Heathcare policy & Benefit services division header

Healthcare Policy & Benefit Services Division

Division Memorandum 2016-03

TO THE HEADS OF ALL STATE AGENCIES

ATTENTION: Personnel and Payroll Officers, Chief Administrative and Fiscal Officers, Business Managers
SUBJECT: 2016 Health Insurance Open Enrollment

I. INTRODUCTION

The state employee annual open enrollment period for health insurance will be held from May 9, 2016 through June 3, 2016 for coverage effective July 1, 2016. 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 if they previously waived coverage. This is the only time employees may enroll in or change a health plan, unless there is a qualifying event, such as marriage, divorce, legal separation, 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.

II. DISCUSSION

A. Plan Offerings

1. Medical Plans and Benefits - There are no medical plan changes this year. Full details of plan choices and premium shares are available in the 2016-17 Active Employee Health Care Options Planner posted on the Comptroller's website.

2. Dental Plans and Benefits - There are no dental plan changes this year. Full details of plan choices and premium shares are available in the 2016-17 Active Employee Health Care Options Planner posted on the Comptroller's website.

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 will be held at various locations across the State from May 9, 2016 through June 3, 2016. The State of Connecticut's health, dental and pharmacy vendors will be available to answer questions and provide information about the benefit plans. Care Management Solutions, Inc. (CMSi), our Health Enhancement Program (HEP) administrator, will be attending each fair to answer HEP questions, provide information on 2016 HEP requirements, and to assist members with chronic disease education and counseling requirements.

C. Health Care Options Planner

The 2016-17 Active Employee Health Care Options Planner is available on the Comptroller's website:

http://www.osc.ct.gov/benefits/openenroll.htm

The Employee Health Care Options Planner contains important information including benefit summaries, applicable employee premium shares, and offers general guidelines to assist employees in making their health benefit choices. In addition, there is contact information for each insurance carrier, including the State's HEP administrator, Care Management Solutions, Inc. (CMSi).

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 by requesting a Core-CT generated enrollment form from their agency Payroll/Human Resources 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.

Care Management Solutions, Inc., the state's Health Enhancement Program (HEP) administrator, 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 feature of HEP is an online portal at www.CTHEP.com. The portal contains an outline of 2016 HEP requirements and will allow you to more easily and securely access information throughout the year. You will be able to view your personal HEP compliance status and, if applicable, the compliance status of your spouse and dependents. In addition, employees may communicate with HEP nurses and representatives through the message center in the online portal. Members accessing the 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 Healthcare Analysis Unit of the Office of the State Comptroller by email to osc.cthep@ct.gov or by fax to (860)702-3556. All new HEP enrollments must be completed by June 3, 2016.

Employees who are currently enrolled in HEP and are in a non-compliant status must complete the HEP Application for Reinstatement Form (CO-1320) and submit the completed form to Care Management Solutions, Inc. in order to be reinstated into HEP compliance status. The form is available online at www.cthep.com.

III. CONCLUSION

The 2016-2017 Health Care Options Planner provides full details of plan choices and premium shares, and is available 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.
Director


Attachments:
2016-17 Employee Health Care Options Planner
2016-17 Active Employee Open Enrollment Fair Schedule

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