Open Enrollment for the UUA Health Plan
Open Enrollment for the Unitarian Universalist Association (UUA) Heath Plan for all eligible staff takes place during the month of November. Eligible staff may join the plan effective January 1, even if they have not taken advantage of past enrollment opportunities.
Through December 3, 2018, eligible employees of UUA congregations and UUA-related employers may enroll in the UUA Health Plan and/or make changes to their existing health insurance coverage. For currently participating employees of Subscribing Employers or for Subscribing Individuals, there is nothing to do to continue coverage for 2019. The coverage for current participants will be carried over and billed at the 2019 rates. All Plan Participants are free to change plans (from High Deductible to Standard PPO, or to switch out of the Standard PPO to any of our High deductible plans) by notifying the UUA Health Plan office at healthinsurance [at] uua [dot] org.
2019 Highlights: UUA Health Plan
Bottom line – rates will stay the same for all plans!
For 2019, we are keeping our base rates the same – a zero increase for the second consecutive year. Members currently in the Plan will see a small age adjustment, around 2½%; a little lower for younger members; a little higher for older members. We have adjusted out-of-pocket amounts.
We will begin the transition to offering IVF coverage. For 2019 we are expanding coverage to include intrauterine insemination (IUI) and related procedures. Beginning January 1, 2020, we will begin covering IVF procedures for all members who have been in the Plan for a least a year as of Dec 31, 2019, and who those who reach the twelve month participation mark in 2020.
Naturopaths will be covered as primary care providers in all states where they are licensed to practice medicine.
Nurse Practitioners will be covered as primary care providers, rather than as specialists.
Eligibility: For our congregations and related organizations, Open Enrollment is an opportunity for all eligible staff to join the plan effective January 1, 2019, even if they have not taken advantage of past enrollment opportunities. Eligible individuals are employees (those receiving a W2, and not independent contractors) scheduled to work 750 hours or more per year.
Plan Background: The UUA Health Plan is a self-insured ERISA/Church plan, owned and managed by the UUA through the UUA Employee Benefits Trust. We contract with Highmark Blue Cross Blue Shield to provide enrollment and claims services, and access to the extensive network of Blue Cross Blue Shield providers in all fifty states and the District of Columbia.
Summaries of Benefits and Coverage: This is a requirement under the Affordable Care Act, first introduced in 2013. We have created a revised SBC for each of the four PPO plans we offer. The descriptions are designed to help employees understand their plan choices for 2019. Currently, 80% of all subscribers are in the Standard PPO plan. The SBC’s are posted on the UUA Health Plan website. A paper copy is available to anyone who requests it by emailing healthinsurance [at] uua [dot] org.
Two-Page Summaries: These are the same summaries found on the UUA website and included in the PPO coverage booklets. They are designed to be a helpful reference whenever a member needs to see their benefits at a glance. Because these two-page summaries are not restricted by the rules governing a Summary of Benefits and Coverage (SBC), they are more readable than the SBCs.
What's New For 2019?
Starting January 1, 2019, we will begin the transition to offering IVF coverage. For 2019 we are expanding coverage to include intrauterine insemination (IUI) and related procedures, including sperm acquisition from a sperm bank. In our Standard PPO plan, coverage will be 100%, with no deductible. In our high deductible plans, where 1st dollar coverage is not permitted as a matter of ACA regulations, the services will be covered after the deductible.
Beginning January 1, 2020, we will begin covering IVF procedures for all members who have been in the Plan for a least a year as of Dec 31, 2019, and those who reach the twelve-month participation mark in 2020. Our ability to phase in this coverage is a tribute to the members who have stayed with us and helped the Plan reach a point where our financial stability allows us to offer a benefit that matches our social justice ideals.
Naturopaths are licensed in many states to provide primary care coverage. We have worked with Highmark to clarify that licensed naturopaths will be covered as primary care doctors. Keep in mind that many naturopaths choose not to be part of a Blue Cross network, so their services could be covered as out-of-network.
Nurse practitioners will now be covered as primary care providers – their true function in most medical practices – rather than being covered as specialists. This change should help a lot of people who regularly see a nurse practitioner for their primary care.
Deductible and Out-of-Pocket Limit Changes
We have made modest increases to the deductible and the out-of-pocket caps in our Standard PPO and Bronze plans. The deductible changes have been kept as low as possible, while keeping our plans within ACA guidelines for relative benefit richness. Please review the two-page benefit grids at the bottom of this page for details.
STABILITY – STILL THE MOST IMPORTANT REASON TO STAY WITH US
We know that health insurance will always be big piece of your personal financial planning. For 2019 we are holding the line on the rates in all of our health plans. The Health Plan Trustees voted to keep the base rates unchanged for 2019, while allowing for small age-related increases, an average of about 2 ½%. Over the last two years, the Plan has been able to decrease cost by a cumulative 1.2%, made possible by both member loyalty to the Plan and our careful management of Plan resources.
THINGS YOU NEED TO DO NOW - Congregations:
- Review all of the plans, from the “Gold” level Standard PPO, to the “Silver” level high-deductible plans that we have offered from Plan inception, to the “Bronze” level high-deductible plan that we first offered in 2014. In conversation with your staff, decide how you want to provide health insurance next year.
- Take a careful look at how you fund health insurance for your staff and how that translates into affordability for your employees. UUA Fair Compensation guidelines continue to recommend that congregations contribute 80% of the cost of individual coverage and 50% of the incremental cost of family coverage. Consider how your congregation will structure contributions and whether it would make sense to base contributions on a “Silver” plan. At the same time, consider what effect that could have on your existing staff and what effect it might have on recruiting future staff.
- If your congregation participates in the UUA Health Plan, review your personnel files, and make sure you have a record of a health plan election or rejection for every eligible employee (everyone projected to work at least 750 hours.)
- Tell your employees to carefully review the 2019 UUA Health Plans, and decide whether to keep their current plan, change plans, or enroll for the first time. If they think that their family income may qualify them for a subsidized plan through the Affordable Care Act (either state-sponsored or the Federal Exchange on www.healthcare.gov), they should follow-up on the Exchange website.
THINGS YOU NEED TO DO NOW - Employees
- Review all of the plans, from the “Gold” level Standard PPO, to the “Silver” level high-deductible plans that we have offered from Plan inception, to the “Bronze” level high-deductible plan that we first offered in 2014.
- Remember that you also have the option to add dependents who were not previously covered.
- If you decide to change plans, notify www.healthinsurance [at] uua [dot] org (healthinsurance [at] uua [dot] org) by December 3. To enroll for the first time, use the online application below:
- Enrollment Application
- Dependent Enrollment Application
- Rate Calculator
- 2019 Standard PPO Benefits Grid (pdf)
- 2019 HDHP with HSA Benefits Grid (pdf)
- 2019 HDHP without HSA Benefits Grid (pdf)
- 2019 HDHP with HSA BRONZE Benefits Grid (pdf)