To better meet the changing needs of families, several improvements have been made to the three health plans offered for employees of the endowed colleges, Mary Opperman, vice president for human resources, announced today (Nov. 9).
One improvement that will apply to all three plans -- HealthNow, Aetna Open Choice, and the 80/20 Plan -- is the introduction of a four-level premium structure. For many years, families of various sizes fit into one premium-paying category, family coverage. This year, for the first time, employees will have the opportunity to choose a coverage option that is more closely tailored to the size of their family or the number of dependents they have. Those options include:
"These and other changes have been made to better meet the changing needs of families and the changing kinds of families that are a part of the Cornell community," Opperman said. "A four-tier structure allows staff and faculty to examine all of their employer-sponsored health plan opportunities and put together the arrangement that fits their family the best."
For the first time, an employee may choose to cover only himself or herself and his or her child or any number of children; or only himself or herself and his or her spouse or same-sex partner, explained Paul Bursic, director of benefit services.
"Insurance company studies show consistently that individual/children coverage and individual/spouse or same-sex partner coverage is less expensive for the plan than is coverage for both children and spouse or same-sex partner. Thus, for next year, lower premiums will be charged for these levels than for the individual/children/spouse or same-sex partner level," Bursic said.
New rates for all health plan options will be detailed in the open enrollment home mailing that was being sent out Nov. 8.
Under another major improvement, the Aetna Open Choice plan will be modified effective Jan. 1, 2001, to help participants reduce the level of paperwork needed to process health care costs. Under the improved plan, more services will be available to an employee in-network simply by paying a $10 co-payment at the time care is sought. Currently the employee must pay the health care provider for the cost of care, then seek reimbursement by Aetna. Under the revised plan, the only paperwork in the transaction will be between the provider and Aetna.
Bursic also announced the first steps in the building of an in-network dental panel for participants in the endowed dental plan. The first practice to sign on was Fall Creek Family Dentistry in Ithaca. Participants who use a panel dentist can receive 100 percent reimbursement for preventive procedures. Other plan changes also favor the use of in-network dentists, Bursic said.
"We have the names of dentists all over central New York that our participants have been using," he said. "We are currently soliciting these dentists to join the panel." Participants can see who has joined the panel by going to the Benefit Services web site at www.ohr.cornell.edu/ohr/benefits/index.html or by calling 255-3936.
Bursic noted that even though the university's expenditures for pharmacy drugs are expected to grow significantly in 2001, the pharmacy co-payments for retail outlets as well as mail order will remain the same. "Next year we will look at one full year of data under the higher co-payments of plan year 2000 to see if these cost-sharing measures remain effective, or if future increases in prescription costs will dictate a future increase in co-payment amounts," he said.
Bursic said that if employees are satisfied with their health plan choice for the coming year, no action is necessary. However, if employees currently have family coverage, they should review the eligibility rules for the new four-tier premium structure to see if they qualify for one of the new categories.
Employees who want to change their health plan at this time will find summary brochures and applications for the HealthNow POS and the Aetna Open Choice PPO plans in the package mailed to their home. It also includes a comparison chart placing the three plans side-by-side for easy assessment, based on the most often-used services. For additional help, call Benefit Services at 255-3936, or e-mail: benefits@cornell.edu.
Bursic cautions that employees may not change their coverage during the plan year unless they have a significant change in work or family circumstances as defined under the IRS regulations that govern pre-tax health premium arrangements.
The open enrollment period for health benefits runs from Nov. 15 through Dec. 8. It is the only time during the year that employees may change their health benefits.
Additional information is included in the For Your Benefit newsletter that went out to employees earlier this week.
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