STATE OF CONNECTICUT
THE STATE COMPTROLLER
55 ELM STREET
HARTFORD, CONNECTICUT 06106-1775
COMPTROLLER'S MEMORANDUM NO. 2006-07
April 24, 2006
TO THE HEADS OF ALL STATE AGENCIES
|ATTENTION:||Personnel and Payroll Officers, Chief Administrative and Fiscal Officers, Business Managers|
|SUBJECT:||2006 - 2007 State Employee Annual Health Insurance Open Enrollment and Health Insurance Processing Procedures|
The state employee health insurance annual open enrollment period will be held from May16, 2006 through June16,2006, for coverage effective July1,2006. 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. For employees that do not respond during this year's open enrollment period, their health insurance status will remain unchanged, except that they will be affected by any change in the deduction amount for their plan. Employees will not be able to enroll in, change, or add dependents to a plan other than during this open enrollment period, except under limited circumstances in response to changes in their work or family status.
The employee is responsible for contacting their agency personnel/payroll representative to file the appropriate forms within 30 days of the event that necessitates a change in enrollment or plan.
II. PLAN CHOICES AND CARRIERS
A. Medical Plans - For the 2006-2007 plan year there are no changes in the medical plan offerings, the medical benefits of all the plans remain aligned and unchanged from last year. Anthem, Health Net and Oxford will continue to offer Point of Service (POS), Point of Enrollment (POE), and Point of Enrollment-Gatekeeper (POE-G) plans.
Employees who reside outside of Connecticut are allowed to choose from two Out-of-Area Plans. The Oxford USA Plan and the Anthem Out-of-Area plan will continue to be available.
The following explains the provider network available within each plan:
Health Net: The Health Net POS and POE network expands coverage beyond Connecticut to New York and New Jersey. Members will have access to in-network physicians and facilities in all three states. Since Health Net's POS and POE plans provide access into New York and New Jersey, if members plan to utilize medical services there, these plans should be compared to the Oxford/UnitedHealthcare plans and the Anthem State Preferred plan. All urgent care and emergencies are covered as in-network services.
Oxford: The Oxford POS and POE network expands coverage beyond Connecticut to New York, New Jersey, Pennsylvania, and Delaware. Members will have access to in-network physicians and facilities outside Connecticut. Since Oxford's POS and POE plans extend outside Connecticut, access should be compared to the Anthem State Preferred network if you seek medical services in Connecticut, New York, New Jersey, Pennsylvania, and Delaware.
Oxford's POS Plan (Freedom Plan Select) and their Out-of-Area Plan (Oxford USA) is associated with the UnitedHealthcare Choice Plus network which provides an extensive national network of physicians and facilities. This network should be directly compared to the Anthem State Preferred and Out-of-Area Plan network, should members have a need for national coverage. This network is based upon agreements with physicians in all states where access is available. Members will not encounter additional out-of-pocket expenses for network physicians. All urgent care and emergencies are covered as in-network services.
Anthem: The Anthem POS and POE networks (BlueCare Network) are based in Connecticut. Members have access to Connecticut physicians and some border facilities in Massachusetts and Rhode Island. Should members need to utilize physicians or facilities outside Connecticut they may be subject to out-of-network charges for the POS or have no coverage for the POE.
Anthem's State Preferred network utilizes a national network of physicians and facilities. Since Anthem's out-of-state, out-of-network reimbursement is based upon Anthem's Connecticut fee arrangements, participants should be careful to seek medical services from network providers if they seek medical services in high cost areas to avoid additional out-of-pocket expenses. All urgent care and emergencies are covered as in-network services.
B. Prescription Drug Plan:
For the 2006-2007 plan year there are no changes to the State's prescription drug offering. PharmaCare remains the State's pharmacy benefits provider.
C. Dental Plans:
For the 2006-2007 plan year there are no changes to the State's dental plan offerings. UnitedHealthcare Dental will continue to administer two dental plans, the Basic Plan and the Enhanced Plan. The Aetna DMO plan, a dental HMO, remains available.
The health insurance rates for the period from July 1, 2006 to June 30, 2007 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
The premium changes announced herein are effective with the following payroll periods:
|June 9 - June 22, 2006||June 16 - June 30, 2006|
|Payable July 7, 2006||Payable June 30, 2006|
V. ENROLLMENT PROCEDURES
Employees who choose to remain with their existing plans do not have to complete a new health insurance enrollment statement.
All Enrollment Statements must be produced using the CORE-CT Benefits Administration system.
Agencies can begin printing Open Enrollment Statements on Tuesday, May 16, 2006. Enrollment statements should be produced only for those employees seeking to make a change during this open enrollment period.
Agencies can enter new elections any time on and after May 16,2006. The enrollment statement will have a closing date of June 12, 2006 printed on it. However, agencies will have until close of business June 16,2006 to complete data entry of employee elections. Therefore, agencies can choose to accept enrollment statements from employees after June 12, 2006. Be advised that the open enrollment process will be closed to agencies at the end of the business day, June 16,2006.
Civil Union Enrollment:
All Civil Union enrollments or changes are to be processed by the Retirement & Benefit Services Division, Central Benefits Unit.
Employees seeking to add medical and dental coverage for their civil union partners and dependent children should be instructed to submit the same documentation to their employing agency that is required of married employees. For federal income tax purposes, if the employee provides more than fifty percent of a civil union partner's financial support the employee should also provide a signed statement to their employing agency stating that fact.
The employing agency, not the employee, is required to submit a representation from the agency as to the employee's intent regarding health insurance coverage along with a copy of the above mentioned documents to the Central Benefits Unit.
Upon its receipt of these materials, the Division will process the change to the employee's records in Core-CT associated with health care coverage for civil union partners and will notify the agency of such action.
Domestic Partner Enrollment:
All Domestic Partner enrollments or changes are to be processed by the Retirement & Benefit Services Division, Central Benefits Unit. The employing agency, not the employee, is required to submit a representation from the agency as to the employee's intent regarding health insurance coverage, agencies are to use the following procedures:
(1) For an employee who has enrolled a domestic partner in their health plan prior to the 2006 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 Central Benefits 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 2006 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, 2006, provided the Affidavit of Domestic Partnership was signed in May or June2006. Upon acceptance of an Affidavit, the Central Benefits Unit will email an Enrollment Statement to the Agency. After the employee completes the Enrollment Statement the Agency should return it to the Central Benefits 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 Central Benefits Unit and wish to enroll their domestic partner during the 2006 Open Enrollment period must notify their Agency. The Agency must send a copy of the completed and signed Core-CT Enrollment Statement to the Central Benefits 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 and BAS activity by May 3, 2006 or those events may not be processed correctly. In addition to the automated
open events report sent to agencies via email, agencies can print the following reports to help identify such events:
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 14, 2006 and bi-weekly employees must be completed by June 16,2006.
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:
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. Employees may attend a fair at any agency or location, subject to the employing agency's operating needs.
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.
Personnel or payroll staff who have questions concerning this memorandum should contact the Comptroller's Retirement & Benefit Services Division, Central Benefits Unit, at (860) 702-3535. Kindly refrain from directing employees to this telephone number.
Very truly yours,
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