Time to ask about new
By Dionne Victor
The Daily Cougar
Monday marked the beginning of open enrollment,
a time when employees can update or make changes to their current health
plans. But for faculty and staff in Rm.
102 of the University Science Center, it was also the first opportunity
they had to ask questions
about those plans.
Employees will notice changes in the offerings
with the withdrawal of AmCare Health Systems, one of the state's current
maintenance organization. Current users
of AmCare have been automatically switched to HealthSelect, the preferred
program. While HealthSelect Plus the other
HMO provided by Texas has stopped accepting new members but will keep their
"ERS has been pretty firm in over the last
four years that they want to keep benefits as they are," said Lance Renfro,
for Human Resources. With the change in
health plans the biggest difference is an increase in premium rates.
The 12.4 percent increase is used to offset
cost of increasing health care cost and will affect employees who claim
is small in comparison to some rate increases
that are 40 percent. Currently the state pays 100 percent of the member
those who are dependent and 50 percent
for those who claim dependents.
Another program that aides employees with
children is the State Kids Insurance Program, a program started in 1999
assistance for dependents up to age 18.
If employees meet the salary requirements, which are done by family size,
income and monthly gross income.
Other requirements include families that
don't qualify for Medicaid and according to Victoria Sanchez, benefits
assistant for the
Department of Human Resources, SKIP is
not an actual insurance program but instead it is an assistance program
that offsets the
cost of healthcare.
Although AmCare's premium rates were significantly
lower than HealthSelect, there was little security when it came to keeping
doctor. For employees who are currently
HealthSelect Plus members, there is also less security when it comes to
having a long-term
"HealthSelect affords the participants
greater selection of physicians and treatment facilities," said Robert
vice-president for human resources. In
comparison the HMOs do not allow their users this freedom which is why
they can operate at
a lower cost, Herrington said.
"Due to the fact that they provide health
benefits and services out-of-area and out-of-network ... the need for physician
services and treatment can be rendered,"
HealthSelect Plus users only receive benefits
when they use a primary care physician and it does not require an annual
The plan offers a minimum co-payment and
also covers services such as well-child care, immunizations and routines
physicals. It is
a self-insured plan that does not require
evidence of insurability.
HealthSelect Plus, which is the only HMO
plan available, is closed to new members and there are currently 1,126
under the program. Some employees are
not satisfied with it. "I originally signed up for HealthSelect Plus, I
was wondering where's
the plus," said Larry Flowers, a carpenter
"The only issue that some employees might
consider as a disadvantage to HealthSelect is that there is a deductible,
pocket expense and a percentage payment
for services including diagnostic, lab and x-ray treatments that most HMO
not currently pay," Herrington said.
Additional question and answer sessions
will be held at 10 a.m. every Tuesday for a month in the University Science