Health plan update [Vol. 4, no. 1 (Oct. 14, 2003)]

Health Plan Update
A Publication of the Board of Regents of the University System of Georgia
October 14, 2003 Volume 4, No. 1

T he arrival of fall heralds the openenrollment period for the University System of Georgia's health benefits -- the time of year in which employees are invited to make changes regarding their health-care coverage for the coming year.
This year's open-enrollment period runs from Oct. 14 to Nov. 14. Only employees who wish to change plans or the level of their health-care coverage for 2004 need to fill out the health-plan election form included in their benefits packets.
Health Plan Update and the plan booklets that will arrive in the employee benefits packets are designed to help employees sail smoothly toward the health-care plan that best suits them and navigate the sea of important information associated with benefits such as the pharmacy program. Employees who have questions after studying these important and insightful materials are urged to contact their Human Resources Office for further information.
Regents Keep Increases to Bare Minimum
In a tight budget year that brought no raises for state employees, the Board of Regents is extremely sensitive to the impact that any increases in premiums or co-payments for health-care benefits will have on the administration, faculty and staff of the University System of Georgia.
To that end, the Office of Support Services and the Office of the Associate Vice Chancellor for Human Resources has worked hard on behalf of System employees this year to minimize health-plan increases and make the array of health-care plans offered to employees as robust and cost-effective as possible.
Despite the implementation of a number of cost-saving strategies that have greatly improved the fiscal soundness of the University System with regard to employee health benefits, the cost of health care continues to escalate. Nationwide, many health plans are trending toward cost increases of 14-18 percent.
The Board of Regents is pleased to have held its increases well below that level. In fact, a few plan premiums actually have decreased -- and any increases that were necessary have been kept to a bare minimum. The 2004 premium rates for each health plan are listed on charts that accompany this first issue of this year's Health Plan Update.

Generic Drugs Are Most Cost-Efficient
Regardless of which health-care plan is chosen, health-plan participants can keep their pharmacy costs as low as possible by remembering to ask pharmacists if there is a generic equivalent for the medication prescribed by their physician or healthcare provider.
Many people raised in an era when the term generic equated to second-rate still think generic prescription drugs aren't as good as brand-name drugs. However, most physicians, pharmacists and other health-plan providers consider generic drugs to be just as safe, effective and high in quality as their brand-name equivalents.
In fact, generic drugs must be approved by the U.S. Food and Drug Administration (FDA), just like brandname drugs. And, to obtain FDA approval, generic drugs must contain the same active
See "Generic Drugs," Page 2

The University System of Georgia has an Open-Enrollment website!
www.usg.edu/admin/humres/benefits/
This is another navigation tool at your disposal to help you in selecting the best health benefits.

Another Way to Save on Premium Costs
USG employees will have some new cost-saving options from which to choose in 2004.
For example, in an effort to minimize health-care costs for employees, the University System has adopted a new four-tier premium structure for all USG health plans that will benefit a parent claiming only a child as a dependent. The four tiers are: "Employee Only,", "Employee + Child," "Employee + Spouse," and "Family." Previously, the "Employee + One" tier made no distinction as to whether the dependent was a child or a spouse. Under the new structure, individuals participating at the "Employee + Child" level will pay less for their premiums than those in the "Employee + Spouse" tier.
Also, a new option will be available in the Kaiser Permanente Health Maintenance Organization (HMO) plan for 2004. Participants in the new "Standard Plan" option will have to satisfy annual deductibles, but will pay lower premiums than their counterparts in Kaiser's "Premium Plan."
"Keep a Lid on It"

Generic Drugs
continued from Page 1
ingredients in the same dosage forms and strengths as their brand-name equivalents.
But here perhaps is the most convincing argument for using generic drugs -- they cost about half as much as brand-name medications.
An the best news of all is, in 2004, there will be no increase in member co-payments for generic drugs. For the first time since the University System began offering a pharmacy benefit in 2001, member co-payments for brand-name medications will increase.
Co-payments for preferred brand-name medications will increase from $20 to $25. Copayments for non-preferred brand-name drugs (PPO and indemnity plans) will increase from a $35 minimum/$70 maximum to a $40 minimum/$100 maximum.

Pharmacy Out-of-Pocket Expense Caps to Change from Monthly to Quarterly
For the past two years, a monthly cap has limited the amount of outof-pocket money members of the Paid Provider Organization (PPO) and indemnity plans can be charged for generic and preferred brandname prescription drugs to $100 for individuals and $200 for families. Once plan members exceed the maximum in any given month, copayments are waived for any additional generic and preferred-brand drugs for the remainder of that month.
In 2004, the University System will change from a monthly to a quarterly out-of-pocket maximum. The maximum will be $450 per quarter for individuals; $900 per quarter for "Employee + Child" and "Employee + Spouse;" and $1,350 per quarter for families.
Please note that the out-of-pocket maximum does not apply to copayments for non-preferred brand-name prescriptions. If a physician insists on prescribing a brand-name drug when a generic is available or if the plan member chooses the brand-name drug over its generic equivalent, the plan member is required to pay the difference in cost between the brand-name or non-preferred brand-name drug and its generic equivalent. This "pay-the-difference" fee is commonly referred to as an "ancillary charge."
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Website a Powerful Resource for Health Information
U SG employees now have a new Internet-based resource for health and wellness information, self-assessment tools and links to a variety of health-care topics and organizations.
MagellanAssist is a website developed by Magellan Behavioral Health "to help you manage modern life's demands."
This handy tool -- available to all employees -- even helps users with referrals to behavioral health-service providers and questions about benefits.
A link to MagellanAssist may be found at www.usg.edu/admin/ humres/benefits/, listed under PPO Resources. To log in, type in 800-631-9943 when prompted and click on "Georgia Board of Regents."