Most people know that the emergency room isn’t always the best place to go when a medical condition arises. But when your child is bleeding or you aren’t sure how injured or sick you are, you might not have time to carefully consider your options for care.
The decision has gotten more complicated recently, with the growth of stand-alone emergency centers that now offer convenient—but not always affordable—care in many communities. It can be easy to confuse a stand-alone emergency center with an urgent care clinic, but you might feel the difference in your wallet later.
That’s why it’s good to think ahead—and to know in advance where to go for what types of situations or conditions. MedlinePlus, a service of the National Institutes of Health (NIH), offers the following guidance.
The need for speed is a good indicator of an emergency. The NIH notes that if you think a person or unborn baby could die or be permanently disabled, it’s an emergency.
Call 9-1-1 to get help immediately if the situation needs immediate attention, such as:
- lack of breathing,
- a head injury in which the victim has passed out or fainted, or acts confused,
- an injury to the spine, especially if there’s loss of feeling or movement,
- an electric shock or lightning strike,
- severe burns or
- a seizure lasting three to five minutes.
Go to an emergency room or call 9-1-1 for problems like:
- trouble breathing,
- passing out or fainting,
- severe chest pain or pressure,
- unexplained or severe pain in the arm or jaw,
- sudden inability to speak, see, walk or move and
- deep or serious wounds.
Urgent Care Situations
Go to an urgent care clinic for:
- common illnesses, such as the cold, flu, or an earache
- minor injuries, such as sprains, minor cuts and burns, or minor broken bones (such as toes).
If you aren’t sure, call your doctor’s office, or call the HealthSelectSM of Texas myNurseLine: (877) 731-8306, or 7-1-1 for TTY
Plan ahead by learning what services and facilities are in your area and in your health plan’s network—before you have a health issue. Put the telephone numbers in the memory of your phone:
- your doctor,
- the closest emergency department,
- your health plan’s nurse line and
- the nearest in-network urgent care clinic.
Did you know that going on leave due to a disability doesn’t automatically start the disability claim process? Participants must file a claim by calling TIPP Customer Care at Aon Hewitt toll-free at (855) 604-6230 (TDD - 711), 7 a.m. – 7 p.m. CT, Monday – Friday.
- If you are going on leave due to an expected or scheduled event, such as childbirth or scheduled surgery, you can file a claim up to 30 days before. This will speed up the process and, if approved, will mean faster access to your money!
- If you have an unexpected disability, you can file a claim as soon as the disability occurs.
Find everything about your coverage at the TIPP website.
If you use CVS for prescription drugs, consider downloading the CVS/Caremark app. Use your CVS username and password from the Caremark.com website to begin using the app. Once logged in, you can refill mail order prescriptions, check for order status, view order history and check for drug interactions.
Life can be filled with uncertainties, but passing on your hard-earned savings to loved ones should be a sure thing. A beneficiary is the person who gets the funds in a participant’s account when the participant dies. That why it’s very important to not only have a beneficiary on file but also to keep beneficiary information updated if there are changes due to marriage, divorce or the death of a named beneficiary.
Every Texa$aver participant can ensure that their loved ones receive the inheritance he or she intends by designating or updating beneficiaries.3
Log into the Texa$aver website.
- Click My Profile.
- Select the link Beneficiary.
If you have questions about the program, please contact the Texa$aver office at (800) 634-5091, TTY / TTD (800) 766-4952.
If you have diabetes, your body doesn't make enough insulin or can't use the insulin it makes. Without insulin, sugar stays in your blood—which might sound sweet, but actually has severe consequences. Over time, high blood sugar levels raise your risk of serious health problems such as kidney disease and blindness. You are also at high risk of heart disease. Type 2 is the most common form of diabetes. The good news is that it can be managed.
You can lower your risk of complications from type 2 diabetes by focusing on three key targets. The American Diabetes Association (ADA) calls them the ABCs:
- A for A1C. The hemoglobin A1C (HbA1C) test shows your average blood sugar levels for the past two to three months.
- B for blood pressure. High blood pressure can lead to heart or blood vessel disease.
- C for cholesterol: Cholesterol is a fatty substance in your blood, high levels of which can put you at risk for heart disease.
Your doctor will determine the ABC levels you should be trying to meet, as well as a treatment plan specific to your condition.
How to Hit Your Targets
- Reach or maintain a healthy weight. Weight and diabetes seem to be linked.
- Eat a healthy diet. Your diet should focus on the same foods as any other healthy diet--fruits, vegetables, whole grains, lean protein and low-fat and fat-free dairy.
- Limit foods high in saturated fats, sodium and added sugars. Avoid trans fats. Be especially careful with sugar-sweetened drinks.
- Figure out what and when to eat. Be consistent. The ADA suggests that all people with diabetes seek nutritional counseling. All Texas Employees Group Benefits Program (GBP) health plans offer nutritional counseling for people at risk for diabetes.
- Exercise regularly. Exercise helps your body respond better to insulin. It also lowers blood pressure and cholesterol and aids in weight loss.
- Take medications and insulin as prescribed.
- Pay attention to other aspects of your lifestyle, too. Smoking, alcohol consumption, dental hygiene and mental health issues affect diabetes too.
The HealthSelectSM of Texas plan requires each participant to choose a primary care physician (PCP) to coordinate health care needs. The designated PCP is responsible for managing referrals to participating specialists, as needed.
Effective September 1, 2014, a PCP may now enter a referral to a specialist for a maximum of 12 visits or 12 months for a non-chronic condition. For a chronic condition, the PCP may enter a referral for a maximum of 99 visits or 12 months.
This change applies to any new referrals entered by a PCP beginning September 1, 2014. It does not apply to existing referrals entered before September 1, 2014, which will be subject to the previous limits.
Participants can view referral information by:
- logging into a personal account at www.myuhc.com/hs or
- calling HealthSelect customer service toll free at (866) 336-9371 (TTY 711) , 8 a.m. - 7 p.m. CT Monday-Friday and 7 a.m. - 3 p.m. CT Saturday.
As part of ongoing efforts to ensure high-quality health benefits for our members at reasonable costs, ERS continues to work with Aon Hewitt to verify dependents’ eligibility to participate in the Texas Employees Group Benefits Program (GBP). The verification helps ensure that only eligible dependents receive health coverage.
Anyone who adds a dependent to health coverage will have to participate in the ongoing verification process, unless the dependent was previously verified as eligible. Employees are required to provide proof to Aon Hewitt that the dependent is eligible for coverage at the time of enrollment.
Aon Hewitt will not accept documentation dated after the day the employee enrolls the dependent. For example: An employee gets married and enrolls the new spouse in health coverage on October 1, 2014, with coverage set to start November 1, 2014. Documentation proving the spouse’s eligibility—a marriage license, for example—must be dated October 1, 2014 or earlier.
Participants who have questions should contact Aon Hewitt toll-free at (800) 987-6605, 7 a.m. - 10 p.m. CT, Monday through Friday.
Starting September 1, 2014, State of Texas Dental Choice Plan now has an extended expense cap. Once participants reach the $1,500 calendar-year maximum benefit for Basic, Major Restorative and Prosthodontic Services (excluding Preventive and Orthodontia Services), the plan will pay 40% of covered expenses for the remainder of the calendar year. Members, who previously had to pay 100% after reaching the $1,500 limit, now will be responsible for only the remaining 60%.
This extended maximum applies to in- and out-of-network providers. However, because in-network providers have contracted rates with HumanaDental, we highly recommend using in-network providers whenever possible. This will save you money in most cases. If you have any questions about finding providers, visit the State of Texas Dental Choice Plan website or call HumanaDental customer service at (800) 233-4013. Please have your dental ID card ready when you call.
Many participants in ERS’ health plans save money by using generic prescriptions (with their doctors’ approval, of course). They started saving even more on September 1, when the copay for generic prescriptions went from $15 to $10 for a 30-day supply ($30 for a 90-day supply). Did you know you could spend even less on many generic drugs at certain pharmacies?
Some pharmacies in Caremark’s standard and Extended Days Supply (EDS) networks charge less than $5 for a 30-day supply of generic drugs and around $10 for a 90-day supply. Check with pharmacies near you to find out their lowest prices on any generics prescribed for you and your family. Or do some online research to see who has low-cost generics.
You can confirm if a pharmacy is in Caremark’s standard or EDS network by visiting the HealthSelectSM of Texas Prescription Drug website. There are hundreds of Texas pharmacies in the networks, including some that currently offer low-cost generics. Keep in mind, however, that Caremark’s lists don’t include pricing information. Also, pharmacies can change their prices at any time. Always check with the pharmacy what the price will be.
We know that, even with good insurance coverage, health costs can add up. So, ERS encourages members save themselves money by taking advantage of good deals when they can.
Finding a breast lump can be scary, but a lump doesn’t always mean cancer. In fact, most lumps are benign (not cancerous). The younger a person is, the more likely it is that her breast lump is benign. Still, it’s a good idea to see your doctor right after noticing a lump or other breast change. The doctor may run tests to find out what’s causing it.
Benign Breast Conditions
There are different benign breast conditions, including:
- Fibrocystic changes: This general breast lumpiness often becomes more obvious as a woman approaches middle age. Fibrocystic changes are the most common benign breast condition.
- Cyclic changes: Changes such as breast tenderness or swelling can occur during the menstrual cycle. They usually go away by the end of the menstrual period.
- Cysts: These are fluid-filled sacs that often enlarge and become tender just before the menstrual period. The doctor may use a thin needle to remove fluid from the cyst and confirm the diagnosis.
- Fibroadenomas: These are solid, round benign tumors that feel rubbery and can be moved around easily. A surgeon may want to remove a fibroadenoma to make sure it is benign.
- Fat necrosis: This scar tissue forms after an injury to the breast. It is most common in women with very large breasts. It can also occur in women who have had breast surgery or radiation therapy.
- Adenosis: This is an excess growth of tissue in the breast's lobules (where milk is produced). If the enlarged lobules are close together, they may feel like a lump. A doctor may need to do a biopsy to tell the difference between adenosis and cancer.
Breast Cancer Symptoms
Early breast cancer usually doesn't cause any symptoms. In most cases it is found during a routine mammogram, often years before it is large enough to be felt as a lump. That’s why regular mammograms are recommended for women at certain ages—to find potential cancers at the earliest stage possible.
As a breast tumor grows, it may cause symptoms that include:
- a lump or thickening in the breast or armpit,
- a change in the size or shape of the breast,
- puckering or dimpling of the skin on the breast,
- a nipple that is turned inward (inverted),
- fluid discharge from the nipple, especially a bloody discharge and
- scaly, red or swollen skin on the breast, or ridged or pitted skin that looks like the skin of an orange.
These symptoms may point to breast cancer, but benign breast conditions can cause some of the same changes. If you have any of them, don't assume the worst, but see your doctor right away. You may need to have a mammogram, ultrasound or other test to find what is causing your symptoms. A biopsy is the only sure way to know if a breast lump is cancer.
With flu season just around the corner, stay healthy by getting a flu shot. If you’re a HealthSelect of TexasSM member, you can get your family’s flu shots covered 100% with no copays, coinsurance, or deductibles when you use a contracted network provider like a participating CVS® MinuteClinic®, Walgreens Pharmacy, or Target® Clinic. Read more on this Flu Shot Fact Sheet.
If you prefer, you can get your flu shot right here on campus at the UH Health Center for only $25.00.
Travel Health Services
The Health Center offers advice, vaccinations and preventive care to traveling individuals according to CDC recommendations. The Centers for Disease Control and Prevention provides travel notices and articles about travel-health related topics aimed at world travelers to help them prepare to manage illness and injury abroad. Go to the UH Health Center website to learn more.
You know the rules. Eat less red meat, cheese and butter. Limit fried foods. Avoid trans fats, saturated fats and dietary cholesterol. With so many things to cut out, what's left to eat?
There are plenty of delicious heart-healthy foods you can eat. Adding certain foods to your diet may actually help lower your bad cholesterol and decrease your risk for heart disease. Foods rich in soluble fiber are cholesterol-friendly and can prevent the body from absorbing cholesterol. Monounsaturated and polyunsaturated fats can help lower cholesterol levels, too.
Here are some ideas that may help decrease your bad cholesterol level and increase the good. Remember that any successful strategy must combine healthy eating and exercise. Ask your doctor what activity level is right for you.
- Oatmeal has soluble fiber. Try oat cereal with fruit and a small handful of nuts, or oat muffins or bars. Oatmeal also makes a good binder in turkey meatloaf.
- Soy protein may lower bad cholesterol in the body. Edamame, soy milk or smoothies with silken tofu are good options.
- Beans and legumes have soluble fiber. Cook up some lean beef-and-bean burgers and serve with salad or side dish with chickpeas, lentils, black-eyed peas, or kidney or lima beans.
- Olive, canola, sunflower, safflower and soybean oils have monounsaturated and polyunsaturated fats. Use them in salad dressing or to sauté vegetables or to fry poultry and fish.
- Avocado has fiber and monounsaturated fat. Add it to salads, sandwiches, soups, salsa, pizza or eggs.
- Whole grains are rich in fiber. Choose brown rice and 100% whole-grain pastas or breads, whole-grain bread for breadcrumbs or stuffing.
- Spinach is a good source of fiber. Use in salads, soups and egg dishes.
- Apples, pears, bananas, oranges and prunes are high in soluble fiber. Eat them with a smear of natural peanut butter or add them to salad.
- Peanut butter is a source of monounsaturated fat. Blend it into smoothies or eat it on whole wheat-toast.
- Walnut, almonds, pecans and hazelnuts are sources of omega-3, a type of polyunsaturated fat. Use them in cereals, muffins, chicken or fish dishes, or on salads or sautéed veggies.
- Salmon, trout, herring, mackerel, sardines and fresh albacore tuna are high in omega-3 fats. Bake, broil, grill or sauté instead of frying.
- Ground flaxseeds have oil that contains omega-3. Add it to cereal, yogurt, breads, muffins, mixed dishes and casseroles.
Food for the Heart
Heart-healthy eating involves more than cutting fat and cholesterol from your food. Learn what foods can help keep you healthy.
Start by limiting certain foods you know can cause trouble, such as butter, red meat, cheese and fried foods. Reducing saturated and trans fats, cholesterol and sodium in your diet is also good. Remember to eat a variety of fruits, vegetables, whole-grains and fiber.
Fill half your plate with fruits and vegetables. The more colorful, the better. Try red peppers, yellow squash, orange carrots and purple cabbage.
- Try brown rice, barley, whole-grain breads, cereals and crackers, and whole-wheat pastas.
- Include kidney, pinto, navy and soy beans for fiber and protein.
- Use fat-free and low-fat dairy products, fish, poultry and lean meats.
- Try fat-free or low-fat milk and yogurt.
- Lean meat such as fish, white meat chicken and turkey are all good choices. Eat poultry without the skin. Keep portions to no more than 6 ounces per day.
- Limit seafood to twice a week. Children and pregnant or nursing women should avoid certain fish that are high in mercury: shark, swordfish, mackerel and tilefish.
- Include healthy fats in your meal plan.
- Limit saturated fats found in red meat, bacon, hot dogs, poultry skin, and high-fat dairy products like butter and half-and-half.
- It’s recommended that the fats you eat mostly come from unsaturated sources, such as vegetable, sunflower, canola and olive oils, nuts and avocado, flaxseed, walnuts, salmon and soybean.
Previous Stories - In Case You Missed Them!
Starting September 1, Texas Employees Group Benefits Program (GBP) participants will pay 30% less for Tier 1 prescription drugs, which include most generic drugs. The copay for Tier 1 drugs will be $10 for a 30-day supply, down from $15. The cost for a 31-to-90-day supply will be $30, down from $45.
ERS is making the change to encourage members to use generic drugs, which generally are no different than their brand-name counterparts. Generics not only help members save money, but also help reduce overall costs for the GBP health plans. Lowering costs in the health plans helps preserve benefits for active employees, retirees, and dependents.
Remember that from September 1 to August 31, you and each of your covered dependents must pay separate $50 deductibles before the plan begins to cover drug costs. For example, if you have two dependents, you would have a total family deductible of $150 per plan year for prescription medications if all of you fill at least $50 worth of prescriptions.
One of the best ways to save money on your health care is to make sure you take generic drugs whenever you can. Always consult your doctor before switching medications. New generic drugs come into the market all the time. It’s important to know when generics become available, because they generally cost less, and they have the lowest copay. Plus, if a generic is available and you buy the brand-name drug instead, you will pay the generic copay plus the difference between the cost of the brand-name and the generic drug.
Don’t forget that employees’ retirement contributions will increase by 0.3%—from 6.6% to 6.9%—on September 1, 2014, the beginning of fiscal year 2015. The increased contribution will be reflected in employees’ salary payments starting October 1.
State lawmakers passed the higher contribution during the 2013 legislative session. It raised retirement contributions not only for employees, but also for the State and for employer agencies. The increases started in fiscal year 2014 (September 1, 2013 - August 31, 2014), when the employee contribution went from 6.5% to 6.6% and the State contribution went from 6.5% to 8% (with 7.5% from state appropriations and 0.5% from state agency appropriations). The combined state and agency contribution will remain at 8% for fiscal year 2015. For more information on the retirement contribution increases, please see ERS’ overview of key legislation affecting state employee benefits.
Did you know UH benefits-eligible staff and faculty are eligible for a two-week trial membership at the Campus Recreation Center? Just bring your Cougar Card to the CRC and sign up at the Member Services counter. If you enjoy your two week trial, you can transition to regular membership for as little as $27 per month. Learn more about the Campus Recreation Center.
Learning your health numbers may help predict future problems. We're talking cholesterol, blood pressure, blood sugar, and body mass index (BMI). These numbers can tell you if you are at a high risk for some serious conditions, including heart disease and diabetes. If you know your numbers, you can take steps to lower your risk.
What do these numbers mean and where should they be?
Blood pressure: less than 120/80 mmHg
Blood pressure measures the force of blood that travels through your arteries. If it's too high, it's a risk factor for heart disease and stroke. The top number (120) measures the systolic pressure. This is the pressure in your arteries when your heart beats. The bottom number (80) measures the diastolic pressure. This is the pressure between heartbeats.
Total cholesterol: below 200 mg/dL
There are two main kinds of cholesterol:
- High-density lipoprotein (HDL) is also known as good cholesterol. HDL should be 40 mg/dL or above for men and 50 mg/dL or higher for women. An HDL of 60 or greater puts you at a LOWER risk of having heart disease. An HDL of less than 40 increases your risk for heart disease.
- Low-density lipoprotein (LDL) is also known as bad cholesterol. The lower this number, the better. Ideally, your LDL level is below 100 mg/dL. Too much bad cholesterol increases your risk for having a heart attack or stroke.
Fasting blood sugar/glucose: less than 100 mg/dL
Fasting blood sugar should be less than 100 mg/dL. Higher blood sugar levels may indicate diabetes.
Body mass index (BMI): less than 25
BMI is a height-to-weight ratio used as an estimate for body fat. Your BMI tells if you are at a healthy weight for your height. A BMI of 25 to 29.9 means you are overweight. A BMI of 30 or higher means you are obese. Being overweight or obese puts you at a higher risk for heart disease, diabetes, and other conditions.
How can I improve my numbers?
If your numbers aren't on target, make some lifestyle changes to lower your risk for heart disease, diabetes, and other diseases.
- Don't smoke.
- Lose excess weight by even a few pounds.
- Exercise regularly after checking with your doctor.
- Eat a healthy diet rich in fruits, vegetables, whole grains, lean meats, and low-fat dairy. Limit saturated fat, trans fat, cholesterol, added sugar, and sodium.
- Reduce stress.
- If your doctor prescribes medication for you, take it regularly.
Are you constantly tired? Physical activity may give you an energy boost.
When you’re feeling tired, you may reach for another cup of coffee or feel you can’t work anything else into your day. But exercise is a healthier solution that may help spark your energy. Low- to moderate-intensity aerobic activity could energize you.
Being busy and staying active are two different things. Check with your doctor first to see if exercise can reduce your fatigue and help your energy levels. Sometimes a health condition can cause constant fatigue. If no medical reason is found, and your doctor gives the okay, try exercising for extra energy.
Try doing light exercises with hand weights or simply march in place. You could walk up the stairs, or better yet, get outside for a brisk walk if the weather is good. Being active may help reduce the risk of developing heart disease, type 2 diabetes, some cancers, and depression. It can also help manage weight, ease stress, and lead to better sleep.
What the guidelines say
Federal physical activity guidelines suggest at least 150 minutes of moderate-intensity aerobic exercise each week. That may seem like a lot, but it's really only half an hour a day, five days a week. You don't have to do the half hour all at once. You can:
- take a brisk 10-minute walk before and after work, and at lunch,
- mow the lawn,
- ride a bike to run errands,
- clean the house
The activity should get your heart rate up. Keep moving for at least 10 minutes for the activity to count as exercise:
- Try to work in two or more days a week of strength-building exercises that work all the major muscle groups. Start with small dumbbells or a stretchy resistance band.
- Short on time? Studies show that 75 minutes of vigorous activity is roughly equivalent to 150 minutes of moderate aerobic activity. But you may need to work up to vigorous exercise over time.
- Gradually replace some moderate exercise with intense bursts, such as high-energy intervals when you jog or walk.
- For even greater health benefits, set a goal of 150 minutes of vigorous aerobic activity. That could be a game of tennis or racquetball for 50 minutes, three times a week.
- Once you get started, exercise could quickly become part of your daily routine.
Beginning in Plan Year 2015, there will no longer be a two-and-a-half month grace period for reimbursable health expenses. Instead, participants will be able to carry over up to $500 in unspent health care account funds to the next plan year. The grace period will still apply Septermber 1, 2014 (end of Plan Year 2014) through November 15, 2015. The carryover will begin September 1, 2015 (end of Plan Year 2015).
Also in Plan Year 2015, participants will be able to reduce health care account contributions with any qualifying life event (QLE). Terminated employees will not be required to continue monthly contributions unless they choose to. Prior to Plan Year 2015, participants could reduce health care account contributions only in the event of a dependent's death.
Health Coverage Waiting Period
Effective June 1, 2014, the health coverage waiting period for new employees changed from 90 days to 60 days. New employees hired on or after June 1, 2104 will have their health coverage effective the first of the month after their 60th day of employment. If the 60th day of employment falls on the first of the month, then health coverage will begin that day.
Effective July 1, 2014, ERS is changing the way HealthSelectSM of Texas covers some compound drugs. A compound drug is one made by combining, mixing, or changing ingredients, as prescribed, to create a custom medication that is not otherwise available.
Beginning July 1:
- Every compound drug with a total cost of $300 or more will require pre-authorization. This will ensure that the compound drug is being prescribed for a “medically accepted indication,” according to U.S. Food and Drug Administration (FDA) guidelines. The total cost includes both the participant’s copayment and the amount paid by HealthSelect. Compound drugs that cost less than $300 do not require pre-authorization at this time.
- A prescribed compound drug may be covered if it contains at least one FDA-approved drug product. However, ERS will pay only for the compounding fees (what the pharmacy charges for making the drug) and FDA-approved products. Bulk chemicals are not FDA-approved drug products and, therefore, will not be covered by HealthSelect. The participant would have to pay the cost of any non-FDA-approved ingredients or non-FDA-approved formulas.
For example: A compound drug has five ingredients, but three of them are not approved by the FDA in the prescribed formula. ERS would pay only for the two FDA-approved ingredients and the compounding fee. The participant would have to pay for the three non-FDA-approved ingredients, in addition to his or her usual copay. The compounding pharmacy can tell the participant how much it would cost.
ERS is putting these rules into place because of increasing concerns about the safety and effectiveness of compound drugs used to treat conditions not directly related to a main diagnosis. In addition, some ingredients of compound drugs are not approved by the FDA in the forms used in compounding. As noted above, bulk chemicals, when added to other ingredients, are not FDA-approved. These new rules are consistent with the policies of the U.S. Centers for Medicare & Medicaid Services (CMS).
Last week, ERS mailed letters about the new policies to HealthSelect participants who filled prescriptions for compound drugs in the last six months. Although these participants make up less than 3% of HealthSelect’s overall membership, we wanted to make you aware, in case you get questions from employees at your agency.
If an employee wants to know the total cost of a compound medication he or she takes, or if a compound medication contains bulk chemical(s), please advise him or her to contact the pharmacy that filled the prescription. For other questions, they can visit http://www.caremark.com/ers or call Caremark toll-free at (888) 886-8490.
Last Annual Enrollment, ERS asked all adult Texas Employees Group benefits Program (GBP) participants to certify whether or not they use tobacco. If you or your adult dependents quit using tobacco or started using tobacco, remember to update the tobacco status in ERS. If you or your dependents' statuses haven't changed, you don't have to do anything.
If you are in the HealthSelect of Texas Prescription Drug Program, you can get maintenance medications with no extra fee if you go to a retail pharmacy in the Extended Days Supply (EDS) network. This option is available at pharmacies that have agreed to match the health plan's mail service cost.
Copays for up to a 30-day supply of non-maintenance medications are $10 for Tier 1 generic drugs. For prescription drugs ordered through an EDS network pharmacy for a 31-day to 90-day supply, the copay is $30 for Tier 1 drugs. For prescriptions ordered through the mail service program, it is $30 copay for a 31-day to 90-day supply.
It will soon be even easier for HealthSelectSM of Texas participants to take advantage of savings and convenience with Caremark’s Extended Days Supply (EDS) network. Caremark, the administrator of HealthSelect of Texas’ prescription drug program, will add CVS pharmacies to the EDS network beginning June 1, 2014.
Caremark’s EDS network allows a HealthSelect of Texas participant to fill a 31-day to 90-day supply of drugs at a lower out-of-pocket cost than a 30-day prescription. Participants can save money and make fewer trips to the drug store.
There are nearly 600 CVS pharmacies across Texas. They’ll join others already in the EDS network, including Brookshire Brothers, H-E-B, Kroger, Target, Walmart, and hundreds of other chain and independent pharmacies throughout the State.
To locate an EDS network pharmacy near you, go to www.caremark.com/ers and use the “Extended Days Supply (EDS) Network” pharmacy locator, or call Caremark Customer Care toll-free at (888) 886-8490. You also can get extended days prescriptions through the mail by calling Caremark’s FastStart® service toll-free at (800) 875-0867.
Under the HealthSelect of Texas in-area plan, an overall out-of-pocket maximum limit of $6,350 for individuals will go into effect on September 1, 2014 but limits do not start over until January 1, 2015. The coinsurance out-of-pocket maximum of $2,000 per individual that is currently in place will remain the same. The $2,250 inpatient hospital copay maximum per individual per year will remain unchanged as well.
An overall out-of-pocket maximum of $12,000 for families will go into effect on September 1, 2014 but limits do not start over until January 1, 2015. The coinsurance maximum of $2,000 that is currently in place for each individual within the family will also remain the same. The $2,250 inpatient hospital copay maximum per individual per year will also remain unchanged.
Currently there is no overall out-of-pocket maximum for the plan, so this is an added benefit to plan participants.
This out-of-pocket maximum will include deductibles (if applicable), medical copays and coinsurance. It does not incldue premiums.
New in Plan Year 2015:
- Inpatient mental health services will no longer have different pricing tiers based on the number of days as an inpatient. Now all inpatient mental health care (even for more than 30 days) is payable at 80% coinsurance at network providers.
- Outpatient professional mental health services will be subject to a $40 copay, rather than the 20% coinsurance. There will no longer be a limit on days of outpatient treatment.
- Outpatient mental health facility benefits will change to $100 plus 20% coinsurance. There is no limit on days of treatment or tiering of benefits. There will no longer be an intermediate benefits category; instead, these changes will be paid under inpatient or outpatient benefits, dependent on the location of services.
It’s become a fact of life that health care costs increase year after year. But ERS has found one way to slow that trend while actually improving the quality of care for many of our members. It’s called a patient-centered medical home (PCMH), and some members are already benefitting from it.
The key to a PCMH program is providing “medical homes” for health plan participants—practices that fully coordinate a patient’s care to ensure that he or she receives the most appropriate treatment.
Here’s how it works:
- ERS negotiates payments for large, integrated groups of primary care physicians, specialists and other health care providers. These payments are based not just on the amount of services the groups provide, but also on whether they meet certain measures that help ensure quality of care.
- ERS pays these groups a monthly fee – on top of the regular payments they get for seeing patients – so they can invest in electronic medical records, nutritionists and health coaches, and other resources to improve coordination of care.
- If a PCMH practice slows cost increases by a set amount while meeting quality care measures, it earns a share of the savings.
The great news is that we’re seeing slower cost increases. The really great new is that patients are receiving higher-quality care, as shown in measures that include:
- fewer emergency room visits,
- fewer patients going back to the hospital after they’re discharged,
- fewer and shorter inpatient hospital stays, and
- more people taking their prescriptions as directed by their doctors or pharmacists.
The ERS PCMH program:
- saved the plan $31 million since 2011,
- received a national award from the State and Local Government Benefits Association,
- was recognized in Governing magazine, and
- is growing! Covenant Health in Lubbock recently joined four other practices based in Austin, Houston, and Tyler to become part of the program.
We’re improving the way your health care is provided and we plan to add more groups in the future.
Treatments for back pain
Back injuries and pain are all too common, and can be a nuisance at best or debilitating at worst. After your back is injured, you will want to learn new habits to avoid re-injuring your back. Once you're feeling better, improved posture, practicing back-safe lifting techniques, a fitness routine, and if necessary, weight loss will help to keep your back healthy. However, before you start to use your back, it must first heal.
Bed rest, ice, and heat
If your back pain is severe, stay in bed, but no longer than two days. Prolonged bed rest weakens your back and deconditions you overall. Make sure you get out of bed and walk around a few times a day.
Apply ice and then heat, in that order. Ice helps to soothe sore muscles and reduce the area of pain. So, for the first few days after injuring your back, apply an ice pack to the painful area for about 20 minutes at a time, a few times each day. Wrap a towel around the ice bag, so that only the towel contacts your skin over the painful area.
Muscles also tighten or spasm in response to injury. Once the pain is reduced, apply a heating pad for about 20 minutes at a time for several times a day. Heat further reduces the pain and tightness.
Over-the-counter pain medicines can be helpful. Non-steroidal anti-inflammatory drugs (NSAIDs)—such as aspirin, ibuprofen, and naproxen—help reduce swelling and therefore can relieve pain caused by swelling. Acetaminophen doesn’t reduce swelling, but can help with some types of pain. Common over-the-counter brands for these types of medicines are listed below; generic versions also are available:
- Acectaminophen: Tylenol
- Aspirin: Bayer, Bufferin, Ecotrin
- Ibuprofen: Advil, Motrin
- Naproxen: Aleve
Keep in mind, that every medication has associated hazards. NSAIDs, for example, may cause stomach bleeding. Always read product labels before taking a drug. Talk to your doctor to learn about risk factors or if you take other medications.
Lower back red flags
Call your doctor if you have:
- tingling, weakness, or numbness of either leg;
- pain down the leg;
- limping or other gait problems;
- loss of bladder or bowel control;
- nausea, vomiting, fever, chills; and/or
- severe pain after injury, such as in a fall or automobile accident.
For U.S. workers, the average one-way trip to work takes about 25 minutes. For 8% of commuters, the daily commute is more than an hour each way, according to the U.S. Census Bureau.
Here are a few tips for improving your commute:
- Listen to soothing tunes or an audio book. Or, just relish the daily quiet time—and focus on the journey.
- Keep your vehicle tidy. Trash and clutter may add to your stress.
- Stay calm by practicing deep breathing every time your foot is on the brake.
- Make a point of leaving home 10 minutes earlier. You'll give yourself the gift of more time and less stress.
- Try public transit. You may find you enjoy that time to read—or just relax.
If your commute is a chore, you can find tips for improving your daily trip and other stress-inducing situations in UnitedHealthcare’s newsletter Healthy Mind Healthy Body. You can subscribe at the Communication Subscription Center. You don’t have to be a HealthSelectSM of Texas participant to subscribe.
We will send an email (to be distributed June 10) and a letter (to be distributed June 16) to non-participating employees highlighting the benefits of a Texa$aver account:
- free one-on-one personal counseling,
- customized digital planning tools,
- free financial workshops and group meetings,
- investment options hand-picked by experts,
- before-tax and/or after-tax benefits,
- funds that offer reimbursements,
- direct deposit from paycheck,
- competitive fees,
- the option to do everything yourself or get help with everything you do, and
- a PLAN for a more secure future!
Texa$aver representatives will also attend Annual Enrollment fairs across the state. Call the Texa$aver Program office toll-free at (800) 634-5091, or email email@example.com to request a workshop or meeting at your agency.
Seven steps to a healthier life
Men face some specific health challenges, but there are things they can do to protect themselves. American men are living longer. A man born in 1900 could expect to live until age 46. Male babies born in 2010 (the most recent data available) are expected to live until age 76.
A longer life combined with poor health, however, can diminish quality of life over time. It’s important for men to take steps to stay healthy for as long as possible. Many of the factors that affect men’s health can be controlled. Here are seven ways men can live a healthier life.
- Get moving. Being active may help you manage weight, ward off some diseases, keep bones stronger and improve mood. Try to get at least 150 minutes per week of moderate-intensity exercise such as brisk walking, biking, and two or more days a week of muscle-building exercises that work legs, hips, back, abdomen, chest, shoulders, and arms.
- Eat a healthy diet that includes fruits, vegetables, whole grains and low-fat dairy. Limit foods with added salt and sugar. Vary protein sources between lean meats, dried beans, peas, and seafood.
- Maintain a healthy weight. Balancing calories is the key. Eat and drink fewer calories than you burn in a day to balance weight. Eat foods rich in nutrients that fill you up, exercise on all or most days of the week, and control your portions.
- Get preventive care. This includes screenings, vaccines and counseling.
- Screening checks for signs of diseases, or catch a disease early on so it can be treated more easily. Recommendations may be based on your age, health and family history.
- A vaccine can prevent diseases like pneumonia and hepatitis B. Flu vaccine is recommended for almost everyone six months and older. Make sure you’re up-to-date on all your vaccines.
- Counseling is the third part of preventive services. Communicate with your health care provider on stress, smoking or alcohol use, obesity, depression, anxiety, or other behavioral health concerns you may have.
- If you use tobacco, take steps to quit.. Tobacco smoke affects almost every part of your body. Habitual smokers are more likely to suffer from certain diseases and have weaker bones. Every day that you don’t smoke can help your body recover. Work with your doctor to develop a quitting plan or may suggest medication to wean you off the nicotine.
- Control your alcohol intake. If you choose to drink, limit your intake to two drinks a day.
- Stay safe outdoors. Accidents are a leading cause of death. Take precautions while playing sports and being active. Remember to wear a helmet and pads when appropriate, and use sunscreen. Always wear your seat belt when driving or riding in a car.
Remember to update any address, email address, or phone number changes in your ERS account so you can receive benefits information from ERS during Annual Enrollment.
You can update information at any time of the year, but you must do so by May 30 to receive Annual Enrollment materials and information at your updated addresses. You should:
- go to the ERS website (www.ers.state.tx.us) and click the Sign In button at the top,
- enter your username and password (or create an online account in five easy steps),
- click the appropriate link under My Personal Information, and
- follow the steps to make changes.
Beginning June 1, 2014, the health coverage waiting period for new employees changes from 90 days to 60 days. New employees hired on or after June 1, 2014 will have their health coverage effective the first of the month after their 60th day of employment. If the 60th day of employment falls on the first of the month, then health coverage will begin that day.
The Employees Retirement System of Texas (ERS) is asking for your voluntary participation in a survey about your health insurance coverage through ERS.
The 83rd Texas Legislature asked ERS to determine if there is a need to provide alternative health plans so that employees have lower-premium options for dependent health coverage. The survey will give members a chance to tell ERS if they’re interested in a lower-premium alternative plan. About the survey:
- ERS has contracted with The University of Texas at Austin’s (UT) Institute for Organizational Excellence to administer this survey. You will be getting an Email or a letter from UT directing you on how to take the survey.
- The voluntary survey will take less than 10 minutes to complete. You will be able to skip any questions that you do not wish to answer, and the information you provide will be kept confidential.
- If you don’t have an email address on file with the state, don’t worry, ERS will send letters with a link to the survey and a code that members without email can take the survey from any computer.
- ERS encourages everyone to participate. We’ll report the results to the Texas Legislature, and they could shape recommendations on health insurance options for the state and higher education workforce.
Please view FAQs at: http://www.ers.state.tx.us/ERS_News/Survey_about_your_health_insurance/
Respondents say no to use-it-or-lose-it grace period and yes to $500 carryover starting in plan year 2015.
Recently, the U.S. Internal Revenue Service (IRS) began allowing a $500 carryover for health care reimbursement accounts. Plans could choose to offer this instead of the two-and-a-half-month grace period during which participants can use unspent account funds.
In light of this change, ERS conducted a survey of members with TexFlex health accounts to find out if they prefer the grace period or the new carryover option. Out of the almost 13,000 members who took the survey, an overwhelming majority of them preferred the carryover.
- 10,192 (78.5 %) opted for the carryover.
- 2,784 (21.5%) chose the grace period.
Under IRS rules, plans can offer only one of the options to all its members. Based on survey results, ERS will implement the $500 carryover for TexFlex health care accounts starting in plan year 2015. Participants will be able to carryover up to $500 each plan year, instead of incurring additional claims in the grace period. The change will not affect the deadline to file claims. Participants will have until August 31 of each year to use all but $500 of the money in their health care accounts, and can file claims for reimbursement through December 31 of that year.
The carryover won’t go into effect until plan year 2015. So, when plan year 2014 ends on August 31, 2014, participants will still have the grace period for incurring health care claims. The carryover will be allowed starting at the end of plan year 2015 (August 31, 2015).
The IRS is allowing the $500 carryover for health care accounts only. Therefore, the change does not affect dependent care reimbursement accounts (DCRAs). DCRAs will continue to have a two-and-a–half-month grace period, with a deadline to incur costs by November 15 and file claims by December 31. DCRA participants will not have the option to carry over funds to the next plan year.
More information about how the health care account carry over will work will be available in Annual Enrollment guides and materials coming out in June, 2014.
The Dependent Eligibility Audit began April 21, 2014, and participants in Texas Employees Group Benefits Program (GBP) health insurance plans who added a dependent since April, 2011 should have received letters from Aon Hewitt. Audit participants need to:
- read the letters (also called notices) from Aon Hewitt to determine which dependents are included in the audit and the due date for submitting documents,
- gather the required documentation, and
- send the required documentation to Aon Hewitt by the due date listed in the letter from Aon Hewitt. (You should not submit the documentation to Human Resources nor to ERS.)
Aon Hewitt will:
- send letters and emails to participants,
- answer questions about the audit,
- provide a secure audit website, and
- receive and review documents.
After the audit is complete, Aon Hewitt will destroy all documents at its secure facility.
If the dependent is found to be eligible, his or her coverage will continue uninterrupted by the audit.
If the dependent is found to be ineligible, ERS will remove him or her from all GBP coverage. An audit participant will receive a letter letting him or her know if a dependent has been found ineligible. An ineligible dependent will not be eligible for COBRA.
Throughout the audit, you can check the status of your verification online. You can also:
- view your audit status,
- obtain documents, and
- access helpful information regarding the audit.
Login –For your login name, use the seven-digit Verification ID number found on the bottom of each page of the letters you receive from Aon Hewitt.
Password – The password is the last four digits of your Social Security number (SSN) and your date of birth in mmddyyyy format. For example, if the last four digits of your SSN are 1234 and you were born on January 1, 1968, your password will be 123401311968. You’ll need to change your password once you log in to the site for the first time.
More information on the audit can be found in the Dependent Eligibility Audit FAQ.
Please note: Audit participants must send all paperwork regarding the Dependent Eligibility Audit directly to Aon Hewitt. HR will not accept dependent eligibility audit documents from employees; instead we will instruct you to send all documentation to Aon Hewitt at the address listed in your letter. Please direct any questions about the audit to Aon Hewitt directly, toll-free, at (800) 987-6605 between 7 a.m. and 10 p.m. CT.
Texa$aver Reaching Out to 400,000 Participants
Many of those who participate in the Texa$aver 401(k) / 457 Program may have recently received a postcard asking to consider increasing Texa$aver contributions as a way to save more for retirement. Legitimate Texa$aver communications can be identified with the logo or logos of Texa$aver, Great-West (the third-party administrator for Texa$aver), or Great-West’s Advised Assets Group (AAG). Communications sent by people or groups not affiliated with Texa$aver will not have these logos:
For questions about Texa$aver, call the Texa$aver program office toll-free at (800) 634-5091.
ERS Website Refresh
ERS has changed their website and invite you to view the updates at www.ERS.state.tx.us . Most of the website navigation remains the same, but some enhancements will provide better access to information for you and those who do business with ERS. Key updates include the following.
- The ERS account login button is bigger and more prominently displayed.
- The layout and color scheme of the website changed.
- The homepage has been rearranged to provide improved access to the information our members need most often.
- Information for our vendors has been restructured.
ERS determined the site needed updates after contracting with a third-party that surveyed website users and talked with them as they navigated the site. The users who participated in the study included new employees, employees near retirement, employees with disabilities, retirees, and vendors. ERS believes the outcome of the upgrade is a better website experience for you.
ERS also posted a link to a survey where you can provide your feedback on the updated website. Please let them know what you think.
Please join UnitedHealth Care on Tuesday, May 13, at 11:30 a.m. for the first in a series of free HealthSelectSM of Texas wellness webinars presented by UnitedHealth Care. There will be a 30-minute presentation and 15 minute Q&A.
The webinar will be hosted on WebEx. You don’t need to have WebEx installed on your computer to participate. Just follow the directions that appear on your screen.
To join the webinar, you must register by following the instructions below:
- Go to https://uhc.webex.com/uhc/onstage/g.php?d=824821680&t=a.
- Create an account, or login to your existing account.
- Meeting Number: 826 677 088
- Meeting Password: ers
You should be able to hear the audio through your computer. If you’d rather use your phone, provide your phone number when you join the meeting, or call the number below and enter the access code.
- Call-in toll-free number (US/Canada): 1-866-469-3239 (Toll-free dialing restrictions: http://www.webex.com/pdf/tollfree_restrictions.pdf )
- Access code: 826 677 088
The webinars are open to all state and higher education employees and retirees, regardless of which health insurance plan they’re enrolled in. Presenters will answer questions about the announced topic, but they can’t answer questions about specific claims or network providers.
Attendance is limited, with only so many computers and phone lines able to access the webinar. If possible, we encourage you to gather with other employees in a conference room and watch the webinar as a group. If demand is great, UHC will schedule another webinar on the same topic later in the month.
The first session will provide simple strategies for reducing stress in everyday life.
ERS has enhanced the look of the TexFlex website in hopes to make it easier to use, while keeping all the current functionality and detailed account information. Participants will have access to:
- a savings calculator,
- a list of common eligible expenses,
- legislative news,
- educational materials, and
Participants don’t need to change their account login
If a member already has registered his or her account, the username and password will stay the same. All the current functionality and detailed account information are still available. Participants, who already have a registered account, continue to use their same username and password. If participants have forgotten their password, they can click on “Forgot Your Password?” for help. www.texas.payflex.com
Here’s a snapshot of the new look and a summary of the features to help with management of a TexFlex account. Once logged in, participants are able to view their personal account information. Here’s a snapshot of the new look and a summary of the features.
After logging in, a participant will see My Dashboard, which shows account alerts (if applicable), news articles, and a snapshot of the account(s).
The Quick Links section features commonly used account management tools.
The Financial Center allows participants to view account balance(s), claim history, card purchases, and contributions. Participants can also submit claims to pay themselves back for eligible out-of-pocket expenses.
Members can sign up for account notifications through My Settings, to stay up to date on account news.
In the United States, 17.6 million people--about one in every 12 adults--abuse alcohol or are alcohol dependent. The factors that put you at increased risk of developing alcoholism are:
- a family member who suffers from alcoholism,
- a history of substance abuse,
- a history of depression,
- having a post-traumatic stress disorder,
- peer pressure,
- stress, and
- easy availability of alcohol.
People with family history of alcoholism should be particularly alert for signs of problems. According to the National Institute on Alcohol Abuse and Alcoholism, children of alcoholics are about four times more likely to develop alcohol problems. The addiction may skip a generation, too. A child of an alcoholic may never drink, but could still pass on a genetic vulnerability or an unhealthy lifestyle that could lead to drinking.
Other important things to consider:
- Risk for alcoholism is higher among people who begin to drink in their early teens, as opposed to after age 21.
- More men than women are alcohol dependent or experience alcohol-related problems.
- Rates of alcohol problems are highest among young adults ages 18 to 29 and lowest among adults 65 years and older.
More than 100,000 Americans die of alcohol-related causes every year. Alcoholism and alcohol abuse can be factors in violent crimes, teen pregnancies, and date rape. If you suspect that you or someone you know has a problem, seek help immediately.
Benefits Training in May
Retirement 101 (HRT039)
When: Tuesday, May 20, 2014 from 2:00pm - 3:30pm
Where: McElhinney Hall, Room 341 (map)
Description: Retirement 101 (HRT039) Following this course, participants will be able to gain a greater understanding of ORP and TRS retirement benefits, gain a greater understanding of ORP and TRS vesting, gain a greater understanding of TRS retirement eligibility, understand eligibility for continued insurance benefits at retirement, understand establishing TRS Service Credit, gain a greater understanding of calculating TRS retirement benefits, employment after retirement guidelines. For questions, please contact the HR Service Center at 713.743.3988.
Be Benefits Wise (HRT022)
When: Tuesday, May 13, 2014 from 12 noon 1:30pm
Where: McElhinney Hall, Room 341 (map)
Description: BE BENEFIT WISE (HRT022) Who should attend: This course is open to all employees. Prerequisites: None. How long: 1.5 hours Need a refresher in benefits? The purpose of this seminar is to increase your knowledge about the benefits you have available to you as a University of Houston employee including: health, dental, optional life insurance, TexFlex (Flexible Spending Account), Short- and Long-Term Disability, and Long term care insurance. For questions, please contact the HR Service Center at 713.743.3988.
ING: Social Security as a Part of my Retirement Income (HRTV20)
ING will be providing a light lunch for all attendees.
When: Wednesday, May 21, 2014 from 11 am – 12 noon
Where: Kiva Room, Farish Hall (map)
Description: ING Financial has invited Mr. Andy Harwick of Social Security Administration to speak on when and how to apply for social security. Mr. Harwick will also address how social security works with TRS and what you can expect from social security.
Annual Enrollment for Plan Year 2015 dates
The University of Houston’s Annual Enrollment with the Employee’s Retirement System of Texas (ERS) will be from Monday, July 14, 2014 through Friday, July 25, 2014. Prior to Annual Enrollment, in May, employees will start getting information on Annual Enrollment. In June, you will receive a Personal Benefits Enrollment Statement from ERS, which include information on benefits, Annual Enrollment choices, and enrollment phases. A schedule of the enrollment phases will also be posted on the ERS website.
As in the past, members will make benefit changes including signing in to your online account on the ERS website or by calling ERS.
Planning is underway for the University of Houston’s Eighth Annual Benefits Fair. As you know, the UH Benefits group holds an Employee Benefits Fair each year to give our employees a chance to meet with representatives and get information about the various offerings they offer.
This year our fair will be held on Wednesday, October 22nd. We hope that by changing our event date to the fall will increase participation and allow more of our faculty members to participate.
Please save the date:
Date: Wednesday, October 22, 2014
Time: 10:00 a.m. – 2:00 p.m.
Location: UH Campus Recreation and Wellness Center
The Benefits Fair Committee is going to bring you an incredible 2014 event. You won't want to miss it!
Dependent Eligibility Audit (DEA) update
The dependent eligibility audit starts this month (April).
As part of our effort to ensure the long term viability of benefits for ERS members, ERS is working with Aon Hewitt to conduct a dependent eligibility audit ERS. The audit will lower instances of fraud by ensuring that only eligible dependents receive health coverage.
During the audit period, Aon Hewitt will:
• send letters and email to ERS participants,
• answer questions about the audit,
• provide a secure audit website, and
• receive and review documents.
The new audit has two parts. The first begins this month and will include dependents who are currently enrolled in health coverage and were added since the previous audit. The second will be for new dependents as they are added to health coverage. The ongoing audit is scheduled to begin in July 2014. Participants will not be required to recertify dependents who were identified as eligible in a previous audit.
Participants who will be part of the audit that begins this month should receive letters from Aon Hewitt beginning April 24. Participants who have questions should call Aon Hewitt directly, toll-free, at (800) 987-6605. Aon Hewitt representatives are available from 7 a.m. to 10 p.m. CT, Monday through Friday.
ERS will provide additional details and an FAQ in the coming weeks and we will share that news with you.
Texas Income Protection Plan (TIPP) participants rely on their disability benefits to pay the bills while on disability leave. That’s why you should understand the disability payment process so you can tell participants what to expect. Following is an overview of the process.
Qualifying for disability payments—Before a participant can receive disability payments, he or she must:
1. file a claim,
2. complete the waiting period (at least 30 consecutive days for short-term disability and at least 180 consecutive days for long-term disability*), and
3. have the claim approved by Aon Hewitt.
First disability payment—If a participant files a disability claim as soon as possible and the claim is approved, he or she will receive the first disability payment on the first business day of the month following completion of the waiting period. Because many factors affect the approval and processing of a disability claim, participants should call TIPP Customer Care at Aon Hewitt to determine when to expect their first payment.
Note: Payments are issued by check and mailed to the participant’s home unless he or she requests direct deposit. Direct deposit forms are available under the Forms and Publications tab on the TIPP website.
Ongoing payments—Disability payments are issued on the first business day of each month. Each payment is for the prior month. This means a payment a participant gets in April is for March benefits.
Learn more or call TIPP Customer Care at Aon Hewitt toll-free at (855) 604-6230 (TDD - 711), Monday – Friday, 7 a.m. – 7 p.m. CT.
*Employees must use all their sick leave (including extended sick leave and sick leave pool) at the same time they are completing the waiting period (30 days or 180 days). If they have more than the specified days of sick leave, benefits are not payable until all of the sick leave is used. They are not required to use your vacation or other annual leave. See page 4 (short-term disability) or page 7 (long-term disability) in the User’s Guide for more information.
Should we change the TexFlex plan?
Recent changes in federal regulations allow plan sponsors to change how health care spending accounts work. The TexFlex Health Care Account is currently surveying its customers to get their thoughts on reimbursement grace periods and carryover amount options. The results of this user survey will be relased at a later date.
Starting September 1, 2014
ERS members will soon have another dental plan option: Careington International Corporation (Careington).
This is a dental service discount plan, not insurance. The plan’s participating dentists have agreed to accept a discounted fee from participants as payment-in-full for services performed.
For Plan Year 2015, which begins September 1, 2014, you can choose 1) the dental discount plan, 2) the State of Texas Dental ChoiceSMPPO administered by HumanaDental, or 3) the HumanaDental DHMO. You can select only one of the three dental offerings.
ERS is working with Careington to develop further details about the new dental discount plan. Complete information will be available to you before Annual Enrollment begins. We are excited to offer this new option to you!
Enrolled in HealthSelectSM of Texas? You can receive your Explanations of Benefits (EOBs), Health Statements, and Claim Letters online instead of through paper mail. If you’re creating your account for the first time, your “Mailing Preference” will automatically be set to “online only.” You’ll get an email alert when a new statement is posted. So, if you have a new email address, you must update it in the HealthSelect online account. By using the “online only” option, you not only help HealthSelect reduce printing and mailing costs, but you can also cut down on clutter and paper use.
Need to update your email address with HealthSelect?
- Go to the My UHC website.
- Log in to the personal account with user name and password.
- Click on “Account Settings.”
- Click on “Change Email, Phone Number, and Security Question.”
- Enter new email address(es) in the indicated field(s).
- Click “Update.”
To learn more about HealthSelect benefits or to register for an online account, visit www.healthselectoftexas.com. If you have trouble logging into your account, call HealthSelect customer service at (866) 336-9371 (TTY 711).
We know that regular exercise can help us maintain a healthy weight and reduce stress. Lack of adequate exercise may put us at a higher risk for serious health issues. Maybe you want to exercise regularly, but aren’t motivated to take the first step. Doctors may have a prescription for that.
Research shows that people are likely to start and stick to an exercise program if their doctors write actual prescriptions instead of just telling them to exercise.
It’s a good idea for people with certain medical conditions to work with their doctors to develop personalized exercise plans.
Usually, an exercise prescription contains three types of exercise:
1. A cardiovascular workout that uses larger muscles and raises the heart rate. Experts recommend at least 150 minutes per week of moderate- to high-intensity aerobic exercise, such as:
- jogging, and
- an elliptical machine.
2. A muscle strengthening workout, such as weight lifting and resistance training, to increase the endurance of all major muscle groups.
3. Flexibility exercises that stretch your muscles, such as bending, stretching, and yoga.
Tips for staying on track
- Start with 10 minutes of exercise at a time and gradually build up to your weekly goals.
- Do what you enjoy. If you love to swim, consider joining a gym with a pool.
- Find a convenient time and place, such as a walk on your lunch break, or jumping jacks and push-ups during television commercial breaks.
- It’s a lot easier to stick to the schedule if you have a workout buddy.
- Track your progress and reward yourself when you reach milestones.
- Wear comfortable shoes and clothes for the activity.
You may think you're doing all you can to protect yourself from the sun. If you apply sunscreen with a high SPF every time you're outdoors - even on cloudy days - that's a great start. But your skin isn't the only area of your body that needs protection from the sun's harsh rays; your eyes also need to be shielded from the sun.
Stepping outside exposes you to ultraviolet (UV) rays and blue light rays. UV and blue light rays are invisible, but can lead to vision loss.
Studies show that exposure to ultraviolet light and blue light may increase your risk of developing cataracts and age-related macular degeneration. They can also cause other types of vision loss, benign growth on the surface of the eye (known as pterygium), and skin cancer around the eyes.
During summer, UV radiation is three times greater than in winter. However, people can be exposed to intense UV rays that are reflected off snow. You can damage your eyes from just a single day in the sun. UV light reflecting off the sand, pavement, or snow can burn the eye’s surface or cornea. Sunburn of the cornea, or photokeratitis, occurs when the eyes are exposed to large quantities of UV light in a short amount of time. It usually recedes within one to two days, but cumulative exposure to UV rays could be a risk factor for the diseases and conditions noted above. You should protect your eyes from the sun all year round.
To defend your eyes against sun damage:
- Wear sunglasses whenever you're outside, especially in the early afternoon and in high altitudes where UV light is most intense.
- Don't be fooled by cloudy days. The sun's rays can pass through clouds and haze, so it's still important to protect your eyes.
- Wear sunglasses that block 99% to 100% of UVA and UVB rays, as well as blue light. Glasses worn at the beach or on ski slopes should be darker to block more light.
- Some sunglasses are mislabeled, so always buy sunglasses from a reputable vendor. Your optician can check your glasses to measure the UV protection.
- Wear a wide-brimmed hat. A wide-brimmed hat or cap will block about half of UV rays. A brimmed hat or cap can also limits UV rays that can reach eyes from above or around glasses.
- Even if you have contact lenses with UV protection, wear your sunglasses.
- When swimming, wear goggles. They protect your eyes from the sun and from chlorine, which can make eyes red and puffy. When swimming in a lake or pond, bacteria can get under contact lenses and cause inflammation of the cornea.
If you have any problems with your eyes, see your eye doctor.
Keeping Your Eyes Healthy
Vision problems and eye conditions affect people of all ages. That’s why it’s important to start taking care of your eyes early in life. The following tips can help:
- Don’t smoke. Regular smoking deprives your body of nutrients that are essential in preventing certain eye diseases. If you need help quitting, talk with your doctor.
- Eat more fruits and veggies. Eat at least five servings of fruits and vegetables every day. Leafy green vegetables, such as spinach and kale, may especially benefit your eyes. These foods contain lutein—an antioxidant that may reduce your risk of some eye conditions.
- Wear sunglasses. Exposing your eyes to too much sunlight may lead to cataracts. Make sure your sunglasses block out UVA and UVB rays. Wear them every time you go outside—even on cloudy or overcast days.
- Protect against injury. Certain sports, jobs, and activities put your eyes at risk for injury or irritation. Wear appropriate eye gear to keep them safe.
- Practice good hygiene. Avoid touching your eyes. This can help prevent the spread of infections such as pinkeye. Don’t share eye drops, makeup, or contact lens supplies.
- Take care of your contact lens. If you wear contact lenses, keep them clean. Always wash your hands before handling your lenses. Don’t exceed recommended time limits for wearing them, and remove them if you feel pain.
Getting your eyes checked is one of the best ways to keep them healthy. Your eye care specialist detects and treats diseases, and corrects any vision changes you might experience. Factors such as age, health, and your risk for eye diseases determine how often you should have an eye exam.
The American Academy of Ophthalmology and the American Academy of Pediatrics recommend that all children receive vision screening during regular well child visits and vision testing starting at about age three. Talk with your eye doctor about your child’s specific needs, especially if you have family history of vision problems or if your child is showing symptoms such as lazy eye, crossed eyes, or drooping of the upper eyelid.
Periodic eye examinations are recommended for everyone over age 18. People over age 65, people with diabetes, and those at risk for eye disease may need frequent evaluations. Talk to your doctor if you experience blurred vision or other problems.
If you have sudden pain, sensitivity, discomfort, redness, or blurred or decreased vision, see your doctor or eye care specialist right away.
The ERS at a Glance report for Fiscal Year 2013 provides a statistical snapshot of the four benefits programs ERS administers: Retirement, Texas Employees Group Benefits Program (GBP), TexFlex, and Texa$aver. It also offers an overview of investment accomplishments during the past fiscal year.
Here are a few highlights:
- The health plan paid more than an estimated $2.5 billion in health care claims.
- TexFlex participants saved an estimated total of $113.5 million in taxes.
- ERS implemented a new evidence of insurability (EOI) online application process for members electing life or disability insurance benefits, making the experience faster and more accurate.
- ERS worked with UnitedHealthcare to increase the HealthSelectSM of Texas physician network to 64,000 doctors throughout the State. UnitedHealthcare also negotiated better rates with physicians, saving the health plan about $15 million.
- The ERS Retirement Trust realized a 10.07% gross investment return, which helped moderate some of the losses incurred during the economic downturn.
The ERS Board of Trustees has awarded the third-party administrator contract for our dental discount plan to Careington International Corporation (Careington). The contract is for a four-year term beginning September 1, 2014 through August 31, 2018.
The dental discount plan is not insurance, but rather a discount program for dental services. The plan’s participating dentists have agreed to accept a discounted fee from participants as payment-in-full for services performed. This is the first time ERS is offering a dental discount plan.
For Plan Year 2015, which begins September 1, 2014, ERS-eligible employees, retirees, and dependents will be able to choose the 1) dental discount plan, 2) the State of Texas Dental ChoiceSM PPO administered by HumanaDental, or 3) the HumanaDental Dental HMO. A participant can select only one of the three dental offerings.
ERS is working with Careington to develop the details of the dental discount plan. Complete information will be available before summer Annual Enrollment. ERS is excited to offer this new option to participants. Stay tuned!
When HealthSelectSM of Texas members create their online accounts with HealthSelect, their “Mailing Preference” will automatically be set to “online only.” This allows them to receive their Explanation of Benefits, Health Statements, and Claim Letters online instead of through paper mail. Members will receive an email alert when a new statement is posted. It is important that members keep their email information current in their HealthSelect online account. By using the “online only” option, members not only help HealthSelect reduce printing and mailing costs, but also can cut down on clutter and paper use.
Following is the process for the members who prefer paper mails and would like to turn off the “online only” option:
- Go to www.myuhc.com.
- Log in to the personal account with user name and password.
- Click on “Account Settings.”
- Click on “Change Mailing and Email Preferences.”
- Under “Change Setting,” click on “Receive paper mailings” for each document or click “Get paper mailings for all documents.”
- Click “Confirm.”
Here’s the process for updating an email address:
- Go to www.myuhc.com.
- Log in to the personal account with user name and password.
- Click on “Account Settings.”
- Click on “Change Email, Phone Number, and Security Question.”
- Enter new email address(es) in the indicated field(s).
- Click “Update.”
To learn more about HealthSelect benefits or to register for an online account, please visit www.healthselectoftexas.com. If you have trouble logging into your account, please contact HealthSelect customer service at (866) 336-9371 (TTY 711).
Texas Parks & Wildlife magazine is your monthly guide to the Texas outdoors. Each issue of this award-winning magazine has outstanding color photos and articles about every facet of outdoor recreation, such as Texas State Parks, fishing, hunting, camping, birding, boating, traveling, and more. State employees may subscribe for a special price of only $10 for a year’s subscription: Texas Parks & Wildlife
Women may dominate the dieting world, but obesity is an issue for men, too. Some men put more thought into how they fuel their cars than how they fuel their bodies. It's no wonder that obesity is on the rise, and that the number of obese men in the U.S. has doubled over the past 25 years.
Ready for a tune-up?
Forget the word "diet." Begin to manage your food intake and activity just like you manage your finances, your relationships, and your job.
Next, think about your health and quality of life. Though your wedding tux may be out of reach, dropping a few pounds and exercising more will improve your fitness, strength, and energy. Check with your doctor before you increase your activity level.
Other benefits of losing weight may include:
- decreased risk of diabetes, heart attack, some types of cancer, hypertension, and sleep apnea,
- better performance in sports,
- longer lifespan (your spouse and kids will appreciate this), and
- enhanced sex life. (Weight loss may even help with erectile dysfunction.)
The game plan
Here is how to get the ball rolling:
Don't skip breakfast. A morning meal gets your metabolic fire started. Ditch your muffin or donut, and have some instant oatmeal with walnuts; eggs and low-fat cheese on an English muffin; peanut butter on whole-wheat toast; or a bowl of whole-grain cereal with nuts and fruit.
Cut portions in half. Men tend to like volume. But overeating is probably what got you here in the first place. So cut back on portions, especially when dining out. When cooking at home, add more veggies to your meal so you're eating more of the right stuff. For instance, add zucchini, mushrooms, and onions to your pasta sauce. Then use more sauce, and less pasta.
Don't overdo protein. Strength training, along with moderate amounts of protein and carbs, is the key to muscle building--not excess protein. Most men get more than enough protein in their diets. Forget protein powders, and stick with lean chicken, turkey, fish, eggs, and beans. Even veggies and grains have protein.
Focus on good carbs. Carbs are essential for energy and building muscle. Stick with wholesome choices and go for fruits and veggies; whole-grain breads, cereals, and pastas; brown rice; and baked and sweet potatoes. Limit cookies, donuts, cakes, large bagels, and white flour rolls.
Pay attention to real hunger. Eat when you are hungry, and stop when you are full. This includes pushing away from the table when there is still food left.
Snack smart. Instead of vending-machine candy, go for a piece of fruit, half a turkey sandwich, or some low-fat cheese and whole-grain crackers. Keep healthy snacks stocked at the office.
Exercise regularly. There is no better one-two punch for weight loss than regular exercise and good nutrition. Work in some type of aerobic exercise most days of the week. Strength train two to three times a week to build muscle. This will help increase your metabolism. Check with your doctor before you increase your activity level.
Travel light. Traveling for business adds an extra challenge. Try to stick to a meal schedule and keep in mind that many restaurants offer lighter fare on their menus.
- For breakfast, go for scrambled eggs with toast, or oatmeal with low-fat milk and fresh fruit. Limit refined carbs, such as bagels, pancakes, and waffles.
- For lunch, opt for salads or sandwiches/wraps with grilled chicken, shrimp, or salmon. Ask to skip or go light on the mayo.
- Watch dinner portions. Don't hesitate to leave leftovers on your plate. Opt for more fish and chicken versus beef, and avoid fried foods.
Limit alcohol. Spoiler alert: alcohol has calories. If you drink, limiting yourself to two drinks a day will cut the amount of calories you consume. It will also help you avoid gaining belly fat and will enhance your overall health.
Finally, don't rush it. A goal of one-half to one pound a week is the most sensible for the long term. When it comes to permanent weight loss, slow and steady wins the race.
The Affordable Care Act (ACA) has been in the news a lot, and we’ve heard from members who have questions about the new law. Many of the provisions of the law that affect Texas Employee Group Benefits Program (GBP) members and their dependents are already in place, such as 100% coverage for preventive services. Your and your dependents’ eligibility for GBP insurance has not changed because of the law. Employees for whom the State pays 100% of the GBP premium are considered to have affordable coverage under the ACA, and GBP coverage currently meets the minimum coverage requirement under the ACA for employees eligible to receive the 100% State premium contribution.
Be aware that this year the “individual mandate” goes into effect. The ACA requires everyone to have health insurance coverage starting in 2014, unless the person or family qualifies for an exemption or transition relief. Everyone, including children, will be subject to a federal tax if they do not have coverage by January 1, 2014, and do not qualify for an exemption or transition relief. An adult or married couple who can claim a child or another individual as a dependent for federal income tax purposes is responsible for paying the tax if that person is not covered starting in 2014.
When you experience a qualifying life event (QLE), you have the opportunity to add or change coverage for yourself or additional family members within 30 days of the event.
Some examples of a QLE are:
- getting married,
- having or adopting a child, or
- your spouse gets a new job.
Recent ERS changes have broadened some QLEs:
If your dependent or dependents gain other coverage on the first day of the month, you are now able to use the last day of the previous month to drop them from your coverage. For example, if a dependent gains other coverage March 1, you can use the date of February 28 to drop him or her from your GBP coverage effective March 1. Please remember that, according to IRS regulations, purchasing coverage through the Affordable Care Act (ACA) Marketplace (also known as the “exchange”) is not an eligible QLE.
If you experience a change in marital status QLE, such as a divorce, and you have a TexFlex health care account, you can now decrease or drop your monthly contributions. For example, if you get divorced February 20, you can drop or decrease your TexFlex health care reimbursement account’s monthly contributions, effective March 1. You would still need to pay back any contributions you’ve already used. All other QLE rules still apply.
Get access to your TexFlex account information anywhere you go with the free PayFlex Mobile™ application. With this app, TexFlex participants can easily manage their accounts virtually 24/7. It’s available for iPhone®, iPad®, Android™, and BlackBerry®.
The PayFlex Mobile app lets you:
- view your account balance and manage your account funds,
- submit a claim for reimbursement and view clams processed,
- view TexFlex debit card purchases and submit documentation (if applicable), and
- view a list of common eligible expense items.
Visit the online TexFlex Resource Center for more information on the app and its features.
You may have noticed that ERS mentions “GBP” quite a bit, but what does it mean? The Texas Employees Group Benefits Program, which ERS calls “GBP” for short, is composed of all the insurance benefits ERS administers for its members. These include health, dental, life, Voluntary Accidental Death and Dismemberment (AD&D), the Texas Income Protection Plan (TIPP), and the Prescription Drug Program. If you have any of these, you are considered GBP participants.
Please be aware that GBP does not include Retirement, TexFlex or Texa$aver, which are also administered by ERS, but as separate programs.
You may have noticed that ERS mentions “GBP” quite a bit, but what does it mean? The Texas Employees Group Benefits Program, which ERS calls “GBP” for short, is composed of all the insurance benefits ERS administers for its members. These include health, dental, life, Voluntary Accidental Death and Dismemberment (AD&D), the Texas Income Protection Plan (TIPP), and the Prescription Drug Program. If you have any of these, you are considered GBP participants.
The December Board of Trustees meeting resulted several changes to ERS policies, including two changes to ERS policies for Texas Employees Group Benefits Program (GBP) participants that are effective January 1, 2014:
- Participants can now drop a covered dependent on the last day of the month prior to the dependent gaining other coverage. The dependent's new coverage must go into effect on the first day of the month after you drop them. For example, if your dependent gained other coverage February 1, you can drop their coverage on your account January 31, effective February 1. Mid-month dates and processing for all other qualifying life event (QLE) scenarios remain unchanged.
- Employees can now decrease their TexFlex health care account contributions due to a change in marital status, such as a divorce. For example, an employee who experiences a divorce can now decrease his or her heath care account contributions that were intended to be used for the spouse, who would no longer be an eligible dependent. This change must be made within 30 days of the qualifying marital status change.
Some participants in the Texa$aver 457 Program will pay lower fees starting February 1, 2014.
In its annual review of the Texa$aver program, ERS determined that revenues from current fees are more than enough to cover the program’s costs. ERS therefore recommended reducing fees for certain accounts, and the ERS Board of Trustees approved the new fees at its December meeting. Texa$aver fees are already lower than the industry standard, so we are pleased to lower them even further for some accounts.
Please visit the Texa$aver website for more information about account fees.
On December 8, all ERS health and dental insurance plans began processing each new participant’s enrollment 30 days before the coverage begin date. New employees now receive initial medical ID cards with “No PCP Selected”. If you select the HumanaDental DHMO plan as a Post Hire Change (PHC), you may also receive an initial dental ID card with “No PCD Selected” before the coverage begin date.
Upon receipt of the initial health or HumanaDental DHMO insurance card, you can call the insurance plan to designate a primary care physician (PCP) or primary care dentist (PCD). A second card will then be sent out with the PCP’s or PCD’s name on it.
Nine ways to exercise ... when you don't have the time
Think you have no time to exercise? These strategies will help you get fit in just minutes a day.
We all know exercise can help us improve our health and lose weight, yet, 25% of adults don't exercise at all, according to the U.S. Surgeon General.
Hectic schedules may be to blame. Who has the time to exercise when juggling work, school, family, and more? It's worth squeezing it in, though, because regular physical activity can relieve daily stress and lift your mood. At the same time, you can reduce your risks of diabetes, high blood pressure, and heart disease.
Aim to be active for at least 30 minutes most days, but it's okay to start slowly. Find activities that you enjoy. You need to find only a few minutes a day to start getting the health benefits. First, check with your doctor before you start or increase your activity level.
Tips for fitting in fitness
- Wake up a little earlier. Start by setting your alarm clock just five minutes earlier. Do stretches and jumping jacks before getting in the shower, or follow a short exercise DVD.
- Find a workout buddy. Exercising with a friend is more fun than working out alone and a good motivator. Ask a coworker to go for a walk during lunch or see if a neighbor wants to shoot hoops.
- Change into exercise clothes before leaving work. You'll be ready for a short walk as soon as you get home.
- Schedule your fitness activities. If you put exercise on your calendar like other appointments, you're more likely to do it.
- Acknowledge your successes. Keep a log of all the times you make a healthy choice to move more, such as by taking the stairs instead of an elevator. After the first week, reward yourself with a new pair of sneakers or a cool new water bottle.
- Create a home (or desk) gym. If you have equipment always at the ready, it will be easy to steal five minutes to use it. A jump rope, a stability ball, exercise bands, and dumbbells don't cost much or take up much room.
- Move while you watch TV. Don't sit idly--or worse, snack--while watching TV. Do sit-ups or jog in place instead, even if only during commercials.
- Play games with your kids. Don't just keep an eye on your kids when they play outside--join in their fun! Play tag or Duck Duck Goose, or just toss a ball back and forth. If your kids love video games, think about swapping their current console for one that encourages movement, like Wii or Xbox One. The whole family will break a sweat using special controllers to compete at boxing, tennis, golf, and bowling.
- Exercise while you work. Raise your activity level and productivity with neck rolls or arm raises (push hands out to the side and then up toward the ceiling). Or do a few modified push-ups on the edge of your desk.
Stepping it up
After you've built short periods of activity into your day, think about times when you could lengthen each burst by a few minutes. The key is to start small and ramp up gradually.
Even if you're worn out from a busy day, try to make time for fitness. Regular exercise actually boosts your energy level. Exercise, along with restricting calories, is also important for shedding pounds and maintaining a healthy weight.
Next time you look for an excuse to skip exercise, remind yourself of the benefits. You're helping yourself feel good, look better, and live longer. Who wouldn't want that?
Watch your diet to help maintain your health
How much does your daily eating habits affect your daily health? Probably more than you think. Along with quitting smoking and exercising regularly, the best way to improve your overall health is to eat well and watch your weight. Your lifestyle habits, including how you choose to eat, are under your control.
Here are some eating tips to help maintain a balanced diet:
- choose whole foods over supplements;
- increase servings of fruits, vegetables, beans, and whole gains;
- keep fat intake to less than 30% of total calories; and
- limit your alcohol intake.
Whole, plant-based foods provide a wide array of fiber, minerals, and vitamins that help fight disease. However, diets high in fat tend to be high in calories and excess alcohol raises the risk of many types of serious illness, including cancer.
So on your next trip to the market, linger in the produce section. Eating balanced meals goes hand in hand with other disease prevention habits, as well. Good nutrition can go a long way toward lowering your risk for heart disease, diabetes, and other serious diseases.
Benefits Training Offerings - January 2014
Be Benefits Wise
January 29, 2014 (11:30am – 1pm)
Need a refresher in benefits? The purpose of this seminar is to increase your knowledge about the benefits you have available to you as a University of Houston employee including: health, dental, optional life insurance, TexFlex (Flexible Spending Account), Short- and Long-Term Disability, and Long term care insurance. For questions, please contact the HR Service Center at 713.743.3988.
January 22, 2014 (10am – 11:30am)
Following this course, participants will be able to gain a greater understanding of ORP and TRS retirement benefits, gain a greater understanding of ORP and TRS vesting, gain a greater understanding of TRS retirement eligibility, understand eligibility for continued insurance benefits at retirement, understand establishing TRS Service Credit, gain a greater understanding of calculating TRS retirement benefits, employment after retirement guidelines. For questions, please contact the HR Service Center at 713.743.3988.
Did you know you can use a TexFlex day care account to pay for qualified adult care or elder day care expenses? If you have experienced a Qualifying Life Event (QLE), you can contribute to a day care account with pre-tax money from your paycheck. This lowers the amount of taxable income, saving you money.
The adult needing care must meet qualifications as determined by the IRS including:
- be a spouse, an elderly parent, an adult child, sibling, stepsibling, or ancestor of taxpayer who is incapable of self-care;
- be claimed as a dependent on federal income taxes; and
- live with the employee for more than half of the tax year.
For in-home care to qualify for reimbursement, the adult needing care must spend at least eight hours per day at home. It is the participant’s responsibility to make sure the person he or she takes care of meets the requirements for a dependent. TexFlex day care accounts are subject to IRS audits.
To add an adult dependent during the plan year, employees must enroll within 31 days of a QLE. For day care accounts, that includes:
- date the previous caregiver died and the survivor looked to the employee for support,
- date a doctor or court certified the adult was incapable of caring for themselves,
- date an adult began living with the employee who provided more than 50% of the support, or
- the beginning of the new tax year when the employee expects to provide 50% of the support to the dependent.
You can also open a TexFlex day care account for adult/elder day care expenses during the annual open enrollment period, without a QLE. The adult dependent must still meet the eligibility requirements listed above. For more information about TexFlex day care accounts, please contact TexFlex Customer Service toll-free at (866) 353-9839.
ERS is pleased to announce KelseyCare Advantage has just received the coveted five-star Medicare rating for the 2014 plan year. This achievement is the result of the program’s quality-rated health and prescription drug plan services. KelseyCare Advantage’s 2014 overall plan rating is based on 48 healthcare/service indicators including detecting and managing illness, keeping members healthy, customer service, and member satisfaction.
If you are 65 or over, about to leave employment, and in the Houston area, sign up for Medicare to be eligible for KelseyCare. To learn more about KelseyCare Advantage, please visit online or call (877) 853-9075.
On January 1, as part of the implementation of the federal Affordable Care Act (ACA), health insurance will be available through the Marketplace. Some ERS participants may be able to purchase coverage for themselves and/or their dependents through the Marketplace, but the availability of such coverage is not a qualifying life event (QLE) that would allow them to drop their overage before the next Annual Enrollment period.
If you have questions or need additional information, please call the HR Service Center at x3-3988.
We are pleased to announce that Quest Diagnostic Laboratories has partnered with ERS to become part of the HealthSelect network as of September 1, 2013. This means HealthSelect participants who receive covered services from Quest will receive in-network benefits.
It is important to note that Quest is a provider to ERS members, not all of the UnitedHealthcare network, which is national in scope. Therefore, you will not see Quest Diagnostic Laboratories on the UnitedHealthcare network provider list or the online provider search tool. If you have questions about HealthSelect providers or benefits, please call HealthSelect Customer Service toll-free at (866) 336-9371.
If you still have funds left in your TexFlex account from Plan Year 2013, September 1, 2012-August 31, 2013, you have until November 15, 2013, to spend it on eligible expenses. File your claims by December 31, 2013, for TexFlex purchases made from September 1, 2012 to November 15, 2013.
Options for submitting a claim:
- Fill out an Express Claim on the TexFlex website and upload your documentation, or you can fax or mail the Express Claim to PayFlex.
- Print a paper claim form and mail it to PayFlex, along with your documentation.
You can check your account balance anytime on the TexFlex website.
Check your paystub
You may have seen changes in your October 1 paystub. Payroll adjustments, increased retirement contributions, and any changes related to Annual Enrollment (including dependent rate changes) were all reflected on October 1 paychecks. For questions related to ERS benefits, log onto ERS OnLine at www.ers.state.tx.us to review your benefits selections.
For all other payroll deductions or questions, please contact the HR Service Center at 713/743-3988.
With flu season just around the corner, be sure to get your flu shot.
If you’re a HealthSelect member, you can get your flu shot covered 100% with no copays, coinsurance, or deductibles when you use a contracted network provider like a participating CVS® MinuteClinic®, Walgreens Pharmacy, or Target® Clinic. Read more on this Flu Shot information sheet.
For all other health plans, please contact your plan representative.
Using generic drugs is a great way for employees and their families to save on prescription drug costs, and cost savings are about to become easier as some big names are going generic, including Singulair® (available now) and Cymbalta® (late 2013), as well as Nexium®, NovoLog®, and NovoLog® FlexPen® (in 2014). That’s good news for HealthSelectSM of Texas prescription drug program participants.
For example, the cost of a 30-day supply of a brand-name drug for insulin is $150, but the generic costs $75. If a member buys the brand-name, it will cost the copay of $20 plus the $75 difference between the brand-name and the generic, which would total $95. Generics are a terrific option for many patients, and prescribing doctors will be happy to address any concerns.
Visiting your doctor for a flu shot? Check your cholesterol, too
It’s important to protect yourself from the flu — and while you’re at the doctor, you can ask him or her to check your cholesterol! Why test? Just like the flu, cholesterol levels tend to be highest in the fall and winter.
Cholesterol can build up for many years before any symptoms develop. It is the most common cause of heart disease, and happens so slowly that you are not even aware of it. Cholesterol can form a substance called plaque on the walls of your arteries, which can prevent enough blood from flowing to the heart. Sometimes, plaque can break off the artery walls to form blood clots that can cause a heart attack or stroke.
You can experience plaque buildup even when you are healthy, which is why cholesterol screening is so important. Be sure to get tested on your next doctor visit!
You’ve probably been hearing a lot about the Affordable Care Act (ACA), as the new Health Insurance Marketplace opens on October 1. The Marketplace is for people who do not have affordable employer-based insurance. Because the State pays 100% of their health insurance premiums, full-time state employees are considered to have affordable insurance and therefore wouldn’t be eligible to purchase insurance through the Marketplace. Still, we understand that some employees might have questions about the ACA.
ERS developed answers to employees’ common questions about the ACA. (We also have answers to employers’ questions—for both state agencies and higher education institutions.) If you and your employees have additional questions, more information is available at Healthcare.gov or call (800) 318-2596.
When enrolling a newborn into an ERS health plan, it is critical to include the appropriate reason for the event when when filling out the form. Your four options are “Adoption,” “Birth,” “Marriage/Acquisition of Other Than Natural Child,” and “Not Newly Acquired.”
If you are enrolling a new baby, make sure to select “Birth.” If you don’t, ERS OnLine will default the new dependent to “Not Newly Acquired” which makes the health coverage effective date the first of the month after the event, rather than the date of birth, and this could affect your claims.
From September 1 to August 31*, you and each of your covered dependents must pay separate $50 deductibles before your insurance plan begins to cover drug costs. For example, if you have two dependents, you would have a total family deductible of $150 per plan year for prescription medications if all of you fill at least $50 worth of prescriptions.
One of the best ways to save money on prescriptions is to make sure you take generic drugs whenever you can. Always consult your doctor before switching medications. New generic drugs come onto the market regularly. It’s important to know when generics become available, because they generally cost less, and they have the lowest copays. If a generic is available and you buy the brand-name drug instead, you will pay the generic copay plus the difference between the cost of the brand-name and the generic drug.
*For Medicare-eligible retirees and dependents in the HealthSelect Medicare Rx program, your drug deductible starts over January 1.
The cost of a 30-day supply of a brand-name drug for diabetes is $150, but the generic costs $75.
If you have not met the $50 yearly deductible, and you buy the brand-name, it would cost you the pre-deduction copay ($50) plus the cost difference between the brand-name and the generic ($75) which would come to $125.
If you have met the $50 yearly deductible, and you buy the brand-name, it would cost you the post-deductible copay for a maintenance medication ($20) plus the cost difference between the brand-name and the generic ($75), which would come to $95.
|Before Meeting Yearly $50 Deductible||After Meeting Yearly $50 Deductible|
|Brand-Name Drug Cost||$150||$150|
|Generic Drug Cost||$75||$75|
|Generic Copay (maintenance medication)||$50||$20|
|Total (Generic Copay + Cost Difference)||$125||$95|
Don’t be fooled by cloudy fall days. The sun’s rays can pass through clouds and haze, so it’s still important to protect your eyes. Defend your eyes against sun damage using these helpful tips:
- Wear sunglasses outside, especially in the early afternoon and in high altitudes – where UV light is most intense.
- Wear sunglasses that block 99% to 100% of UVA and UVB rays, as well as blue light. Some sunglasses are mislabeled, so always buy from a reputable source. Your optician can check your glasses to measurer UV protection.
- Even if you have contact lenses with UV protection, wear your sunglasses.
- Wear a wide-brimmed hat or cap to increase protection.
On October 24, HealthSelect of Texas, administered by UnitedHealthcare, will introduce enhanced login security on myuhc.com/hs to better protect your health information online. Please be aware:
- You should have received an email about the planned update.
- If you registered on myuhc.com/hs prior to October 2012, you will be asked to update your security questions and contact information.
- If you registered after October 2012, you will not have to make updates.
- If you log in from an unrecognized device, you will receive a secure access code. You can choose to receive the code by email, text, or phone call.
- If you log in from a recognized device, then you don't need an access code.
For more information, contact the HealthSelect Customer Service team toll-free at (866) 336-9371.
This legislative session brought some changes to the ERS benefits programs. These changes are intended to comply with new Federal mandates while reducing costs so that ERS can continue to provide coverage well into into the future:
- A tiered insurance contribution for retirees based on years of service.
- A tobacco certification requirement for everyone enrolled in health insurance.
- A change in the health coverage waiting period for new employees.
The tobacco certification requirement went into effect on September 1, 2013. For clarification on other retirement and insurance changes, please see the chart below. For more information you can also visit the ERS legislative webpage at www.ers.state.tx.us/About_ERS/Legislative and the Texas Legislature Online at www.capitol.state.tx.us.
|What changed?||How did it change?||Who is affected?||When is it effective?|
|Insurance state contribution for retirees changes||
The insurance state contribution for retirees changed based on years of service. This change rewards long-term employees by providing them with a higher contribution toward health insurance premiums in retirement.
As a full-time employee, if you have at least:
|GBP members with less than five
years2 of GBP participation on 8/31/2014
|Definition of a “full-time” employee changes||The definition of a full-time employee for benefit purposes is changing. As of 9/1/2013, a full-time employee is an individual designated by his or her employer as working 30 hours or more per week. If you work 30 hours or more per week in a benefits-eligible position and do not have student status as a requirement for employment, you will receive the full state contribution for your health insurance premium.||Employees||9/1/2013|
|Health coverage waiting period decreases||As a new employee, your health coverage begin date is the first of the month following your 60th day of employment, not to exceed 90 days.||New employees hired on 9/1/2014
1Part-time employees receive half the contribution of a full-time employee.
2You must have 10 years of GBP participation to be eligible for insurance at retirement.
ERS members can now apply for coverage for a disabled dependent over age 26, even if they were not previously covered.
Evidence of insurability (EOI), also known as proof of good health, will not be required to add Dependent Term Life Insurance coverage for disabled dependents over the age 26 if they are added no later than September 30, 2013. These dependents are considered “newly eligible” due to new legislation (HB 2155). After September 30, the EOI requirement for Dependent Life will only be waived for a new employee enrolling a dependent for the first time, or for a newly eligible dependent who gains coverage due to incapacitation.
For additional details, including a complete explanation of eligibility requirements and signup periods, please visit the ERS website: http://www.ers.state.tx.us/News/Articles/Disabled_dependents_over_26/
ERS members can have great discount offers sent right to their inbox! Go to Discount Purchase Program, www.beneplace.com/discountprogramers/, select “active employee”, and click “Sign up” (on the upper left side of the website) to start receiving timely special offers – make sure you select your current status as “employee” from the drop-down menu and add firstname.lastname@example.org and email@example.com to your address book so messages don’t land in your junk folder.
You’ll get big discounts on products and services you already use, with convenient direct links to the best deals – no more hunting around online! Plus, save even more with exclusive seasonal offers.
You can stop the emails at any time. Simply click the “unsubscribe” link in any offer email you receive. And if you change your mind, signing up again is easy!
Any personal information you provide will be used solely for communication purposes and will not be shared.
Getting your eyes checked is one of the best ways to help them stay healthy. The American Academy of Ophthalmology and the American Academy of Pediatrics recommend that, starting at about age three, all children receive vision screening during regular well child visits. Everyone over age 18 should have periodic eye examinations. People over age 65, people with diabetes, and those at risk for eye disease may need more frequent evaluations.
Remember, if you have sudden pain, sensitivity, discomfort, redness, or blurred or decreased vision, see your doctor or eye care specialist right away.
Here is an overview of basic vision benefits for each health insurance plan offered by the State of Texas. For more information, please call your plan representative.
Overview of vision benefits
|Plan||HealthSelectSM of Texas*|
|Routine Eye Exam||100% after $40 copay using network doctor, or
80% if you receive services subject to coinsurance
Does not include contact lens exam
Up to 30% discount off retail price at certain providers
10% discount at participating Walmart® and Sam's Club® locations
|Lenses||• Single vision lenses—you pay $45 or less
• Lined bifocal lenses—you pay $65 or less
• Lined trifocal lenses—you pay $95 or less
|Contacts||Up to a 20% discount for fitting and materials for non-disposable lenses|
|More Information||Health and Vision Discount Flier|
*All vision benefits for HealthSelect are for the calendar year.
You can also visit discountprogramers.com for 15% off eyewear and contacts for you and your family.
Payroll adjustments for benefit changes you made during Annual Enrollment, along with premium rate changes for dependents, will be reflected in your October 1 pay stub. For questions about these deductions or benefits, please contact ERS toll-free at (866) 399-6908, Monday-Friday from 7:30 a.m. – 5:30 p.m.
For all other payroll deductions or questions, please contact the HR Service Center at (713) 743-3988.
Website updated and call center available
On September 1, Aon Hewitt became the administrator of the Texas Income Protection Plan (TIPP), which is our short-term and long-term disability insurance program.
Aon Hewitt provides customer service and claims administration for TIPP. Program participants can now call TIPP Customer Care at Aon Hewitt toll-free at (855) 604-6230, Monday through Friday from 7 a.m. to 7 p.m. CT. Members can also visit the updated TIPP website.
Be aware that some primary care physicians (PCPs) are calling their clinics “urgent care centers,” even though they are not credentialed as such. This is particularly true in areas of Texas where there are no urgent care centers available. Employees are utilizing these PCP clinics and offices as urgent care centers, only to find out later that the services they received will not be paid at in-network benefit levels. Make sure to verify that your urgent care center qualifies as a credentialed urgent care center before you need their services!
HealthSelectSM of Texas members can get guidance on whether to visit a PCP, urgent care center, or hospital emergency room by calling myNurseLineSM toll-free at (877) 731-8306. Registered nurses are available to help 24/7, at no extra cost to members.
Reminder - Enroll Newborns for Health Insurance Coverage
UnitedHealthcare (UHC) will send every HealthSelect of Texas participant who is receiving prenatal care a Healthy Pregnancy Guide, which is an informational booklet that includes an insert reminding the parent-to-be to enroll the newborn in their health plan. UHC is also adding a reminder to their contact center and provider line checklist for the participant to enroll his or her baby in the health plan within 31 days of being born.
The ERS Board of Trustees awarded third-party administration of the Texas Employees Group Benefits Program (GBP) disability insurance plans to Aon Hewitt Absence Management LLC (Aon Hewitt). The contract will cover a four-year term beginning September 1, 2013, through August 31, 2017. Aon Hewitt will provide customer service and claims administration to disability plan members.
With the change in administrators, ERS is taking the opportunity to brand the disability plans as Texas Income Protection PlanSM (TIPP). You will see TIPP used in future communications regarding disability plan information. TIPP includes both the short and long-term disability options. Short-term disability provides a maximum benefit of 66% of an enrolled employee’s monthly salary up to a maximum of $10,000 or $6,600, whichever is less, for a period no longer than five months. Long-term disability coverage provides a maximum benefit of 60% of an enrolled employee’s monthly salary up to a maximum of $10,000 or $6,000, whichever is less, for a period ranging from 12 months up to full Social Security benefit age, depending on the employee’s age at the time of disability.
Look for Aon Hewitt to provide more information on the disability plans:
- TIPP Customer Care will begin taking calls on September 3, 2013, and will be available Monday – Friday from 7 a.m. to 7 p.m. CT.
- TIPP website update in September will include useful information for both new and existing customers
For more information, you can review the TIPP FAQ.
If you are using Internet Explorer version 10 (IE 10), you might see errors when you sign into your ERS OnLine accounts.
If this is happening to you, please try using IE9 (or an earlier version), Google Chrome, or Mozilla Firefox to access your accounts. If you prefer to continue using IE10, you can try changing the “view-as” setting in Internet Explorer to IE 9:
- Open Internet Explorer.
- Press the F12 key; a menu bar will appear at the bottom of the screen.
- Click “Browser Mode: IE10 Compat View.”
- Change Compatibility View to Internet Explorer 9.
- Press the F12 key again to make the menu disappear.
- ERS OnLine will now display properly.
- You will need to repeat these steps if you close Internet Explorer and open it again.
These instructions can also be found online.
If this doesn’t help, you can also call ERS. Please understand that hold times may be long during Annual Enrollment.
If any of your employees or colleagues have a problem viewing their ERS OnLine information, please share this information or suggest they call ERS toll-free at (866) 399-6908.
Remember that from September 1 to August 31*, you and each of your covered dependents must pay separate $50 prescription deductibles before your plan will begin covering drug costs. For example, if you have two dependents, you would have a total family deductible of $150 per plan year for prescription medications if all of you fill at least $50 worth of prescriptions.
One of the best ways to save money on your health care is to make sure you take generic drugs, if approved by your doctor. New generic drugs come into the market all the time, and they generally cost less and have the lowest copay. Furthermore, if a generic is available and you buy the brand-name drug instead, you will pay the generic copay plus the difference between the cost of the brand-name and the generic drug.
The cost of a 30-day supply of a brand-name drug for diabetes is $150, but the generic costs $75.
If you have not met the $50 yearly deductible, and you buy the brand-name, it would cost you the pre-deduction copay ($50) plus the cost difference between the brand-name and the generic ($75) which would come out to $125.
If you have met the $50 yearly deductible, and you buy the brand-name, it would cost you the post-deductible copay for a maintenance medication ($20) plus the cost difference between the brand-name and the generic ($75), which would come out to $95.
|Before Meeting Yearly $50 Deductible||After Meeting Yearly $50 Deductible|
|Brand-Name Drug Cost||150.00||150.00|
|Generic Drug Cost||75.00||75.00|
|Generic Copay (maintenance medication)||50.00||20.00|
|Total (Generic Copay + Cost Difference)||125.00||95.00|
Participants can be reimbursed up to the amount available in their accounts each month, but the rules surrounding eligible dependent day care expenses has changed:
Effective immediately, a child turning 13 is considered a qualifying life event (QLE) for TexFlex accounts. This means employees can change contributions to their TexFlex Dependent Care Reimbursement accounts if their children turn 13 during the plan year, without waiting until the next Annual Enrollment period. In the past, employees were unable to change contributions if their children turned 13—the cut-off age for child care reimbursement—during the plan year, which meant they often had to forfeit unspent account funds.
The Board of Trustees adopted Plan Year 2014 rates for the health, dental, life, Voluntary Accidental Death and Dismemberment (AD&D), and disability plans. Contribution rates for health insurance are set based on funding provided by the Texas Legislature. With the 83rd Texas Legislature still in session, and no final approved appropriation, the ERS Board of Trustees adopted Plan Year 2014 health insurance rates at a level not to exceed the anticipated funding increase of 7%. This increase is expected to adequately support health plan costs through the next plan year under the current benefit structure. The Board of Trustees granted authority to the ERS Executive Director to lower the adopted contribution rates should the final appropriation be lower than anticipated, or it is determined that lower rates can support the health plan and current benefits.
Individuals enrolled in the State of Texas Dental Choice PlanSM will experience no increase in their monthly member contribution rates while those enrolled in the HumanaDental DHMO will pay approximately 7% more during Plan Year 2014. The increases for HumanaDental DHMO participants will range from 60 cents for member-only coverage to $1.83 for spouse and children coverage.
There will be no change in the monthly cost for Life Insurance and Voluntary AD&D coverage and no change in the cost for Long-term Disability coverage. However, it was necessary to increase rates for Short-term Disability coverage. Persons enrolled in the Short-term Disability plan will experience an increase in monthly cost of 4 cents per $100 of monthly covered salary.
If you are a HealthSelectSM of Texas participant, you can get most of your questions answered by contacting the HealthSelect Customer Service team toll-free at (866) 336-9371. You can ask questions about such things as benefits, claims, finding network providers, updating or changing primary care physicians (PCPs), and confirming referrals.
Some benefits under HealthSelect don’t require a referral from a PCP. You don’t have to get referrals when you go to an urgent care center, convenience care clinic, or OB/GYN provider or when you receive mental health/substance abuse counseling.
Since January 1, 2013, HealthSelect cards issued to new participants no longer display the Caremark logo. If you lose your prescription ID card, call Caremark toll-free at (888) 886-8490.
Scott & White will expand coverage to three additional counties as of September 1, 2013 – Austin, Freestone, and Waller counties. The map with the pending counties is available on the ERS website. ERS is notifying members in the three counties about their new health insurance option. ERS has also updated the Benefits Coordinator Guide to Annual Enrollment 2013 with this information.
As required by the federal Affordable Care Act, effective September 1, 2013, all state and higher education employees working at least 30 hours a week should be designated as full-time employees for health insurance coverage. This means that, beginning September 1, the State will pay the full health insurance premium for any employee eligible for ERS medical insurance who works at least 30 hours a week. Until September 1, employees who work less than 40 hours a week are considered part-time, and the State pays only 50% of their health insurance premiums.
If you wish to add insurance coverage for a dependent who was dropped due to the recent Dependent Eligibility Audit, it is your responsibility to submit all valid proof of dependent eligibility documentation during Annual Enrollment.
If you submit proof of eligibility documentation due to Annual Enrollment, then you must also include a completed Annual Enrollment Form found on the Annual Enrollment page after July 8.
Send documentation to ERS by:
- fax at (512) 867-7438, or
- mail to:
ERS Customer Benefits
Attn: Benefit Support Services
P. O. Box 13207
Austin, Texas 78711-3207
All individuals enrolled in ERS health insurance plans must certify their status as tobacco users or non-users. Beginning September 1, 2013, GBP members who do not certify their tobacco-use status will be charged a monthly tobacco user premium—even if they don’t use tobacco.
Under the new policy, ERS members must certify that they and their dependents do or do not use tobacco, or be charged a premium of $30 each (up to $90 per household per month). Members will have until August 31, 2013 to certify, to avoid incurring the additional premium for non-certification in September. The new policy is based on legislation passed in the recent session.
The following chart provides an overview of who will pay an additional $30 premium each month (up to $90 per household). Please note that only adults who fail to certify will be charged the additional premium; those under 18 who are not certified will not be charged. Certified tobacco users of any age—adults and minors—will be charged.
|Certified as Tobacco User||Certified as Non-user||Failed to Certify|
|Covered Adult Dependent (18 Years and Over)||Pays||Doesn't Pay||Pays|
|Covered Child Dependent (Under 18 Years)||Pays||Doesn't Pay||Doesn't Pay|
ERS understands this is a significant change and will be notifying members--in Annual Enrollment materials, at Annual Enrollment fairs, and in News About Your Benefits--about the need to certify, the possible additional premium, and how to certify themselves and their dependents.
As of September 1, 2013, because of changes to federal law, the maximum health care annual contribution for the ERS TexFlex program will drop to $2,496 (12 months) or $2,493 (nine months).
On September 1 of each year, if you were enrolled in TexFlex, you will automatically be re-enrolled in TexFlex accounts at your same annual contribution level—unless you make a change during Annual Enrollment.
The annual TexFlex health care pre-tax contribution limit is $2,496 for 12 months or $2,493 for nine months. If you contributed more than the maximum to a health care account last year, your contribution for this year will drop to $2,496 (12 months) or $2,493 (nine months) automatically.
The annual TexFlex day care pre-tax contribution limit is about $5,000 per household/family, or the employee or spouse’s earned income, if lower. If you and your spouse each have a day care account, you are limited to $5,000 between the two of you..The administrative fee ($12) and the optional TexFlex debit card fee ($15) will remain the same for each account. The optional debit card fee is $15, even if you have both health care and day care accounts.
You don’t have to wait until Annual Enrollment to change your beneficiaries.
It’s important to tell us who you want to receive your retirement account and life insurance benefits in the event of your death. This person is called your beneficiary. You can have more than one beneficiary. Before going online to select your beneficiary, make sure you have your beneficiary’s Social Security number (SSN), date of birth, and mailing address.
These instructions apply to beneficiaries for your ERS insurance and retirement benefits. View information on designating Texa$aver plan beneficiaries.
Hypertension strikes one in three American adults. Learn the top lifestyle strategies that can make a real impact on lowering your blood pressure.
About one in every three American adults has hypertension, or high blood pressure. Medication is often prescribed, but that's not the only solution. Many lifestyle strategies have also been shown to have an impact. For some, weight loss combined with exercise and a healthy eating plan may reduce or eliminate the need for medication altogether.
Your doctor can help you decide whether to take a combined approach (medication plus lifestyle) or whether to try following these healthy lifestyle strategies first:
1. Increase exercise. Aerobic exercise can lower blood pressure and also help with weight loss. It doesn't take a time-consuming workout in a gym to reap the benefits, either.
- As few as 30 minutes of moderate exercise on most days of the week has been shown to be effective.
- Aerobic activities such as walking, biking, swimming, and water aerobics often produce the best results.
- Before you start an exercise program, ask your doctor what type and amount of exercise is right for you.
2. Cut your salt intake. One teaspoon (2,400 mg) is the maximum recommended daily amount. Reducing this to two thirds of a teaspoon (1,500 mg) can make a big difference.
- Check labels of food and over-the-counter medication for their sodium content.
- Use herbs and spices, instead of salt, to flavor foods.
- Avoid processed foods such as canned and frozen ready-to-eat foods, cheeses, and luncheon meats.
3. Eat a healthy diet. Follow the DASH (Dietary Approaches to Stop Hypertension) guidelines. This has been shown to lower systolic and diastolic blood pressure, even without other interventions.
- The DASH diet is rich in fruits, vegetables, whole grains, and low-fat dairy products. It restricts intake of saturated fats, red meat, and sugar.
- The increased fiber, potassium, calcium, and magnesium from these foods are all thought to play a role in reducing blood pressure.
4. Lose weight. For every two pounds of weight loss, you can lower your systolic pressure by one point and your diastolic pressure by 1.4 points.
- Gradual weight loss of one to two pounds per week is most effective.
- Keep a food journal to track exactly what and how much you eat.
- Choose foods low in saturated fat, cholesterol, trans fats, and refined sugar.
- Watch your portion sizes.
- Don’t skip meals. Eating three meals a day plus snacks is essential in weight management.
- Aim for 25 to 30 grams of fiber daily, which will fill you up and curb your hunger.
5. Limit alcohol. Drinking a lot of alcohol can raise blood pressure.
- The maximum you should drink is no more than one drink a day for women, two drinks for men.
- One drink is the equivalent of 12 ounces of beer, five ounces of wine, or two ounces of hard liquor.
- Help yourself to relax and cope better with stress from your busy life with these techniques:
- Simplify. Try to cut out activities that eat up your time but deliver little value. Learn to say "no." Clean out your house, car, and garage of things that you no longer need. Let go of relationships that complicate your life more than they add.
- Take a deep breath. Making a conscious effort to deepen and slow down your breathing can help you relax.
- Exercise. Physical activity is a natural stress-buster.
- Get plenty of sleep. Being sleep-deprived can make your problems seem bigger than they really are.
The key is to discover what works for you. Choose your strategies, take action, and start enjoying the benefits. You can lower your blood pressure and help prevent other chronic diseases at the same time.
Seven common excuses keep many people from realizing the benefits of exercise. Here's how to overcome these barriers and enjoy being more active.
"I don't have time to exercise." "Exercise is boring."
Does this sound like you? If you've used these or similar excuses to avoid exercise, you're not alone. Two out of three Americans don’t get enough exercise. Don't let these excuses stop you from exercising.
Here are the top seven barriers to exercise and ways to hurdle over them:
1. No time
- Spend a week identifying 30-minute time slots that you can set aside for exercise. Then mark your day planner accordingly. Find ways to work physical activity into your everyday life. Park farther from your office, take the stairs instead of the elevator, or ride your bike to the grocery store. Other time "obstacles" to hurdle:
- Travel for work - Choose a hotel with a fitness center or pool. Pack a bathing suit and a pair of sneakers.
- Family obligations - Fit in exercise with the kids. Play together. Find time to work out when the kids are at school or staying with a friend.
2. Lack of support from family or friends
Tell your family or friends that you want to be more active. Ask them to support your efforts. Get your spouse/significant other or friend to jog or play tennis with you. Find a group or join a gym or a hiking, biking, or running club.
3. No energy
We all have times when we’re more energetic. If you are a morning person, maybe working out before going to the office is best. If you feel an energy boost after work, then you may want to hit the gym on your way home. Others find time in the middle of the day.
4. No willpower
If you're saying this, you may need to write yourself a contract. It may be as simple as writing down a time to exercise in your calendar or date book. You are more likely to do it if you write it down. Choose an activity you enjoy. To stay motivated, choose a reward to work toward and keep you going. Working out with a buddy (tennis partner, walking companion) will also keep it fun and keep you motivated.
5. Fear of injury
Talk to your doctor first to get the go-ahead to exercise. If it has been some time since you've exercised regularly, start out slowly so you don't get hurt. Choose a low-impact activity that won't injure your knees or other joints. Choose an activity that's appropriate for your age and ability level. Remember to warm up and cool down before and after exercise.
6. Lack of skill
If you can walk, you can exercise. In fact, you can build an entire exercise routine around walking. If you always wanted to learn to swim or play tennis, now is the time. You may want to take a class to develop new skills.
7. Lack of resources
This barrier may be related to money or location. You don't need to join an expensive gym to exercise. All you need is a pair of sneakers or comfortable walking shoes. Go to a nearby park or make up your own route in your neighborhood. If there's no park nearby or your neighborhood is not pedestrian-friendly, then find a recreation program or health facility at work. And don't let the summer heat keep you from staying in shape. Take your walking routine to the mall. Work out in the privacy of your home with your favorite aerobics DVD.
You probably know that exercise has many benefits, such as warding off heart disease and diabetes. Exercising 60 to 90 minutes a day can help you to reach a healthy weight. Keeping a routine of 30 to 60 minutes a day helps you stay at a healthy weight. You can even benefit if you break up your exercise program into several 10-minute intervals a day.
So don't let these excuses keep your from achieving fun activity and healthy returns. Check with your doctor to find out what a good activity level is for you, and then start getting fit.
Resource: United HealthCare Services, Inc.
As you get older, are you having more and more “senior moments”? Although forgetfulness seems to come hand in hand with aging, could it be that something as simple as exercise could help enhance your memory?
Exercise may be the most wonderful wonder drug of them all—maintaining not just your body, but your mind as well.
Scientists are finding that exercise actually may help prevent mental decline as we age. Regular exercise may enhance memory, planning, and organization skills, as well as the ability to juggle mental tasks.
Researchers believe regular exercise—for at least 30 minutes on most days of the week—can help keep your brain sharp. Exercise improves how well the body can pump blood to the brain, helping it perform better. Scientists speculate that activity stimulates the growth of nerve cells in the hippocampus, the region of the brain involved in memory.
Another positive effect deals with lowering blood pressure. This is important to most adults, particularly as they age. In fact, most elderly people do have high blood pressure. Those with uncontrolled high blood pressure are more likely to have trouble thinking, remembering, and learning.
Activity can also help with depression, a common problem among the elderly. Depression can affect memory and concentration. Exercise helps relieve feelings of depression by increasing blood flow and improving how the brain handles the chemicals that are responsible for mood.
You can't beat exercise. Not only can it help your brain, it can also keep your muscles and joints strong—all important for helping prevent falls, dealing with arthritis, strengthening your heart, improving your energy levels, and warding off health problems such as diabetes and certain cancers. Even if you have lived a sedentary life up until now, you can still limber up to help keep your brain—and your body—in shape.
First, be sure to check with your doctor before starting any exercise. Together, you can choose a routine that’s safe for you.
- Get at least 30 minutes of activity—most or all days of the week—that makes you breathe harder. You can break up those 30 minutes throughout your day by taking a 10- or 15-minute walk in the morning, another at lunch, and a third in the evening. To tell if you aren't working hard enough, give yourself the "talk test." If you can talk without any effort, you aren't working out hard enough. If you can't talk at all, you are pushing too hard.
- Don't neglect your muscles. If you don't use them, you'll lose them. Strong muscles help you with numerous everyday tasks such as grocery-carrying and getting out of a chair on your own.
- Work on your balance. Stand on one foot, then the other. If you're able, try not to hold onto anything for support. Stand up from sitting in a chair without using your hands or arms. Every now and then, walk heel-to-toe.
- Be sure to stretch as part of a well-rounded routine of strength and conditioning exercises. Stretching can help prevent back pain and help you remain limber. Never stretch so far that it hurts.
Resource: United HealthCare Services, Inc.
Snacking can and should be a part of any nutritious meal plan. Here's how to make it healthy.
The word "snack" usually conjures up images of cookies, chips, and even candy. But snack food doesn't have to mean "junk food." What's more, nutritious, well-planned snacks can be a vital part of your meal plan.
Why not think about snacks as nutritious, planned "mini-meals" and not just junk food? Most growing children need more quality nutrients than they normally eat during a day's worth of meals. And unless you are eating three very well balanced meals, snacks can give an extra daily nutrition boost to adults, too.
Simple snack suggestions
Start by talking to the whole family about the snack suggestions below. Pick your favorite ideas, type up your own list, and stick it on the fridge. Then stock up on your choices so they will be ready-made and at your fingertips.
Mixed food ideas
Good after-school or between-meal snacks should include fruits and/or vegetables, but also a little protein and whole grain to help stave off hunger until dinner:
- Whole-grain, low-sugar cereal and low-fat milk,
- Low-fat string cheese and whole-grain crackers,
- Whole-wheat English muffin with melted low-fat cheese,
- Whole-grain waffle topped with fruited yogurt and fresh fruit,
- Yogurt or cottage cheese topped with sliced fruit and cereal or nuts,
- Whole-wheat toast topped with natural peanut butter and sliced banana,
- Whole-grain crackers, hummus, and raw veggies,
- Low-fat cottage cheese with diced tomatoes, cucumbers, and a dash of fresh pepper,
- Fruit smoothie (blend together low-fat yogurt, frozen fruit, skim milk, 100% juice),
- Baked potato topped with chili beans or broccoli and low-fat cheese, or
- A bowl of bean or vegetable soup.
Fruits and veggies
Many kids will surprise you and eat raw fruits and veggies, especially when they are hungry. After school or right before dinner is the best time to "sneak" them in.
The key is to make healthy snacks visible and appealing. Without saying a word, place a veggie tray near your kids when they are busy doing homework or playing before dinner. Then watch the food disappear. Don't forget to munch on them yourself while you’re cooking.
- Use colorful veggies, such as cherry tomatoes, yellow and red peppers, sliced cucumber, carrot and celery sticks, and sugar snap peas.
- Make a creamy vegetable dip. Mix your favorite dry salad dressing mix into plain Greek yogurt to make a great tasting low-fat dip.
- Leave apples, plums, nectarines, or peaches in a bowl in the kitchen.
- Cut up cantaloupe or watermelon and leave in a clear container in the fridge.
- Put firm grapes and orange wedges out on a plate after dinner or at snack time.
If you're really in the mood for something crunchy and salty, stick with foods that don't have hydrogenated fats and are free of food dyes.
- Trail mix--Combine nuts and seeds (such as almonds, walnuts, peanuts, and sunflower seeds) with raisins, dried cranberries, dried apricots, pretzel bits, and oat cereal bits,
- Baked or trans-fat-free tortilla chips,
- Low-fat microwave popcorn, or
- Low-sugar granola bars.
If your sweet tooth strikes, go for natural sugar from fruit. Otherwise, stick to foods that come in one-serving packages to prevent overindulgence:
- Frozen fruit bar (no high-fructose corn syrup),
- Fudge bar (typically, 60 to 90 calories and only one gram of fat),
- Low-fat pudding cups,
- All-natural applesauce,
- Ginger snaps, or
- Mini flavored rice cakes.
Keep in mind that foods like chips and cookies are fine to snack on once in a while. But if you get into the habit of serving and eating nutritious snacks most of the time, you'll be helping yourself—and your kids—establish healthy patterns for a lifetime.
Resource: United HealthCare Services, Inc.
Please encourage all employees enrolled in a state health plan, who have not yet done so, to sign in to their accounts on the ERS website and certify whether or not they or their covered dependents 18 years old or older use tobacco. Even if employees and their dependents don't use tobacco, they still must certify their status as non-tobacco users. More>>
Many people have allergies. Signs often include sneezing and sniffles. You also may have a runny or stuffy nose. Your eyes may be itchy or watery. Or, you may have a headache. More>>
If you recently changed your address, email address, or phone number, don't forget to update that information in your online ERS account by May 31, 2013 at 5 p.m. More>>
Ask any parent. One of the scariest things about raising a child may be letting him or her drive. With proms, graduations, and beach trips, you may feel more nervous than ever about your child's safety on the road—and with good reason. More>>
You've heard the mantra—get at least five servings of fruits and vegetables a day. In reality, you should aim for five to nine servings. Unfortunately, the typical American eats only about one serving a day. More>>
Disability Carrier change effective September 1, 2013 from Dearborn to Aon Hewitt Absence Management, LCC
The Employee’s Retirement System of Texas (ERS) Board of Trustees has awarded the third-party administrator contract for our disability insurance plans to Aon Hewitt Absence Management, LLC (Aon Hewitt). The contract will cover a four-year term from September 1, 2013 through August 31, 2017. Aon Hewitt’s offices dedicated to ERS are located in The Woodlands, Texas.
ERS disability coverage is available to active employees as an optional benefit and provides benefits for disabilities resulting from occupational and non-occupational illness or injury.
- Short-term Disability Insurance provides a maximum benefit of 66% of an enrolled employee’s monthly salary up to a maximum of $10,000 or $6,600, whichever is less, for a period up to five months.
- Long-term Disability Insurance coverage provides a maximum benefit of 60% of an enrolled employee’s monthly salary up to a maximum of $10,000 or $6,000, whichever is less, for a period ranging from 12 months up to age 65, depending on the employee’s age at the time of disability.
As of December 2012, 113,653 ERS employees were enrolled in Short-term Disability Insurance and 89,298 employees were enrolled in Long-term Disability Insurance. Premiums paid by employees who elect to participate in these plans cover the full cost of these benefits. The ERS Board of Trustees will determine the amount of premiums for Plan Year 2014 at its May Board meeting
Click here to find seasonal savings on financial services! Get your taxes done for a discount, or refinance and lower your monthly mortgage payments.
The ERS TexFlex program currently allows members to contribute up to $5,000 a year into a health care FSA. As of September 1, 2013, changes to federal law will lower the health care maximum contribution from up to $5,000 to up to $2,500. This change is required by the Affordable Care Act.
On September 1 of each year, participants are automatically re-enrolled in TexFlex accounts at the same annual contribution amount unless they make a change during Annual Enrollment. If the member's Plan Year 2013 annual contribution was more than the new limit, however, ERS will automatically reduce the annual contribution to the new limit for the upcoming plan year.
TexFlex is a use-it-or-lose-it program. The money contributed to a TexFlex account doesn't roll over to the next plan year, so members must use it all. For Plan Year 2013, members have until November 15, 2013 to spend TexFlex money, and until December 31, 2013 to file claims for reimbursement of funds spent before November 15, 2013. This aspect of the program did not change.
Q: What is the effective date for the new health care FSA maximum annual limit?
A: The new limit goes into effect on September 1, 2013.
Q: What is the new maximum annual limit for the health care FSA?
A: The new maximum annual limit is $2,500 ($208 per month if you get paid over 12 months, or $277 if you get paid over 9 months).
Q: Will the maximum limit of a TexFlex day care account change?
A: No, the limit will remain $5,000 for day care accounts.
Q: What will happen to employees who were contributing more than the new limit?
A: Their contributions will automatically be changed to the new limit, unless they make a change during Annual Enrollment.
Employees who have Long-Term Care (LTC) insurance through ERS may have recently received a letter from John Hancock regarding their LTC policy. Those employees with this LTC coverage has had a policy number change however, as long as you continue to pay your premiums, your LTC insurance will not change. The letter was sent to inform participants of a change in the administration of their LTC policy. Going forward, John Hancock will be the participants' direct contact for any questions about LTC coverage. Participants can contact a John Hancock representative toll-free at (800) 400-9396.
Do you have a hard time understanding the referral process? Do you know how to follow an explanation of benefits (EOB)? See the following tips from HealthSelectSM of Texas.
HealthSelect requires that your primary care physician (PCP) provide referrals to in-network specialists for in-network benefits to apply.
- Remember to double-check with your PCP to make sure your referrals are up to date. If UnitedHealthcare does not show your referral on file, your PCP will need to submit a new referral.
- Your PCP must use UnitedHealthcare’s online provider portal to submit a referral.
- Use your personal online account at www.healthselectoftexas.com to verify that a referral is on file.
- Any PCP referrals transferred from the prior carrier (Blue Cross and Blue Shield of Texas) cannot be viewed through your personal online account.
- Contact HealthSelect toll-free at (866) 336-9371 to inquire about any referrals that aren’t showing up on your personal online account.
Explanation of Benefits
You can view the explanation of benefits (EOB) you receive from HealthSelect through your personal online account at www.healthselectoftexas.com. EOBs provide information such as billed charges, services provided, how much the plan paid, and your financial responsibility for the claim. The Sample Explanation of Benefits (EOB) Statement (PDF)(536 KB) explains the information provided in each EOB section.
Vision problems and eye conditions can affect people of all ages. That's why it's so important to take care of your eyes—starting early in life. More>>
Beginning April 1, 2013, you can use debit cards as either “debit” or “credit” cards. If you choose debit, you will need a personal identification number, or PIN, to use the card. If your spouse or a dependent also has a card for your account, they will use the same PIN you use. You will need the PIN for debit transactions at any location that accepts your PayFlex card – pharmacies, doctors’ offices, other health care providers, day care providers, etc.
To get a PIN, contact PayFlex Card Services on or after April 1, 2013 by calling toll-free at (888) 999-0121. If you try to call the number before April 1, you will hear a message telling you to call back on or after April 1. Once you have your PIN, you can use the card right away. You will not need a PIN to use the card for credit.
This change is part of a new federal law that will reduce the amount of credit card fees that merchants pay. Some merchants may require you to choose debit and not let you use credit. This change does not affect the fees you pay for your TexFlex account or TexFlex debit card.
Starting on May 1, 2013, you will also have to activate a new card before you can use it. If you already have a card, it was pre-activated, and you don’t need to do anything. New or replacement cards issued on or after May 1, however, will have to be activated by the owner. You can activate the card the same way you would activate any other debit or credit card. Each card will contain an activation label with a toll-free number. You will dial (877) 261-9951 to activate your cards.
If you have questions about these changes, please call the number on the back of your debit card.
There will be a Retirement Planning Event entitled: “Retirewise” presented by Metlife, Thursday, April 11th and Thursday April 25th. These sessions will be held in Human Resources as follows:
When: Thursday, April 11 and April 25th (11:30a – 2:30p)
Where: HR Training Room 341 McElhinney
Who should attend: This course is open to all employees
How long: 3 hours each session
Topic: Retirewise (Course HRTV13 and 16)
Workshop Series: It’s never too late—or early—to plan for your retirement
MetLife understands that one of the biggest financial challenges people face is planning and saving for retirement. To help our employees address this challenge, MetLife is pleased to offer Retirewise®, a complimentary workshop series that can help you achieve your retirement goals. Regardless of your age, this workshop will bet you started putting all the pieces together.
This session provides you the opportunity to:
- Attend a four-part complimentary workshop series (in two sessions) that covers a range of important financial and retirement topics
- Receive a comprehensive workbook that provides resources you can reference during and after the workshop
- Schedule an optional one-on-one consultation with the same Retirewise representative who delivered the workshop
View an interactive presentation to learn more about the benefits of attending. Participants must commit to attending BOTH 3 hour sessions. MetLife will provide a light lunch for these two sessions.
Please register in PASS. Contact the HR Service Center at 713/743-3988 if you have questions/concerns.
If employees have changed their email addresses, mailing addresses, or phone numbers, they should update that information in their online ERS accounts. More>>
Dental Choice PlanSM Updates for Plan Participants
The Dental Maximum Benefit is the amount of benefits the State of Texas Dental Choice PlanSM will pay in a calendar year. Once you reach the Maximum Benefit, you must pay all additional expenses. The annual dental maximum is $1,500, and it "starts over" each January 1. This means that as of January 1, 2013, you have access to another $1,500 for dental expenses through December 31, 2013. The annual maximum applies for each covered person.
If you are a State of Texas Dental Choice PlanSM participant, any covered dental expenses that applied to your deductible during the last three months of 2012 will apply to your 2013 deductible. More>>
On February 1, Minnesota Life, the administrator for ERS’ life insurance, made it possible for members to submit proof of good health (also known as evidence of insurability, or EOI) for Optional Term Life Insurance and/or Dependent Term Life Insurance online. EOI is an application process in which an employee wishes to make benefits elections after their initial 30 days of employment or during the annual open enrollment period.The new web-based process should make it more convenient for members to apply for Life EOI—and faster for them to get a response—although the option to mail or fax paper EOI forms will still be available. More>>
HealthSelectSM of Texas tips to keep you on track
With a HealthSelect Online Personal Account, you can easily manage your health benefits. More>>
FML Policy Changes
We have been reviewing our FML/Parental Leave (FML) practices in HR and are working to improve the timeliness in approving/denying FML applications for our employees. Effective 12/1/2012, we require ALL FML documents (application and certification) to be forwarded directly to Human Resources for processing. The FML application is no longer required to have the supervisor’s and College Business Administrator’s signature. Employees are still required to inform their supervisors/departments of their requested leave as well as submit a leave request form for the time off.
When an employee is interested in going on FML, they need to contact Human Resources (713/743-3988 or stop by the HR Service Center—Room 325 McElhinney) to receive and provide the FML application and physician’s certification. The employee will receive the necessary forms to complete along with detailed instructions on completing, and returning the forms to the HR Service Center for processing.
Within five business days of receiving the application, the employee’s supervisor (as noted on the application), Department Administrator and College Business Administrator will be notified of receipt of the application for FML. Within fifteen (15) calendar days from the date of receiving the application in Human Resources, the employee and supervisor will receive an approved or denied response from Human Resources unless not practicable under the circumstances.
Please review the updated policy at http://www.uh.edu/af/universityservices/policies/mapp/02/020201.pdf (for FML) and http://www.uh.edu/af/universityservices/policies/mapp/02/020202.pdf (for Parental Leave).
We anticipate seeing significant improvement in the timeliness in responding to your employee’s FML requests.
HealthSelect coinsurance maximums and non-network deductibles start over January 1.
Remember that HealthSelectSM of Texas medical coinsurance maximums and deductibles for non-network services are based on the calendar year, January 1 to December 31. At the start of each calendar year, you are responsible for any applicable deductible or coinsurance amounts. These amounts don't carry over from the previous calendar year.
Please be advised that under the Affordable Care Act, contraceptive prescription drugs are covered at 100%, effective September 1, for all Texas Employees Group Benefits Program health plans. Some restrictions apply, such as that drugs must be prescribed by a physician and be FDA approved, and that 100% coverage will not apply to brand-name drugs with a generic equivalent. Deductibles do not apply to these medications.
The contribution maximums for each of the Texa$aver 401(k) and 457 Plans have increased by $500 to $17,500 for the 2013 calendar year. More>>
Resources for Employees Facing Separation
We understand that separation from UH is a difficult time for employees. In an effort to ease your transition, HR has compiled resource information to assist you. Information includes resources for the following areas: Retirement; Benefits; Job Search; Bills; Legal and Medical; and Frugal Living.
For more information go to: http://www.uh.edu/hr-communications/separated-employees/
CUSTOMER SERVICE CENTER 325 McElhinney
The Human Resources Team is here to assist you with all your HR needs. In an effort to serve you better, please use the Customer Service Center as your start point when coming to HR. All appointment check-ins, information inquiries and employment document finalizations should start at the Customer Service Center in 325 McElhinney, located as you exit the elevator on the 3rd floor. Representatives will assist you directly or make sure you are directed to the right person.
Contact Information: Phone 713-743-3988 or EMAIL at CSC@uh.edu
Customer Service Feedback: http://www.surveymonkey.com/s/HRCustomerServiceFeedback
Communications and Updates: http://www.uh.edu/hr-communications/index.php/#custservice
Please contact the HR Customer Service Center for any questions 713-743-3988 or via email at CSC@uh.eduu . Angie, Mindy and Jose are ready to assist you or direct you to the appropriate resource.