Open Enrollment for Long Term Care Insurance for Faculty and Staff
The University of Pittsburgh is committed to providing benefit solutions that will help you plan for a future of financial stability and security. In keeping with this commitment, we are pleased to announce that there will be an open enrollment for the group sponsored Long Term Care Insurance plan from April 20, 2011 to May 31, 2011.
Long Term Care is defined as the type of care provided either at home or in a facility to someone who needs assistance with activities of daily living, or suffers severe cognitive impairment, due to an accident, an illness or advancing age.
Long Term Care Insurance can help you preserve your independence and financial security, and can help relieve your family members of the burden of making decisions about how to pay for care. In addition, Long Term Care Insurance provides you with a choice of how and where you receive care. Like most people today, you probably want to receive quality care that lets you stay at home for as long as possible and have the flexibility to choose the care options that work best for you and your family.
The national average cost for care in a long term care facility is $80,000 per year. Home-based care costs vary depending on the type and frequency of care required. For most of us, this expense could have a significant impact on our financial security.
Many people believe that health insurance or a government program will pay for long term care. Health insurance will not cover these costs, and government programs like Medicare and Medicaid fall short as well. Without insurance protection, your assets could disappear quickly, along with your ability to make choices and maintain control over your life. In fact, 72 percent of those entering nursing homes are impoverished within one year.
To illustrate the value of Group Long Term Care Insurance, consider the grid below. The grid shows the return on investment an individual may experience when enrolled in the Group Long Term Care Insurance, based upon the amount of money paid in premiums versus the lifetime benefit provided by the coverage. The examples below are based upon enrollment in “Plan 2” of Unum’s Group Long Term Care Insurance (covering long term care facilities, professional home care, and total home care, without inflation protection) with a monthly benefit of $6,000 and benefit duration of 6 years. As indicated by the grid, the maximum lifetime benefit provided by the Group Long Term Care Insurance coverage far exceeds the total premiums paid by participants of almost any age.
*Assuming the Long Term Care Insurance benefit will begin at age 80 (benefit may begin at any age if meeting Unum’s eligibility criteria).
During the open enrollment period you will have the opportunity to enroll for Group Long Term Care Insurance, or increase your Group Long Term Care Insurance if you currently are enrolled, without completing an Evidence of Insurability Application (referred to as Guarantee Issue). The opportunity to purchase this insurance at a group rate is available to faculty, staff, and their extended families. There is no guarantee this opportunity will be available in the future. All enrollment forms must be received by Unum no later than May 31, 2011.
The University’s Long Term Care Insurance carrier, Unum, will have representatives at this year’s on-campus benefits fairs. Please feel free to visit the Unum table at one of the Benefits Fairs.
Please contact the Unum toll-free line at 1-800-227-4165 if you have questions. You may also access Unum’s informational Web site at:
Open Enrollment – An Opportunity to Make Changes to Your Benefit Elections
Annually, the University offers an annual open enrollment period that provides an opportunity for faculty and staff to make changes to their benefit elections. During this time, eligible members may make changes in benefit coverage; otherwise, the elected benefits remain in place until the following open enrollment period. The only exception to this IRS provision involves a status change or life event. Examples of a life event include marriage, divorce, a significant change in a spouse’s insurance coverage, birth of a child, etc.
The open enrollment period is a good time to review your current elections and question if they meet your needs. A few good questions to consider include:
• Does my current medical option meet my needs?
• Are there other dental options that I should consider?
• Do I have the right amount of life insurance to protect my family?
• Do I defer too much or too little income for my spending accounts?
• Should I consider spouse/dependent life insurance?
• Would I save money if I joined the vision program?
• How do I check my benefits and make changes?
A statement displaying your current benefit elections is included in your open enrollment packet. This information is also available on-line. To review your benefits on-line and/or make changes, following the instructions below. Many faculty and staff now log on to the University system through my.pitt.edu. This is also the portal to the open enrollment process.
1. Go to my.pitt.edu
2. Enter your University username and password
3. Select “PRISM Login”
4. Select “PHR Employee Self Service”
5. Select “Benefits” and continue through the Open Enrollment Online Self-Service process.
Need Help Logging on to the System?
• You may reset your password on-line with a click on “Forgot your password?” within the my.pitt.edu login page.
• Contact the Technology Help Desk at 412-624-HELP (4357). The Help Desk will ask specific security questions to confirm your identity and will give you a new password over the phone only if you can answer these questions.
• Stop at a campus computing lab with your ID. The lab consultant will verify your identity and call the Help Desk, which will give you a new password over the phone.
Benefit Changes in the New Plan Year
Each year an effort is made to balance benefit plan changes against the ever-rising cost of insurance premiums. Increases in co-payment generally help offset the increase in the cost of services provided within the plan. While general inflation remains low, health care and pharmacy trends continue to rise more sharply.
The overall increase in health care costs is 3.3% after changes. The University will continue to absorb 80% of the health care costs while faculty and staff will be responsible for 20% of the premiums.
As outlined in the open enrollment packets, the following are effective July 1, 2011:
Co-payment changes in the Panther Gold HMO plan are as follows:
Current July 1, 2011
Doctor office visit $15 $20
Specialist office visit $25 $30
Prescription Drug Program
Co-payment changes (30-day supply) in the prescription drug program apply to all medical plans. Co-payments are double for a 90-day supply.
Changes are as follows:
Current July 1, 2011
Generic $10 $12
Preferred brand $32 $34
Non-preferred brand $64 $68
Specialty medications $64 $73
A new tier-level co-payment structure was added for specialty medications. They generally are defined as medications that cost in excess of $600 per month.
Coverage for Overage Dependents
The health care reform provisions that affect dependent health care coverage are effective July 1, 2011. The new policy allows adult married and unmarried children, up to the age of 26, to be covered under their parent’s medical insurance. The federal health care reform provisions will supersede Pennsylvania’s Act 4 provision that provided coverage up to age 30. However, any dependents that are age 26 or older and enrolled in coverage as of June 30, 2011, will be grandfathered for coverage under Act 4 as long as they meet the eligibility criteria.
Davis Vision also will permit coverage of dependents, regardless of student status, up to age 26.
United Concordia will continue to follow its current plan provision that allows dependents to be covered up to age 19. Full-time students may be covered up to age 25.
Important Vendor Contact Information
Office hours: 8 am-5 pm EST, 300 Craig Hall
412-624-8160 (Main Line) • 412-624-3485 (Fax)
Please visit our web site for FAQs, downloadable forms and other benefits information.
UPMC Health Plan
1-888-499-6885 • www.upmchealthplan.com
United Concordia 1-877-215-3616 • www.ucci.com
Davis Vision 1-800-999-5431 • www.davisvision.com
TIAA-CREF 1-800-842-2776 • www.tiaa-cref.org
Vanguard 1-800-523-1188 • www.vanguard.com
Flexible Spending Accounts
1-888-499-6885 • www.hr.pitt.edu/benefits/flexible.htm
1-866-647-3432 • www.hr.pitt.edu/benefits/lifesolutions.htm
412-624-8070 • www.bc.pitt.edu/payroll/index.html