Open enrollment for health benefits begins April 9

Open enrollment for health benefits begins Monday, April 9, and ends Friday, April 27, at 11:59 p.m. All selections and changes must be made online via Esther (http://esther.rice.edu) and will be effective July 1.

Although medical premiums are increasing slightly, the Rice benefits plan will remain largely unchanged, said Janel Edson, benefits manager.

The monthly premiums are going up by 6 percent; however, the increase is half of last year’s premium increase, which Edson attributed to more thoughtful use of benefits by employees.

“A lower increase in premiums this year is a result of our employees making smart choices in terms of their care,” Edson said. “What employees are not always aware of is that the usage/claims of the plan is a major component that drives the premium increase. When employees take responsibility and are conscientious of their choices, it saves everyone money.”

For example, this past year emergency room use decreased by 18 percent, Edson said, and more employees are using urgent-care centers for nonemergent issues. Since emergency room copayments for the HMO, POS and PPO plans are $150 and urgent-care center copayments are $50, employees who made more careful selections for appropriate care helped save Rice — and themselves — more than a quarter-million dollars, she said.

Rice also saw savings over the past year from more employees choosing generic prescription drugs rather than brand name as well as from more using the mail order prescription program, she said.

For the 2012-2013 plan year, the monthly cost for the RiceCare HMO plan for an employee only will be $81; for employee plus spouse/partner, $307. The monthly cost for the RiceCare Flexplan (POS) for an employee only will be $126; employee plus spouse/partner will be $447. For RiceCare PPO, the monthly employee-only cost will be $214; employee plus spouse/partner will be $649. For RiceCare Catastrophic, the monthly employee-only cost will be $56; employee plus spouse/partner will be $189.

Depending on the plan, Rice picks up the tab for between 63 and 84 percent of the monthly cost of the premium.

This year the pharmacy benefit program will remain unchanged; copays and coinsurance, the portion of the drug cost that employees are responsible to pay, will remain the same. For all plans, generic drugs cost $10; formulary brands cost $30; nonformulary brands cost $50; specialty medications cost 25 percent of their price, up to $75. A three-month supply of generics by mail order is $20; formulary brands are $60; and nonformulary brands are $100.

One significant change this year is the limit on medical spending accounts. Per health care reform legislation, the maximum amount that each employee can contribute to a medical spending account is $2,500.

Another change is the addition of network chiropractic coverage for the HMO, Flexplan (POS) and PPO plans for up to 20 visits per plan year.

Dental plans will remain unchanged and rates for the dental maintenance organization (DMO) will remain the same — $13.28 per month for employee only; $24.18 for employee plus one; and $33.86 for employee plus two or more. Rates for the United Concordia Indemnity Dental Plan will increase slightly — $44.62 per month for employee only (a $1.51 increase); $88.96 for employee plus one (a $3 increase); and $130.19 for employee plus two or more (a $4.40 increase).

A summary of the changes in the benefits plan is available at benefits.rice.edu, along with other information.

Benefits open enrollment must be completed online via Esther. Faculty and staff will need their user ID number from the employee ID to access their account (be sure to use a capital “E”). The PIN is a 6-digit number that they selected.

Employees who miss the April 27 deadline for open enrollment will automatically be re-enrolled in their current plan, but without any contributions to a medical spending account. Employees must re-enroll each year to set their medical and dependent-care spending account contribution, even if they are currently enrolled in the plan. The account is reset to $0 each year unless employees actively re-enroll through Esther.

Employees who are not making any changes to their current medical plan do not have to do anything unless they want a to contribute to a medical or dependent-care spending account.

Human Resources representatives will be at RiceFest April 10 from 11 a.m. to 3 p.m. in Rice Memorial Center to answer questions about open enrollment. Employees also can contact benefits representatives at benefits@rice.edu or 713-348-2363.