University Times

Most Pitt employees will pay $6-$24 more a month for their UPMC medical insurance premiums beginning in July, but will save money on preventive care and health screenings.

The cost to employees for the prescription drug, vision and dental plans will stay the same.

The new health care plan is effective July 1. Details of the benefits are contained in packets sent to faculty and staff by Human Resources late last week.

Individuals enrolled in the Panther Gold Plan — accounting for about 90 percent of employees receiving health care benefits through Pitt — will see their monthly health care premiums increase from $38 to $44 a month (a 15.7 percent increase) with family coverage rising from $218 to $242 a month (up 11 percent).

There will be no premium increases for the Premier, Plus and Basic plans.

Under new guidelines emphasizing preventive care, Pitt will waive an employee’s health insurance premium for July 2006 if that employee and the covered spouse or domestic partner complete a basic metabolic panel and lipid profile between July 1 and March 31, 2006. Employees will be sent more details in June on this new benefit, Human Resources administrators said.

Regardless of the Pitt medical plan chosen, employees will be entitled to, at no cost to them, age-related preventive services such as pediatric immunizations, mammography, colonoscopy, PAP tests and prostate exams. These services no longer will be subject to co-payments, deductibles and coinsurance.

Also new this year, smoking cessation products will be covered by the Your Choice Pharmacy Drug Program.

This year’s focus on “fitness for life” tries to encourage faculty and staff to adopt a healthy lifestyle and to get tested early for potential illnesses, according to Ron Frisch, associate vice chancellor of Human Resources.

“We believe these efforts could have an impact on health care in the future and the cost of health care,” he said. “For example, if we’re able to identify, through early intervention, a cholesterol problem, we can provide people with prescriptions that might mitigate a heart episode.” Medications and a healthy lifestyle can diminish the odds of serious health problems, he explained.

For instance, based on a review of aggregate claims data, administrators here are certain that high cholesterol is a problem for Pitt faculty and staff. According to James Edgerton, assistant vice chancellor for Human Resources, “Twenty percent of Pitt employees (and family members in Pitt’s health insurance pool) that we know of have high cholesterol and high blood pressure.”

Changing people’s behavior is key to preventing illnesses, and thus controlling escalating health costs, according to Pitt officials. Edgerton, referring to the aggregate claims data, explained that 50 percent of Pitt’s health cost increases are driven by individual behavior. “We smoke too much and drink too much. We don’t eat right and we don’t exercise.”

To make healthy living more attractive, Pitt employees will have access to the following:

•Fees paid by Pitt employees for the School of Education’s Wellness Program can be reimbursed through Pitt’s pre-tax flexible spending account.

• To better inform faculty and staff of other health programs and screenings, Human Resources has launched a new website: www.hr.pitt.edu/fitness.

• Employees can obtain a personalized health profile by filling out a “fitness for life questionnaire” at www.upmchealthplan.com. Members will need their medical insurance member identification number to access the questionnaire.

Generally, faculty and staff familiar with this year’s health care plan negotiations were pleased with this year’s offerings.

“The increases this year will be absorbed by taking advantage of the blood and lipid tests which will waive one month’s health premium payment,” said Rich Colwell, president of the Staff Association Council. “But next year that incentive won’t be there and you might feel the increase then. I would like to thank Ron Frisch and his crew for the fine job of curbing the high cost of health care increases.”

As usual, the University is picking up 80 percent of next year’s almost 9 percent increase for health insurance costs, according to Frisch. The balance is passed on to individuals through higher premiums. During the current fiscal year, the University’s overall health cost is projected to be about $65 million.

There was no competitive bidding for the new health care plans, according to Frisch. Since the University is self-insured, it has an administrative services only agreement with UPMC for medical insurance, which is reviewed annually. Dental and vision care plans will be in the second year of a two-year agreement.

—Mary Ann Thomas