July 7, 2000
Volume XXXIII, No. 27

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Benefits specialist answers questions about health coverage

Many questions have surfaced as a result of the announced changes in health and dental insurance for the coming year. We asked Human Resources Benefits Specialist Georgina Anguiano Elliott to address some of them. Remember, Open Enrollment ends July 31, so now is the time to make changes to your coverage.

Q: UT Select is my health insurance company, and my spouse and three children are also on the plan. With the increase in rates this year, what can I do to keep my costs down?

A: Consider switching to the Prudential HMO. The out-of-pocket costs are much lower, especially if you're insuring your whole family. Unlike a traditional indemnity plan, an HMO does not require you to pay a deductible before benefits kick in, and it covers routine checkups, not just medically necessary treatment.

If you go with an HMO, however, you do have to choose a primary care physician from a list of participating doctors. That physician is in charge of all your care, including tests and prescriptions, and must refer you to a specialist if you need to see one. Each member of your family can have his or her own primary care physician, and women are permitted to have OB/GYN physicians in addition to their primary doctors.

One caution is in order: Prudential will cover you and your dependents only if you live within the company's service area. For Health Science Center employees who live in the Rio Grande Valley or Laredo, for example, Prudential is not an option.

For more details on how to save money with an HMO, you can visit with a Prudential representative at the Benefits Fair July 11 and 12 and review the company's literature.

Q: If I decide to switch my coverage to Prudential, will I need to fill out an evidence of insurability form?

A: No. Prudential does not require evidence of insurability (EOI). If you want to add a child or your spouse, you will need to fill out the dependent information form and enroll the dependent through the UT Touch system, using either a touch-tone telephone or a personal computer. The UT Touch phone number is 1-800-888-6824 and the Internet address is http://www.utsystem.edu/egi/touc9920.cfm.

Q: What if I want to increase my life insurance?

A: To make a change in your life insurance, you need to fill out the EOI form. For example, if you want to increase your level of coverage from two times your annual earnings to three times or if you want to add a dependent, you must request an EOI application from Human Resources' benefits section (ext. 7-0123) and return it no later than July 14.

Q: I know that Delta Prevent will no longer be offered. Will my coverage automatically be switched to Delta Standard?

A: No. This is a very important issue for employees to understand. If you are currently signed up with Delta Prevent, you must sign up for Delta Standard or United Dental Care of Texas or you won't have dental coverage. You can make the change to either of those plans through the UT Touch system. You will need to enter your personal identification number, which will be mailed to your home.

Q: What if I decide not to sign up for dental insurance this year? Will I have a chance again next year?

A: Yes, you will be able to sign up next year, but please note an important difference between our dental plans. You are free to enroll in and drop out of United Dental Care of Texas without penalty. The Delta Dental Plan has a different policy. If you elect not to take a UT dental plan this year and decide to enroll in Delta Standard in the future, your benefits will be reduced for the first two years that you are covered. But you remain eligible for full benefits in Delta Standard as long as you retain coverage in one of the UT dental plans. Ask for more information at the Benefits Fair.

Q: I'm thinking of signing up for UT Flex for the first time. Can you explain how that works?

A: UT Flex enables employees to open accounts for health care reimbursement and dependent care reimbursement. Determine the amount you want deducted from each paycheck, and enroll through UT Touch during the Open Enrollment period. Submit claim forms and receipts as expenses occur. Dollars placed into the accounts are pre-tax dollars, saving you money.

The health care account will reimburse you for many out-of-pocket expenses such as laboratory fees and prescription drug co-payments. (IRS Publication 502 describes reimbursable expenses.) The account does not reimburse premiums you pay for medical, dental or vision plans.

The dependent care account will reimburse you for the cost of day care. Expenses must be employment-related, and a "Qualified Dependent Care Provider" must provide the care.

At the time of enrollment, you may set aside a minimum of $15 a month and a maximum of $416. That money will be deposited into one or both of your reimbursement accounts. If you wish, you may contribute the maximum to both the health care and dependent care accounts, depending on your marital status and tax situation. However, you must use the money before year-end or you will forfeit it.

The Salary Conversion Agreement, which authorizes the Health Science Center to redirect part of your salary to UT Flex accounts, expires at the end of each plan year. A new agreement must be entered on UT Touch annually during Open Enrollment.

UT Flex will not be represented at the Benefits Fair, so if you have questions about this option, call the benefits section. As with other employee benefits, you can join UT Flex through the UT Touch system.