Health enrollment period begins soon

The time is approaching for University employees to think about whether they want to change their health plans.

The annual enrollment period for health plans begins Aug. 1 and runs until Sept. 2. Employees should receive enrollment information later this month in the mail at their homes.

Employees who do not want to change plans don't have to do anything. Any employee who wants to switch their plan or add dependents needs to fill out and send an enrollment form to the University's Benefits Office.

Any changes would take effect Oct. 1, the beginning of the next health plan year. However, any changes in premiums will show up in September paychecks.

Few program changes

Paul Sebo of the State Health Benefits Office said that other than price changes, there were few changes within the programs offered by the State Health Plan and the dozen health maintenance organizations available to state employees.

"There are no dramatic changes at all," Sebo said. "The HMOs are doing pretty much this year what they did last year."

While the General Assembly has not completed work on the budget, the state is expected to continue contributing the same amount--$144.60--per month for health coverage.

That means that employees who sign up for coverage for only themselves through the State Health Plan would have to pay no additional amount for coverage.

Employees who choose an HMO or who add dependents to their coverage will pay an additional monthly amount for that coverage, with rates varying among the State Health Plan and the HMOs.

Six of the HMOs are raising their rates, with increases in the monthly employee contribution for employee-only coverage ranging from 5 percent to 85 percent. Two HMOs are lowering their rates and two others are keeping their rates the same.

Making choices, finding information

Employees should carefully consider their needs when making choices among health plans, Sebo said.

All of the HMOs are required to at least match the level of coverage offered by the State Health Plan, he said. Therefore, Sebo said, price may be the top consideration for many employees.

Another important consideration is location, he said. Some of the HMOs do not operate in the Triangle area and surrounding counties. Others have agreements to send their patients to certain hospitals.

Nora Robbins, Carolina's senior director of Human Resources Services, said employees with questions about their individual circumstances should call the State Health Plan and the HMOs. Each of the organizations has a toll-free telephone number.

Employees should write down and keep in their records the name of the person with whom they speak and the answers they give in case there later is a dispute, Robbins said.

Employees may find help making decisions by using a variety of resources:

HealthTouch UNC Hospitals and the School of Medicine offer a telephone service to help people make choices concerning health plans. The HealthTouch service is an automated service with recordings that may be accessed with a touch-tone phone. Topics include cost considerations, how to fill out enrollment forms and basic descriptions of the various health plans. The service may be reached at 6-0000.

Callers may request a brochure listing all of the topics included in the HealthTouch service. The HealthTouch topics concerning state employee health care enrollment are listed on the service's World Wide Web page .

Department of Insurance The North Carolina Department of Insurance maintains a web site that lists information concerning HMOs operating in North Carolina, http://www.sips.state.nc.us/DOI/MCD/hmoinfo.htm. The site includes information on how many people are enrolled in each of the programs and which counties they serve.

NCQA The National Committee for Quality Assurance, a nonprofit organization that accredits HMOs, has a web site that contains general information concerning choosing health care plans, http://www.ncqa.org/consumer.htm. The NCQA's web site also contains information on whether HMOs have been reviewed and are accredited by the organization.

AMA The American Medical Association also maintains a web site with general information concerning health plan choices, http://www.ama-assn.org/insight/gen_hlth/ahcpr/ahcprfin.htm.

The Gazette The University Gazette will publish an update with more
information concerning the health care plans in its Aug. 13 edition. As more information becomes available it will be posted on the Gazette's web page, http://www.unc.edu/news/gaz.

Monthly Health Plan Costs

Here is a list of the new monthly employee contribution costs and percentage change from last year's costs for each of the health plans available to state employees. The calculations are based on the assumption the General Assembly makes no changes in the state's contribution.

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