Information About Changes
Thu, 06/17/2010 - 6:53am
Here's the link for a quick Q&A regarding the changes to our health benefits, for anyone interested.
http://www.tennessee.gov/finance/ins/partners_qa.html
Myself, I'm disgusted at the looks of this. Anyway, in my department (SWORPS) there has been a lot of discussion and rumors associated with the change. If there is a document which explains things in greater detail, would someone mind to post it?
I will withhold the rest of my comments until I can get the rumors that are floating around confirmed or denied.
Wes
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TSEA is apparently distributing a handout with the new premiums (how much for each level: employee, e+spouse, e+child/ren, e+s+c) even though they're not posted on the website. I was asked to call TN Partners in Health and find out about this.
1. Before she would even talk to me, the CSR wanted my name, member ID number, address, phone, and date of birth.
2. "You'll get information about the premiums when you get your enrollment packet on September 15."
3. Question: Since this is a whole new insurance plan, with new premium levels, I wondered -- I did not add my husband to my insurance when I first started working at UT. Will I be able to add him during the open enrollment period?
Answer: You will have to wait for a qualifying life event or for 2012.
Question: Even though this is a completely new insurance plan, with this new premium structure, and the webpage says open enrollment, I still won't be able to add my husband beginning in 2011?
Answer: No, you won't. This is just for the insurance you currently have. You can add him in 2012.
Question: What happens in 2012 that will make it possible for me to add him?
Answer: That's when you'll be able to add him.
4. I didn't think to ask, "If we won't get the premiums until September, why is TSEA passing them around?" and I apologize. I should have thought of that.
Didn't the State already try this mail order pharmacy thing once before and dropped it because it was taking business away from Tennessee pharmacys? So what has changed?
I was just forwarded an email that had the website for ParTNers for Health.
http://partnersforhealthtn.org/
There is a good deal of information here.
Wes
I read the material. It has a few bits of information that is helpful, but as far as details we will have to wait for their release. Given Tennessee's reluctance to properly fund state government this is better than what might be expected.
My concern would be now that we are near of have reached the 1,000 member level, we need to work the legislature to make sure that CWA has a member on the insurance committee so we are on top of what is going on. We need to be able to talk about and influence the direction of compensation issues like health care.
Total agreement on this point. When I read the provided link about the health care changes, that was the first thing I noticed - that supposedly TEA and TSEA were consulted in the planning process regarding these changes. Maybe UCW was supposedly consulted as well - I've been busy lately so maybe I missed that? But it doesn't seem like the "powers that be" with the state are giving UCW the recognition and legitimacy we deserve as a critical stakeholder. If those other "employee associations" get access to policy planning/ consultation, than so should we. These state committees need to understand that we are absolutely a force to be contended with on any matters like this, and that UCW will always have a seat at the table.
Cameron,
There was a followup email that said Walgreens had agreed to accept all Caremark plans, as stipulated in their contract. Here's the text:
From: UT Payroll Office [rchance@tennessee.edu]
June 22, 2010
To: UT System-wide Faculty and Staff
From: Director of Payroll Rob Chance
Subject: Pharmacy Plan/Walgreens Update
Beginning July 1, 2010, Caremark CVS will become the pharmacy benefits manager for all employees participating in the State of Tennessee Group Health Insurance Program. If you have not received your new prescription card, please call the Caremark call center on July 1 at 1-877-522-TNRX (8679). A customer service representative will order a new card for you and provide instructions on how to print a temporary card from the Caremark website.
WALGREENS UPDATE
On June 15, 2010 employees were notified that Walgreens Pharmacy would NOT be included in the Caremark CVS pharmacy network. However, Caremark and Walgreens now have reached an agreement and Walgreens will continue to be a part of the 30-day pharmacy network. However, Walgreens will NOT be part of the 90-day mail at retail network effective July 1, 2010.
90-DAY MAIL AT RETAIL
The Caremark 90-day mail at retail network is more limited than the Caremark 30 day network. This limitation provides savings to the health plans and allows the plans to preserve other valuable health benefits. You can locate a participating 90-day mail at retail pharmacy by visiting the Caremark Web Site. The address is: http://www2.caremark.com/stateoftn/
Participants will have three options for filling maintenance medications:
Use a participating 30-day retail pharmacy to fill prescriptions on a monthly basis.
Use a participating 90-day mail at retail pharmacy to fill 90-day supplies for reduced co-pay.
Use the CVS Caremark Mail Service Pharmacy to fill 90-day supplies for a reduced co-pay and have prescriptions sent directly to your home with no shipping costs.
If you have any questions, please call Caremark 24/7 at 1-877-522-TNRX (8679).
Earlier in the week it was announced that state employees who used Walgreens for their prescriptions would no longer be able to use the pharmacy as part of their pharmaceutical benefits through CVS Caremark (see http://www.state.tn.us/finance/ins/pdf/cvs_qa.pdf)
On Friday Walgreens and CVS reached an agreement which allows state employees to continue to use Walgreens (http://http://nashville.bizjournals.com/nashville/stories/2010/06/14/daily41.html)
UCW has been in contact with a watchdog group, Alarmed about CVS Caremark (http://www.alarmedaboutcvscaremark.org), which has a good deal of information that should be of alarm to higher education employees.
According to the watchdog group, CVS Caremark has settled "several government fraud suits", including:
It seems important that UCW should form a statewide committee to research this and other issues related to changes to our health care benefits. Any volunteers out there?
Cameron
Has UT decided to allow children of employees to stay on their insurance plan until they are 26? Wasn't this new law effectively immediately?
Debbie,
If I correctly understand the summaries of the federal law, that provision takes effect six months after the bill was signed, so approximately September 2010.
http://www.nytimes.com/2010/03/22/your-money/health-insurance/22consumer.html
According to an email from Simek on Friday, final decisions are not being made until a meeting in July. So there is still time, very little time, but time to try and sway this decision.
Here's the quote from the email: