|55 ELM STREET
Telephone: (860) 702-3480
|HEALTH CARE COST
|STATE OF CONNECTICUT
OFFICE OF THE STATE COMPTROLLER
HEALTHCARE POLICY & BENEFIT SERVICES DIVISION
|ATTENTION:||Personnel and Payroll Officers, Chief Administrative and Fiscal Officers, Business Managers|
|SUBJECT:||2013 Health Insurance Open Enrollment|
The state employee health insurance annual open enrollment period will be held from May 13, 2013 through June 7, 2013 for coverage effective July 1, 2013. This memorandum discusses enrollment procedures and how employees can access information about available health plan choices and premiums.
During open enrollment, employees may change medical and/or dental plans, add or drop coverage for eligible family members, or enroll in coverage if they previously waived it. This is the only time employees may enroll in or change a health plan, unless the employee experiences a qualifying event, such as marriage, divorce, civil union, birth, adoption, legal guardianship or loss of other health insurance coverage by an eligible dependent. The employee is responsible for contacting their agency personnel/payroll representative to file the appropriate forms within 31 days of the event that necessitates a change in enrollment or plan.
A. Plan Offerings and Changes
1. Medical Plans and Benefits - Full details of plan choices and premium shares will be available in the Health Care Options Planner that will be posted on the Comptroller's website, www.osc.ct.gov. The health insurance rates for the period from July 1, 2013 to June 30, 2014 have been updated and the employee premium share for the medical plans has been adjusted accordingly.
2. Dental Plans and Benefits - There will be no changes in the dental plans. Employee premium shares for the dental plans will be in the Health Care Options Planner posted on the Comptroller's website www.osc.ct.gov. The dental insurance rates for the period from July 1, 2013 to June 30, 2014 have been updated and the employee premium share for the dental plans has been adjusted accordingly.
3. Pharmacy Plans and Benefits - Employees are required to use the State of Connecticut Maintenance Drug Network to fill prescriptions for maintenance medications. The first prescription for any medication (30-day supply) may be filled at the employee's local participating retail pharmacy. After that, refills for maintenance medications must be filled through a participating State of Connecticut Maintenance Drug Network pharmacy. These directories are maintained on the Comptroller's website at www.osc.ct.gov by individual state.
B. Open Enrollment Fairs - Open Enrollment fairs are to be held at
various locations across the state from May 13, 2013 through June 7, 2013. The
statewide schedule of enrollment fairs is attached for posting and should be
communicated to employees. Employees may attend a fair held at any agency or
location, subject to the agency's operating needs.
The State of Connecticut health insurance vendors, as well as ING and Transamerica Long Term Care, will be attending the fairs. Staff from the Office of the State Comptroller, Healthcare Analysis Unit, along with the State's new Health Enhancement Program (HEP) vendor, Care Management Solutions will attend each fair. These representatives will be able to answer questions about the benefit plans, assist with HEP-related questions, and provide information on the new online portal, www.cthep.com.
C. Health Care Options Planner
The Health Care Options Planner, which details the plans, will be available this year on the Comptroller's website www.osc.ct.gov. The Planner contains information regarding applicable employee premium shares, offers certain general guidelines to assist employees in making their choices, and provides helpful information related to the Health Enhancement Program (HEP). Contact information for each carrier is listed in the Planner for any employee who has specific questions on the medical, dental, or pharmacy plans. The State's new HEP vendor, Care Management Solutions, is listed for any employee who has HEP-related questions, including those related to the new online portal.
D. Enrollment Statements
Enrollment statements will not be included with the Planner or in any marketing material sent to employees, nor will carriers have enrollment statements available at the open enrollment fairs. Enrollment Statements must be system generated by Core-CT. Employees electing or changing coverage may do so only through their personnel or payroll office.
E. Health Enhancement Program and New Enrollment
Participation in the Health Enhancement Program (HEP) provides incentives (i.e. reduced premiums and co-pays, waived deductibles, etc.) for employees and their dependents that have completed age-based health screenings and exams. HEP guidelines are described in detail in the 2011 SEBAC Agreement.
The state has selected Care Management Solutions to administer the state's Health Enhancement Program (HEP). Care Management Solutions is available to you, your spouse, and your dependents regardless of which carrier you have selected for your medical and/or dental insurance. The goal is to make it easier for you to successfully complete your annual requirements, and to review your personal HEP compliance status in a meaningful way.
A key new feature of HEP is an improved online portal at www.CTHEP.com. This portal will allow you to more easily and securely access information throughout the year. You will have access to your personal HEP compliance status and, if applicable, the compliance status of your spouse and dependents. The portal contains an outline of HEP requirements for preventive care, recommendations for chronic care management, interactive self-learning modules, and personal progress tracking. In addition, employees may communicate with HEP nurses and representatives through the message center in the online portal. Members accessing the new HEP portal for the first time will need to complete a short registration process.
Employees who are not currently enrolled in HEP may elect to do so during open enrollment by completing a Health Enhancement Program Enrollment Form (CO-1314). The form is available on the Comptroller's website www.osc.ct.gov. Employees can submit completed forms to their agency Payroll/Human Resources office. Forms must then be forwarded to the Central Benefits Unit of the Office of the State Comptroller. All new HEP enrollments must be completed by June 7, 2013.
The 2013-2014 Health Care Options Planner provides full details of plan choices and premium shares, and will be posted online at www.osc.ct.gov . Monthly rates for COBRA continuation coverage will be transmitted to agencies through subsequent communications. Personnel or payroll staff members who have questions concerning the Open Enrollment process should contact the Comptroller's Healthcare Policy & Benefit Services Division at (860) 702-3535.
Very truly yours,
Thomas Woodruff, Ph.D.
2013-14 Employee Health Care Options Planner
2013-14 Active Employee Open Enrollment Fair Schedule
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& Benefit Services Division
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