October 22, 2009
Costs up, plans changing, new dependent audit in force as Open Enrollment approaches
It’s best to pay close attention to the changes in UW medical plans for 2010 — many employee out-of-pocket costs are going up dramatically, and there is a new audit that requires you to prove eligibility for your dependents or lose that coverage.
This year’s Open Enrollment period, the time for making substantive changes to your health coverage, is from Oct. 26 to Nov. 30.
“This is a serious year,” said Kathleen Dwyer, executive director of UW Benefits & Worklife. “No matter what plan you’re in, some aspect of that is going to go up in cost, and you need to understand what that is.”
Also, Benefits & Worklife will sponsor three benefit fairs for employees, and these are excellent opportunities to get needed information or even switch coverage plans if you wish. They will be held:
- Tuesday, Oct. 27, 10 a.m. to 3 p.m., HUB East Ballroom (with presentations for retirees as well).
- Wednesday, Oct. 28,10 a.m. to 3 p.m., UW Medical Center and Health Sciences lobbies.
- Thursday, Oct. 29, 10 a.m. to 3 p.m., Harborview Medical Center Research and Training Building.
Even people who have comfortably kept the same health coverage for years should pay attention to the changes coming, Dwyer said. She suggested that all employees read the newsletter titled For Your Benefit just sent out by the Washington State Health Care Authority. (If you missed it, read a PDF version online here.)
Here are a few highlights of medical plan changes coming for 2010 (numbers are all for non-Medicare members only).
For those on the Uniform Medical Plan:
- The monthly premium will rise from $26 for individual employees and $82 for a full family to $41 and $123, respectively.
- Coinsurance — the part paid by the employee after insurance pays — will rise from 10 percent to 15 percent.
- The annual medical deductible will rise from $200 per person and $600 per family to $250 per person and $750 per family.
- The total out-of-pocket limit will rise from $1,500 per person and $3,000 per family to $2,000 per person and $4,000 per family.
For those on the two Group Health plans — the Classic and Value plans — monthly premiums will actually go down, but other patient costs such as deductibles and per-visit co-pays will increase, some sharply.
For those on the Group Health Value plan:
- Annual deductibles will rise from $100 per person and $300 per family to $350 per person and $1,050 per family.
- The annual out-of-pocket total will rise from $1,500 per person and $3,000 per family to $2,000 per person and $6,000 per family.
- Copayments for each visit will double, from $15 to $30.
For those on the Group Health Classic plan:
- There was no deductible in the past, but starting in 2010 there will be a deductible of $250 per person and $750 per family.
- The annual out-of-pocket total will rise from $750 per person and $1,500 per family to $2,000 per person and $6,000 per family.
- Copayments for each visit will more than double, from $10 to $25.
Out-of-pocket limits and deductibles will also rise for the relatively few UW employees covered by the Kaiser Permanente Classic and Value plans.
Pre-tax accounts can save money
Dwyer stressed that two pre-tax programs — the Flexible Spending Account (FSA) and the Dependent Care Assistance Program (DCAP) — can be helpful for families budgeting medical and other costs. For each, you can set aside any amount from $240 to $3,600 through the year to help pay eligible health care expenses. For the DCAP program, a family can put aside up to a total of $5,000.
Employees must re-enroll for these two money-saving programs every year. But remember that they are use-it-or-lose-it programs — if you fail to use the total set aside for the year, you lose the remaining balance.
The Flexible Spending Account allows employees to dedicate from $240 to $3,600 before taxes to pay for balances after insurance payments, prescriptions and other covered medical costs. Learn more about that program here.
And the Dependent Care Assistance Program can help pay for eligible dependent care expenses. Learn more here.
Mandatory dependent audit
A new and important project of the state Health Care Authority (HCA) this year is the Mandatory Dependent Audit. This requires that all employees with covered dependents submit paperwork proving the eligibility of that dependent to the state by Nov. 30, the end of the open enrollment period.
For eligibility, a copy of your 2008 income tax return showing your and your spouse’s names (with financial information blacked out) will do. Alternatively, you could send in a copy of a marriage license and another current identifying document such as a credit card, utility bill or shared vehicle registration.
And note this, from the HCA newsletter: “Dependents without verified eligibility will be disenrolled from the plan effective Jan. 1, 2010.”
If you have a person on your coverage inappropriately, Dwyer said, you can drop that coverage during Open Enrollment without penalty or a retroactive audit of past payments.
“I want employees to understand that if they take action now to remove a dependent” who should not be listed, “there will not be any repercussions. Simply get them off now and that will be that. This is the window of opportunity for employees to take action.”
One bit of more positive news is that beginning in 2010, in addition to same-sex domestic partners, state employees may add their opposite-sex state-registered domestic partner age 62 or older as a dependent for coverage.
Dwyer said her office has had many calls from employees wondering if they will receive any confirmation of their dependent audit submission, and she said the answer is yes — the state will send out confirmation letters to all.
In this difficult time for health care, Dwyer encouraged all employees review their coverage and possible cost-savings plans, and to learn about changes for 2010.
She added, however, that despite all the increases, the cost sharing by Washington state for medical and dental coverage remains the same — the state pays an average of 88 percent and the employees pay about 12 percent.
“The ratio has remained the same,” she said. “it’s just more expensive for us all.”
Learn more about open enrollment and the changing details of UW health care plans online here.</A
