July 5, 2017–Although United HealthCare will no longer administer the state’s health insurance programs as of Sept. 1, University of Houston faculty and staff should see no difference in their plans, according to Breion Rollins, benefits manager at UH.
After a thorough bidding process, the Employees Retirement System of Texas Board of Trustees has selected Blue Cross Blue Shield of Texas (BCBSTX) to serve as the plan administrator for HealthSelect of Texas and Consumer Directed HealthSelect for a six-year contract.
“Blue Cross Blue Shield apparently came to the table with the greatest value for what the state is trying to accomplish for its employees,” Rollins said, adding the change in administrators should have minimal, if any, effect on rates or out-of-pocket costs.
Faculty and staff can learn more about BCBSTX at UH’s upcoming annual wellness and benefits fair. Representatives from the insurance company are expected to attend the event, which takes place from 10 a.m. to 2 p.m., Wednesday, July 12 at the Recreation and Wellness Center. In addition to Blue Cross Blue Shield, KelseyCare and about 50 other vendors and organizations will be at the fair to discuss services and programs available to UH employees in the areas of health, vision, finance and personal wellness. There will also be special offers and raffles to win great prizes, including a FitBit Flex.
Rollins sat down with UH Today to discuss the change in administrators and summer benefits enrollment.
When will faculty and staff whose doctors are not in the network be notified?
BCBSTX plans to send letters and make telephone calls to participants who may be affected by certain changes. Faculty and staff may also find general information and answers to questions about the transition at www.bcbstx.com/hs. A BCBSTX personal health assistant can answer questions and provide information by phone or live chat at www.bcbstx.com/hs. For live chat, scroll to the bottom of the personal health assistants page. To speak with a personal health assistant, call 800-252-8039 toll-free from 7 a.m. to 7 p.m. Monday through Friday and from 7 a.m. to 3 p.m. on Saturdays.
What are the options for faculty and staff whose doctors will not be in HealthSelect network starting Sept. 1?
They may continue to see their providers but out of network. However, they will have to pay higher out-of-pocket costs, including an out-of-network deductible in HealthSelect of Texas or a higher deductible in Consumer Directed HealthSelect. It costs much less to see a provider who is in the HealthSelect network. They may call BCBSTX for assistance in finding a new provider who is in the network.
Additionally, employees who are pregnant and in their second or third trimester, or receiving care for a chronic illness or an acute medical condition may be able to continue to receive health care services from their current provider after Sept. 1 for a certain period even if the provider will no longer be in the network. They will need to fill out and submit to BCBSTX a Transition of Care form. For more information, call a BCBSTX Personal Health Assistant toll-free at 800-252-8039.
Finally, there have been some questions on whether Kelsey Seybold Clinic will remain in network. According to ERS, Kelsey-Seybold has agreed to participate in the HealthSelect of Texas plan network under BCBSTX. If you are enrolled in or plan to enroll in HealthSelect of Texas and have a Kelsey-Seybold physician as your primary care physician (PCP), you will have open access to all Kelsey-Seybold providers and locations. That means you will not need a referral from your Kelsey-Seybold PCP to see another Kelsey-Seybold provider. If you need medical services that Kelsey-Seybold does not provide, your PCP will refer you to an affiliate provider of Kelsey-Seybold.
If you are enrolled in HealthSelect of Texas and do not choose a Kelsey-Seybold PCP, you will not be able to see any Kelsey-Seybold provider. Kelsey-Seybold providers do not take referrals from doctors outside Kelsey-Seybold.
Will the cost (co-payments and co-insurance) remain the same for the coming fiscal year?
The change in plan administrators does not directly affect rates or out-of-pocket costs like copays and coinsurance. ERS manages the contract and sets rates, eligibility and enrollment for all the health plans in the Texas Employees Group Benefits Program. ERS also sets the plan design, including copays, coinsurance and deductibles. As of now, we are seeing a slight increase in dependent coverage and no announced changes in co-payments and co-insurance.
When will summer benefits enrollment start and end for UH?
UH’s summer benefits enrollment takes place from July 9 to 22. During this time, faculty and staff will have the opportunity to enroll in new benefit programs or change their current coverage. Changes will go into effect on Sept. 1. If you don't want to make changes to your benefits, you do not need to do anything. Your current coverage will continue. For additional about the transition, the various health plans and cost, visit the ERS website.
By Francine Parker