitioning the university's drug plan to its formulary. When it assumed administration of the university's drug plan in July 2006, EnvisionRx agreed to continue Medical Mutual/Medco's formulary to lessen the impact of the transition. Information regarding Envision Rx's formulary will be available in the coming weeks.

  • Basic Medical Plan will no longer be offered. This plan had served as an alternative to the PPO plan and offered no payroll premiums or set physician network but did require a high deductible and high co-insurance maximum. To streamline the benefits program, the Basic Plan will be eliminated. HR will work directly with the 140 employees who subscribe to this plan to help them understand their options.

There will be no changes for the rates employees pay or the benefits provided for the dental and life insurance programs. 

"Ohio University remains committed to providing a comprehensive and competitive benefits package for employees and their families," said Jim Kemper, associate vice president for finance and administration for human resources. "The committee worked hard to ensure these needed changes had the least impact on Ohio University families."

According to Greg Fialko, director of compensation and benefits and a member of the health benefits committee, the group reviewed many different options for how to charge employees before reaching consensus on the list. 

"Assessing premiums through the nine salary brackets ended up as the unanimous decision," Fialko said. "These changes distribute cost increases to all employees through the payroll premiums as well as to benefit users through the increased drug co-pays and co-insurance maximums." 

The university's annual open enrollment process begins Monday, May 21, and continues through Friday, June 1. Employees should watch campus mail on Monday for information regarding this process. 

"As always, we want our employees to get the information and assistance they need to fully understand their benefits program and choices," Fialko said. "HR will be hosting a number of information sessions to assist in that effort." The first session will be from 3 to 4 p.m. Monday, May 21, in Room 141/145 of the Human Resources Training Center. Fialko said additional sessions will be announced on HR's Web site, including a video conference for members of the regional campuses. 


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Published: Jul 20, 2006 3:50:00 PM
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