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April 19, 2007

Benefits open enrollment runs until May 9

Pitt employees will see premium increases as well as certain co-payment and prescription drug cost increases for the health plan year that begins July 1.

According to Human Resources officials, the overall increase to Pitt’s medical plans, which are administered by UPMC Health Plan, is 3.9 percent. Regionally and nationally, health care renewals, after adjustments to plan designs, are ranging from 6 percent to more than 8 percent, according to Ron Frisch, associate vice chancellor for Human Resources.

Pitt’s overall health care costs for the coming plan year are projected to be about $82 million, up from roughly $79 million for the current plan year. The University will continue to absorb 80 percent of the annual rate increase to the medical programs covered under the UPMC medical plan options.

Details of the benefits plans, including vision and dental plan options, and long-term care and life insurance choices, are contained in packets mailed to all employees’ campus addresses last week.

Employees who have not received their informational packets should contact Benefits at 412/624-8160.

Employees who elect not to make any changes to their current benefits need not take any action; all others must make changes during the open enrollment period, which began this week and runs through 5 p.m. on May 9.

Changes must be made electronically by following the online enrollment procedure, which is accessible at by clicking on the “open enrollment” link. An instruction sheet for online enrollment is provided in the printed enrollment materials.

A confirmation letter will be sent to the employee’s home address within a few days of changes being made, according to Human Resources.


For Panther Gold enrollees, who make up about 90 percent of employees receiving health care benefits through Pitt, premiums will increase from $47 to $49 per month for individuals, and from $261 to $269 a month for family coverage.

Panther Premier monthly premiums will be increased from $43 to $45 for individuals and from $247 to $255 for family coverage. Family coverage premiums will increase from $138 to $142 for Panther Plus enrollees, with a premium increase for individuals from $5 to $6 per month in that plan.

There will continue to be no charge for individual coverage for Panther Basic subscribers; family coverage is rising from $15 to $18 per month.

Regardless of the Pitt medical plan chosen, employees continue to be entitled to age-related wellness and preventive services completed in-network, such as pediatric immunizations, mammography, colonoscopy, PAP tests and prostate exams. These services are not subject to co-payments or deductibles.

Some prescription drug co-payments will increase for the first time in three years. Over that three-year period, prescription drug inflation has increased by 40-50 percent, Benefits officials noted.

• Generic co-payments will remain the same: $10 for a 30-day (retail) supply and $20 for a 90-day supply. Subscribers can get 90-day supplies through the Falk Pharmacy and the Student Health Services or through mail order with Express Scripts.

• Preferred brand name co-pays will rise from $24 to $28 for a 30-day supply and from $48 to $56 for a 90-day supply.

• Non-preferred brand name (non-formulary) co-pays will rise from $48 to $56 for a 30-day supply and from $96 to $112 for a 90-day supply.

Emergency room co-payments will be increased from $30 to $50 per visit for adults. The co-payment for dependents under the age of 18 will remain at $30 per visit for Panther Gold enrollees.

A $50 co-payment per visit (maximum of four co-payments per plan year) is included under the Panther Gold program for surgical service performed in an outpatient facility setting, and for up to 23-hour observation room service performed in a hospital setting.

The University’s dental and vision contracts cover the current plan year as well as the upcoming plan year.

For dental coverage, Pitt has contracted with United Concordia, which offers three plan options. The rates and plan designs remain the same. Concordia Plus subscribers pay $13.53 for individual coverage and $44.77 for family coverage per month; Concordia Flex I subscribers pay $16.50 for individual coverage and $50.96 for family coverage per month, and Concordia Flex II subscribers pay $24.41 for individual coverage and $93 for family coverage per month.

United Concordia has added one change: Pregnant women are eligible for a third dental checkup and cleaning under all plan options.

The Davis Vision program will maintain its current rates and plan design. Individuals pay monthly premiums of $3.71 for individual coverage and $9.07 for family coverage.

Pitt has signed a new two-year contract with Aetna as its life insurance carrier. Rates are unchanged. However, premiums for optional life insurance increase as participants move into an older age bracket.

This year, Aetna is offering a one-time opportunity to sign up for optional life insurance equal to an employee’s salary. Employees can enroll without having to provide evidence of insurability, that is, without answering any medical questions.

Other new features of Pitt’s medical-related offerings include an expansion of services of the Faculty and Staff Assistance Program (FSAP). FSAP has added “Life Solutions” to its name to reflect including referral services for child care and emergency child care; referral services for elder care; adoption counseling, and other concierge-type services designed to help reduce stress related to balancing work and personal life.

Services of the Faculty and Staff Assistance Program/Life Solutions are offered at no cost. Information is available at 1-866/647-3432 or online at

UPMC Health Plan will cover services offered at Eckerd Take Care Health Centers as an alternative to certain emergency room services. The Eckerd services require only a co-payment charge. Information on services and locations of the centers can be found online at


More information on Pitt’s health care and other employee benefits can be found at

Wellness-related information and links to other health information, including Pitt’s fitness for life initiative, and web sites can be found at

In the coming months, the fitness for life program, launched in July 2005, will be disseminating information on incentive programs, including a $50 gift certificate for completing certain wellness activities, HR officials said. In addition, weight-reduction competitions and educational programs will be offered to support healthy lifestyles.


John Baker, president of the University Senate, told the University Times that the process to develop the 2007-2008 plan was sound, both fiscally and medically.

“The changes in next year’s plan are reasonable and balanced, relative to what other health plans charge,” said Baker, who serves on the medical advisory committee that, with advice from independent consultant Mercer Consulting, advises Benefits personnel on Pitt’s medical benefits.

The committee reviewed last year’s claims data, national survey data and projections by Mercer in developing a projected cost increase for the upcoming plan year, he said. “We needed to bring in an additional $3 million in order to keep the plan sound,” said Baker.

Baker praised Human Resources personnel for their work in managing Pitt’s benefits programs, including the development of the fitness for life initiative, which promotes healthy living and disease risk-reduction with the goal of leading to a reduction to long-term medical costs.

“Our health plan compares favorably to other health plans, even to the plan that UPMC offers its own employees,” Baker maintained. “Prescription drug inflation in particular is a serious problem ,which the University has managed quite well with regard to keeping employee costs low. Pitt also should be commended for keeping the 80-20 (University-employee) premium cost ratio despite the constant rise in medical costs every year,” he added.

“The medical advisory committee discussed possible adjustments to the UPMC Health Plan to cover the projected cost increases, and agreed to the proposed changes that ended up in the plan; other potential changes were dropped,” Baker said.

Changes also were discussed in confidence with the Senate benefits and welfare committee, noted Baker.

Patricia Weiss, chair of the benefits and welfare committee, said, “I have found the Mercer data to be very helpful. We are always concerned about increases in premiums and co-pays; being able to put these in a national context does not remove the sting, but it is reassuring. The administration’s logic — impose small incremental increases over time, rather than a single large increase — is sound. Most importantly, we are vigilant about a wholesale erosion in health benefits.”

Weiss, a member of the medical advisory committee, also commented on the expansion of the scope of FSAP’s activities. “There is a national movement toward a more comprehensive approach to employee well-being, sometimes labeled as work/life balance,” she told the University Times. “That’s the type of orientation needed to address personal and family issues such as child care and elder care that can have a major impact on employee outlook and performance.”

Staff Association Council (SAC) President Rich Colwell, who also is a member of the medical advisory committee, said, “When we started discussions with Mercer, we were looking at 5.3 percent overall increase. We got that down to 3.9 percent. As a committee, we didn’t agree about everything, but these were good discussions, not heated. HR Benefits staff work very hard to keep costs down, and we’re doing better than most organizations in doing that.”

Steve Zupcic, chair of the SAC benefits committee who also is a member of the medical advisory committee, commented, “As health care costs increase, and most experts say they will, I hope we don’t take further steps to hide these increases as co-pays and instead make them more transparent. In other words, I hope in the future health care insurance continues to be a safety net for the most vulnerable of our population, some of whom are experiencing extremely high co-pay costs over the course of a year. We don’t want to have a pay-as-you-go system.”


This week, Human Resources held benefits fairs on the Pittsburgh campus.

Also scheduled are benefits fairs at Greensburg (April 24, 10:30 a.m.-1:30 p.m., 101 and 118 Village Hall); Bradford (April 25, 11 a.m.-2 p.m., Mukaiyama University Room, Frame-Westerberg Commons); Titusville (April 26, 10:30 a.m.-1:30 p.m., Haskell Memorial Library), and Johnstown (April 30, 10:30 a.m.-1:30 p.m., Cambria Room, Student Union).

Benefits staff and representatives from the insurance carriers will be on hand to answer questions.

—Peter Hart

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