55 ELM STREET HARTFORD, CONNECTICUT 06106-1775 Telephone: (860) 702-3480 Facsimile:(860) 702-3556 |
||
HEALTH CARE COST CONTAINMENT COMMITTEE |
||
STATE OF CONNECTICUT OFFICE OF THE STATE COMPTROLLER HEALTHCARE POLICY & BENEFIT SERVICES DIVISION |
ATTENTION: | Personnel and Payroll Officers, Chief Administrative and Fiscal Officers, Business Managers |
---|---|
SUBJECT: | 2012 Health Insurance Open Enrollment |
I. INTRODUCTION
The state employee health insurance annual open enrollment period will be held
from May 1, 2012 through May 31, 2012 for coverage effective July 1, 2012. This
memorandum discusses enrollment procedures and how employees can access
information about available health plan choices and premiums.
During open enrollment, employees may change medical and/or dental plans, add or
drop coverage for eligible family members, or enroll in coverage if they
previously waived it. This is the only time employees may enroll in or change a
health plan. These changes are not allowed at other times unless an employee
experiences a qualifying event, such as marriage, divorce, civil union, birth,
adoption, legal guardianship or loss of other health insurance coverage by an
eligible dependent. The employee is responsible for contacting their agency
personnel/payroll representative to file the appropriate forms within 31 days of
the event that necessitates a change in enrollment or plan.
II. DISCUSSION
A. Plan Offerings and Changes
1. Medical Plans and Benefits - Full details of plan choices and premium shares
will be available in the Health Care Options Planner that will be posted on the
Comptroller's website, osc.ct.gov.
In accordance with the SEBAC V Agreement, office visit co-payments under all POE
and POE-G plans will increase from $10 per visit to $15 per visit. There
are no changes to payroll deductions for 2012-2013.
2. Dental Plans and Benefits - There will be no changes in the dental plans.
Employee premium shares for the dental plans will be in the Health Care Options
Planner posted on the Comptroller's website osc.ct.gov. There are no
changes to payroll deductions for 2012-2013.
3. Pharmacy Plans and Benefits - Use of the State of Connecticut Maintenance
Drug Network for maintenance drugs will continue. As a reminder, employees can
fill their first prescription for an ongoing medication (30-day supply) at their
local pharmacy. After that, refills for maintenance medications must be filled
through a participating State of Connecticut Maintenance Drug Network pharmacy.
These directories are maintained on the Comptroller's website at
osc.ct.gov
by individual state.
B. Open Enrollment Fairs - Open Enrollment fairs are to be held at various
locations across the state throughout the month of May. The statewide
schedule of enrollment fairs is attached for posting and should be communicated
to employees. Employees may attend a fair held at any agency or location,
subject to the employing agency's operating needs. Staff from the
Healthcare Analysis Unit of the Office of the State Comptroller will be on hand
to assist with questions related to the Health Enhancement Program.
This year ING will be available to answer questions about the Deferred
Compensation Plan, Alternate Retirement Plan and 403(b) plan.
C. Health Care Options Planner
The Health Care Options Planner, which details the plans, will be available this
year on the Comptroller's website osc.ct.gov. The Planner contains
information regarding applicable employee premium shares, offers certain general
guidelines to assist employees in making their choices, and provides helpful
information related to the Health Enhancement Program. Contact information for
each carrier is listed in the Planner for any employee who has specific
questions on the plans.
D. Enrollment Statements
Enrollment statements will not be included with the Planner or in any marketing
material sent to employees, nor will carriers have enrollment statements
available at the open enrollment fairs. Enrollment Statements must be system
generated by Core-CT. Employees electing or changing coverage may do so
only through their personnel or payroll office, which will be the repository of
all enrollment statements. This procedure is intended to ensure that vendor
marketing efforts and enrollment processing are maintained as entirely distinct
functions.
E. Health Enhancement Program Compliance and New Enrollment
Successful participation in the Health Enhancement Program (HEP) provides
incentives for enrolled employees and their dependents (i.e. reduced premiums
and co-pays, waived deductibles, etc.) that have completed age-based health
screenings and exams. HEP guidelines are described in detail in the 2011
SEBAC Agreement. Anthem and Oxford/UnitedHealthcare have sent
correspondence to all HEP enrolled employees. For those households that
have met compliance, the employees were issued a letter noting their compliance
status. Individual members who do not have paid claims showing completion
of required screenings as of April 1, 2012 were issued letters with a list of
their outstanding screenings and instructions on how to report their compliance
efforts.
During Open Enrollment, non-compliant HEP participants will have the opportunity to report scheduled exams or screenings using a secure website, www.cthep.com , or by completing the Compliance Notification Form (CO-1316) and submitting it to the Office of the State Comptroller, Healthcare Analysis Unit. All reporting must be completed by May 31, 2012. Those who report will be granted an extension through December 31, 2012 to complete scheduled exams.
If an enrolled employee or spouse has completed a requirement under other coverage or their physician does not feel it is clinically appropriate to have a screening required by HEP, he or she must submit a completed Physician Notification Form (CO-1317) to their medical carrier.
If an enrolled employee or dependent has full dentures or is not currently
enrolled in State-sponsored dental coverage, he or she may note the dental
cleaning requirement as "Exempt" and select from a drop-down menu the supporting
reason for exemption online at www.cthep.com.
Employees may enroll in HEP by completing a Health Enhancement Program
Enrollment Form (CO-1314), available on the Comptroller's website and submitting
completed forms to their agency Payroll/Human Resources office. Forms must
then be forwarded to the Central Benefits Unit of the Office of the State
Comptroller. All new HEP enrollments must be completed by May 31, 2012.
Additional information and HEP forms are available on the Comptroller's website
at osc.ct.gov.
III. CONCLUSION
Payroll-related matters, including employee health premium shares and detailed
information regarding the structure of the state employee health insurance plan
for fiscal year 2012-2013, and monthly rates for COBRA continuation coverage
will be transmitted to agencies through subsequent communications. Personnel or
Payroll staff members who have questions concerning the Open Enrollment process
should contact the Comptroller's Healthcare Policy & Benefit Services Division
at (860) 702-3535.
Very truly yours,
Thomas Woodruff, Ph.D.
Division Director
Attachments:
Return to Index of 2012 Healthcare Policy
& Benefit Services Division
Memoranda
Return to Index of Comptroller's Memoranda
Return to Comptroller's Home Page