ERS Annual Enrollment - Health InsuranceJuly 14 - July 27, 2014

Health Insurance Updates for Plan Year FY2015

What You Need to Know:

Premiums will increase 6.89%. Increased drug costs & usage are factors driving the rate increase.

Insurance rates listed below are ERS’ best estimates based on information available at the time of printing. Rates could change between now and Sept 1, depending on possible decisions by state lawmakers; however, final rates for PY2015 will not exceed those listed below.

Full-Time Employee Part-Time Employee Rates
Total *

State Pays

Member Pays

Increase Total *

State Pays

Member Pays

Increase
Member Only 537.66 537.66 0 0 Member Only 537.66 268.83 268.83 17.26
Member & Spouse 1,153.42 845.54 307.88 19.86 Member & Spouse 1,153.42 422.77 730.65 47.05
Member & Child(ren) 949.94 743.80 206.14 13.28 Member & Child(ren) 949.94 371.90 578.04 37.18
Member & Family 1,565.70 1,051.68 514.02 33.14 Member & Family 1,565.70 525.84 1039.86 66.97

* Includes premium for Basic Term Life Insurance

Other Items of Interest:

  • Copays for Tier 1 generic drugs have decreased.
  • Mental health benefits will be enhanced:
    • Inpatient mental health services
    • Outpatient professional mental health services
    • Outpatient mental health facility benefits
  • Hearing aid benefit will increase to $1,000 per ear every 36 months (up from the previous benefit of $500 per ear every 36 months).
  • Breast pumps for nursing mothers will be covered at 100% of retail cost (one per delivery). Participants will file a paper claim with a copy of the receipt for reimbursement.

Overall out-of-pocket maximums (includes medical copays and coinsurance) are being implemented - see below.

maximums