University Times

For the first time in a decade, the University is offering a new employee health plan option. A new preferred provider organization (PPO) plan is being added to the existing three PPO plans and one health maintenance organization (HMO) for the benefits year that begins July 1.

The new Panther Advocate PPO allows participants to reduce their annual deductible through wellness incentives.

John Kozar, assistant vice chancellor of Human Resources, encouraged employees to take a look at the new option to see if it could be more economical. Panther Advocate’s monthly premiums are slightly lower than Panther Gold HMO’s — $60 vs. $70 for individuals and $297 vs. $325 for families — and the HMO’s co-pays are increasing in the coming year.

The Panther Advocate plan’s annual deductible starts out at $750 for individuals and $1,500 for families but can be reduced to $250 for individuals and $500 for families by completing incentives such as biometric screening, age- and gender-appropriate screenings, immunizations and health coaching.

After the deductible is met, the plan picks up 90 percent of the cost of in-network services.

“This program would be more attractive to many, provided you complete the incentives in a timely manner,” said Kozar.

Unlike HMO participants, who pay a fixed co-pay for services, PPO participants pay for their health-care services until their deductible is met. “PPOs force you to understand the cost of services whereas under an HMO you pay the co-pay and don’t really worry about the cost,” Kozar explained. “Under the PPO where you are responsible for the deductible, you’re going to worry about the cost of services.”

The new plan may appeal to individuals with few health-care claims, but even those who have a significant amount of claims should take a look and do the math, Kozar said. “Look at what your true out-of-pocket costs are. If you’re the informed consumer, this plan could work well.”

To allow employees time to review the expanded options, open enrollment, typically a three-week period, is being extended to four weeks (ending May 22) and special information sessions on Panther Advocate are being scheduled, some in conjunction with benefits fairs, said Kozar.

To view a schedule and register for a Panther Advocate information session, visit www2.hr.pitt.edu/PantherAdvocate.

—Kimberly K. Barlow