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Open Enrollment for the UUA Health Plan

Open Enrollment for the Unitarian Universalist Association (UUA) Heath Plan has begun for all eligible staff takes place during the month of November. Eligible staff may join the plan effective January 1, 2015, even if they have not taken advantage of past enrollment opportunities.

For currently participating employees of Subscribing Employers or for Subscribing Individuals, there is nothing to do to continue coverage for 2015. Current participants will be carried over and be billed the 2015 rates. Participants are free to change plans (from High Deductible to Standard PPO, for example, or to switch to the Bronze HD plan) by notifying the UUA Health Plan office at healthinsurance @ uua.org.

What's New For 2015?

For the UUA Health Plan—We have worked very hard to enhance our plans in ways that reflect our UU values, without adding to the near-inevitable increase in medical costs—costs that we do not control. Consolidation of medical practices, hospital purchases of medical groups, and the rapid introduction of specialty drugs all conspire to drive up costs. What have we been able to do?

  1. In all of our plans (other than our Medicare Supplement plan, whose benefits are fixed by law), we have removed the $25,000 lifetime cap on transgender services. All transgender services will now be covered at the same level as other medical treatment.
  2. In our Standard PPO, we have increased our Hearing Aid benefit from $2,000 to $3,000 every 24 months, which we hope will encourage more hearing-impaired people to seek treatment.
  3. In all of our plans, we have put on hold any plan to move to mandatory mail order for certain classes of maintenance medications. We will continue to make a voluntary program available that will give all members a chance to save on copays and have prescriptions delivered at home, if they choose that option.
  4. We have held the line on all co-pays and the maximum out-of pocket responsibility, with the exception of the Emergency Room co-pay in the Standard PPO, which will increase from $60 to $100, waived if the member is admitted. Offsetting the ER co-pay, prescription co-pays will now count toward the out-of-pocket maximum.
  5. We will continue to have a highly trained and responsive health plan staff in the Office of Church Staff Finances. Time and again over the course of the year, we hear—from you—that having someone at the UUA to call when there is a problem is perhaps the most valuable service we offer.  Your calls are answered by UUA staff, not a distant call center whose employees have no personal connection to the Plan.

For 2015, all base rates for our plans will increase 9.5%, the lowest possible increase consistent with maintaining the financial strength of the Plan, and nearly identical to last year’s rate change. Our age-rating structure will add another few percentage points for employees currently in the plan, consistent with past years.

Things You Need to Do Now

Congregations

First, look closely at the next tier of available plans with your employees. Our High Deductible plans, currently the choice of about 10% of members, offer the same broad provider network as our Standard plan, but place more of the burden for smaller expenses directly on the member. Our HD plans are similar in structure to the “Silver” plans offered on the Exchanges—which all base their subsidy calculations on “Silver” benefits.  With overall HD plan costs being about 20% lower than the Standard PPO, both congregations and employees save.

Second, to the extent that small business exchanges (or “SHOP”) are functional in 2015, congregations can evaluate their choices on the Exchange. Plan choices will be limited, some state-run SHOP exchanges may come with mandatory contribution requirements for all employees, and the enrollment process may again be rocky. Keep in mind that a congregation that chooses a SHOP option will not be able to come back to the UUA until the next open enrollment. For those congregations that find SHOP to be acceptable, and that can live with the mandatory contribution requirement in the IRS regulations, there is a federal small business tax credit that might offset some of the cost, if workforce size and average pay requirements are met.

Employees

First, look closely at the next tier of available plans. Our High Deductible plans, currently the choice of about 10% of members, offer the same broad provider network as our Standard plan, but make you responsible for much more of the smaller day-to-day expenses. Our HD plans are similar in structure to the “Silver” plans offered on the Exchanges. Our High Deductible plans cost about 20% less than the Standard PPO. If you feel you can manage significantly more out of pocket cost, our Bronze high deductible plan offers rates 40% below the Standard PPO.

Second, if you think you might qualify for subsidized care, explore the health plans available on your state’s insurance exchange. If the net cost to you for employee-only coverage in the least expensive plan your employer offers exceeds 9 ½ % of your family’s adjusted gross income, AND your family income is less than 400% of the Federal Poverty Level, you will get some amount of subsidy, which may make an Exchange plan a better financial option for you

IIf you decide to change plans, notify healthinsurance @ uua.orgby December 1. If you decide to enroll for the first time, follow the instructions on the UUA Health Plan website.

Thinking Beyond the Numbers

The UUA Health Plan is proud of our efforts to keep premium increases as low as possible since 2007. We also know that numbers do not tell the whole story. Our commitment to justice and equity in the management of the Plan – a value the Health Plan Trustees rank first among the principles guiding Plan management – is something we all can be proud of. We offer a transgender services benefit that has been revised for 2015 to eliminate any difference between those reimbursements and other services.  We have implemented the full range of women’s health services in the ACA, including access to free contraception, something many other denominations have not done, and that several high-profile lawsuits have challenged.  We led the way among large plans in offering full insurance access for same-sex couples. We offer full mental health benefit parity, and did that long before it became an ACA requirement.  We have a supplementary benefit providing up to $2,500 annually for children with learning disabilities. And in our Standard PPO we include one of the best hearing aid benefits in the country, and we have increased it by 50% in 2015.

For more information contact healthinsurance @ uua.org.

This work is made possible by the generosity of individual donors and congregations. Please consider making a donation today.

Last updated on Saturday, November 8, 2014.

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