COMPTROLLER'S SEAL STATE OF CONNECTICUT

STATE OF CONNECTICUT

NANCY WYMAN
COMPTROLLER
OFFICE OF THE STATE COMPTROLLER
55 ELM STREET
HARTFORD, CONNECTICUT 06106-1775
MARK OJAKIAN
DEPUTY COMPTROLLER

COMPTROLLER'S MEMORANDUM NO. 2005-13

April 29, 2005

TO THE HEADS OF ALL STATE AGENCIES

ATTENTION: Personnel and Payroll Officers, Chief Administrative and Fiscal Officers, Business Managers
SUBJECT: 2005 - 2006 State Employee Annual Health Insurance Open Enrollment and Health Insurance Processing Procedures

I. INTRODUCTION 

The state employee health insurance annual open enrollment period will be held from May 23, 2005 through June 17, 2005, for coverage effective July 1, 2005. In that connection, this memorandum establishes available health plan choices, health insurance rates and the effective payroll dates, and discusses enrollment procedures. Open enrollment fairs will be held statewide during the open enrollment period; the schedule of fairs will be issued in a future memorandum. Full details of plan choices will be available at the open enrollment fairs and in the HealthCare Options planner that will be mailed to all employees. 

Please read the information in this memorandum carefully as it explains a number of changes this year. ConnectiCare, Anthem Dental and CIGNA Dental will no longer be available after June 30, 2005. Oxford (a UnitedHealthcare Company) has been added as a medical carrier. United Dental and Aetna DMO have been added as new dental carriers. PharmaCare replaces Anthem Prescription as the pharmacy benefits provider. Employees who choose to remain with their existing plans do not have to complete a new health insurance enrollment statement. However, current ConnectiCare and CIGNA members should be advised that if they do not make a new plan choice they will be automatically enrolled in a comparable plan. Current Anthem Dental members that do not choose a different dental plan will be automatically enrolled in the UnitedHealthcare Dental basic plan. Additional details are available in the next section and in section V of this memorandum titled Enrollment Procedures. 

II. PLAN CHOICES AND CARRIERS 

A. Medical Plans - For the 2005-2006 plan year there are a number of changes in the medical plan offerings however, the medical benefits of all the plans remain aligned and unchanged from last year. Anthem and Health Net will continue to offer Point of Service (POS), Point of Enrollment (POE), and Point of Enrollment-Gatekeeper (POE-G) plans. Oxford Health Plans will offer POS, POE and POE-G plans. ConnectiCare will not be offered after June 30, 2005.

Employees who reside outside of Connecticut will now be allowed to choose from two Out of Area Plans. The Oxford USA Plan will be offered as a new option for these employees and the Anthem Out of Area plan will continue to be available.

B. Prescription Drug Plan: PharmaCare will replace Anthem as the State's pharmacy benefits provider for all covered employees, retirees, and their eligible dependents. This change in pharmacy administration does not impact benefits or co-pays. PharmaCare has a national network of over 55,000 chain and independent retail pharmacies. For ease in transition employees will be mailed a PharmaCare prescription card and a pharmacy directory prior to July 1, 2005.

C. Dental Plans: UnitedHealthcare will replace Anthem as the carrier for the basic employee dental plan. The dental benefits of the UnitedHealthcare Dental indemnity plan are aligned with the schedule that was applicable to the Anthem Indemnity Dental plan however; the basic plan allows employees to visit any dentist. For ease in transition, any employee who chooses to remain in the basic dental plan will be mailed member cards prior to July 1, 2005 from United Healthcare Dental. Any employee who chooses a different dental plan will receive a member card from that plan after July 1, 2005.

The Aetna DMO plan, also a dental HMO, will replace the CIGNA Dental HMO. For ease in transition, any employee previously enrolled in the CIGNA dental plan who chooses to remain with the Aetna DMO plan will be mailed a member card prior to July 1, 2005 from Aetna DMO. Any employee who chooses a different dental plan will receive a member card from that plan after July 1, 2005.

This year, the State will offer a third dental plan choice, the UnitedHealthCare Enhanced Dental Plan which is a PPO Plan featuring Preventive and Diagnostic care covered at 100%. There is also coverage for Orthodontia. To maximize the benefits available under this plan, employees may utilize a select network of contracted dentists and specialists. There is an out of network feature. 

III. RATES 

The health insurance rates for the period from July 1, 2005 to June 30, 2006 have been modified to reflect the premiums negotiated with the carriers. The attached rate chart reflects the employee premium shares for the bi-weekly and the semi-monthly pay periods and includes monthly employee premium shares for benefits billing purposes. 

IV. PAYROLL EFFECTIVE DATES 

By way of background, as a function of the implementation of Core-CT Benefits Administration in 2003, health insurance premiums were shifted from pre-payment to concurrent payment. Therefore, the changes announced herein will be effective in the following payroll periods: 

Bi-Weekly Semi-Monthly
June 10 - June 23, 2005 June 16 - June 30, 2005
Payable July 8, 2005 Payable June 30, 2005

V. ENROLLMENT PROCEDURES

Employees who choose to remain with their existing plans do not have to complete a new health insurance enrollment statement.

ConnectiCare: Employees currently enrolled in the ConnectiCare medical plans who do not choose another medical plan during the Open Enrollment period will be defaulted into the comparable Oxford Health medical plan option as follows:

ConnectiCare POS to Oxford POS
ConnectiCare POE to Oxford POE
ConnectiCare POE-Gated to Oxford POE-Gated

The change to the default plan will be automatic, and no Agency action is required.

Anthem Dental and CIGNA Dental: Employees currently enrolled in the Anthem Indemnity Dental plan who do not choose the UnitedHealthcare Options PPO or the Aetna DMO will be defaulted into the comparable UnitedHealthCare basic dental plan option. Employees currently enrolled in the CIGNA Dental plan who do not choose the UnitedHealthcare basic dental or the UnitedHealthcare Options PPO will be defaulted into the comparable Aetna DMO plan.

The change to the default plan will be automatic, and no Agency action is required.

Anthem Prescription: All employees enrolled in Anthem Prescription drug coverage will be defaulted into the comparable PharmaCare Prescription drug option.

The change to the default plan will be automatic, and no Agency action is required.

Domestic Partner Enrollment:

(1) For an employee who has enrolled a domestic partner in their health plan prior to the 2005 Open Enrollment period and requests a change to another carrier or coverage option, the Agency must send a copy of the completed and signed Core-CT Enrollment Statement to the Retirement & Benefit Services Division, Health Care Analysis Unit. This unit is responsible for processing the changes. The Confirmation Statement will be emailed to the Agency.

(2) Employees who wish to enroll their domestic partner during the 2005 Open Enrollment period must submit an Affidavit of Domestic Partnership to their agency who in turn will forward it to the Health Care Analysis Unit. Coverage will be effective July 1, 2005, provided the Affidavit of Domestic Partnership was signed in May or June 2005. Upon acceptance of an Affidavit, the Health Care Analysis Unit will email an Enrollment Statement to the Agency. After the employee completes the Enrollment Statement the Agency should return it to the Health Care Analysis Unit, which will process the enrollment changes, and email the Confirmation Statement to the Agency.

(3) Employees who have an existing approved Affidavit on file with the Health Care Analysis Unit and wish to enroll their domestic partner during the 2005 Open Enrollment period must notify their Agency. The Agency must send a copy of the completed and signed Core-CT Enrollment Statement to the Health Care Analysis Unit, which will process the enrollment changes, and email the Confirmation Statement to the Agency. 

VI. ADDITIONAL INFORMATION 

Be advised that agencies must process and finalize all open Event Maintenance (CTEM) events by May 20, 2005 or those events may not be processed correctly. Agencies can print the following reports to help identify such events:

Compensate Employees>

Administer Automated Benefits>Report>Benefit Terminations
Administer Automated Benefits>Report>Invalid Benefit Elections Dept
Administer Automated Benefits>Report>Missing Elections
Administer Base Benefits>Report>Base Benefit Audit by Agency

All Enrollment Statements must be produced using the CORE-CT Benefits Administration system.

Agencies can begin printing Open Enrollment Statements on Monday, May 23, 2005. Enrollment statements should be produced only for those employees seeking to make a change during this open enrollment period.

The open enrollment period for employees to complete and return enrollment statements to their agency personnel/payroll representatives will be from Monday May 23, 2005 through Friday June 17, 2005.

Agencies can enter new elections any time on and after May 23, 2005. Agencies will have until close of business June 24, 2005 to complete data entry of employee elections. The open enrollment process will be closed to agencies at the end of the business day, June 24, 2005. 

In conjunction with open enrollment agencies may have other events such as new hires or family status changes. For these events, normal event maintenance processing will continue, for instance: 

Data cleanup/error corrections attributable to the open enrollment period must be completed in accordance with the following deadlines: semi-monthly employees must be completed by June 15, 2005 and bi-weekly employees must be completed by June 24, 2005. 

In addition to printing confirmation statements for changes made as a result of family status, confirmation statements may also be printed for Open Enrollment changes. 

Further information concerning open enrollment is available on the Core-CT website at:

http://www.core-ct.state.ct.us/user/hrjobaids/ben/default.htm

VII. NOTICE TO EMPLOYEES 

Please inform your employees of the open enrollment period and the open enrollment fairs and direct them to the Comptroller's Web site at www.osc.state.ct.us to obtain the information necessary for them to make an informed choice during the open enrollment period. 

The HealthCare Options planner will be mailed to all employees eligible for state-paid health benefits. Be advised that it will be mailed to the default address on the CORE-CT Personal Data page. If this address is other than the employee's home address, the Agency will be responsible for forwarding the planner to the employee. The planner will include a schedule of all applicable biweekly payroll deductions, and a description of available options. The semi-monthly and 100% premium rate schedules will be sent to the affected agencies. 

VIII. QUESTIONS

Personnel or payroll staff who have questions concerning this memorandum should contact the Comptroller's Retirement & Benefit Services Division, Health Care Analysis Unit, at (860) 702-3535. Kindly refrain from directing employees to this telephone number. 

Very truly yours,

Nancy Wyman
State Comptroller

NW/NM/WPM 

Attachment:

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