Division Memo to Agencies
STATE OF CONNECTICUT
HEALTHCARE POLICY & BENEFIT SERVICES DIVISION
OFFICE OF THE STATE COMPTROLLER
Healthcare Policy & Benefit Services Division
Division Memorandum 2014-07
TO THE HEADS OF ALL STATE AGENCIES
|ATTENTION:||Personnel and Payroll Officers, Chief Administrative and Fiscal Officers, Business Managers|
|SUBJECT:||2014 Health Insurance Open Enrollment|
The state employee annual open enrollment period for health insurance will be held from May 12, 2014 through June 6, 2014, for coverage effective July 1, 2014. This memorandum discusses enrollment procedures and how employees can access information about available health plan choices and premiums.
During open enrollment, employees may change medical and/or dental plans, add or drop coverage for eligible family members, or enroll in coverage if they previously waived it. This is the only time employees may enroll in or change a health plan, unless the employee experiences a qualifying event, such as marriage, divorce, civil union, birth, adoption, legal guardianship or loss of other health insurance coverage by an eligible dependent. The employee is responsible for contacting their agency personnel/payroll representative to file the appropriate forms within 31 days of the event that necessitates a change in enrollment or plan.
A. Plan Offerings and Changes
1. Medical Plans and Benefits – Full details of plan choices and premium shares are available in the 2014-15 Active Employee Health Care Options Planner posted on the Comptroller’s website.
2. Dental Plans and Benefits – Effective July 1, 2014, Cigna will be the sole carrier for all State of Connecticut dental plans: Basic, Enhanced, and Dental HMO (DHMO). Dental benefits offered under the Basic and Enhanced plans will not change, except for some improvements and modernizations. Members in the Basic plan may continue to see any dentist and will not be subject to balance billing. Enhanced plan members will now have access to the Cigna Dental PPO Network. A list of network providers can be viewed at www.cigna.com/stateofct. There are no changes to the DHMO plan.
Employees will have the option to choose the Basic, Enhanced or DHMO Plan during Open Enrollment. If an employee does not wish to make a change during open enrollment, their existing dental plan will automatically default in Core-CT to the corresponding Cigna plan.
Members enrolled in the Basic and Enhanced plan, as well as new members in the DHMO plan will receive new Cigna Dental ID cards by 7/1/2014. The employee premium shares for dental are shown in the 2014-15 Active Employee Health Care Options Planner posted on the Comptroller’s website.
3. Pharmacy Plans and Benefits – Employees are required to use the State of Connecticut Maintenance Drug Network to fill prescriptions for maintenance medications (90-day supply). The first prescription for any medication (30-day supply) can be filled at any participating retail pharmacy. After that, refills for maintenance medications must be filled through a pharmacy participating in the State of Connecticut Maintenance Drug Network. These directories are maintained on the Comptroller’s website at www.osc.ct.gov by individual state.
B. Open Enrollment Fairs – Open Enrollment fairs will be held at various locations across the State from May 12, 2014 through June 6, 2014. The State of Connecticut’s health, dental and pharmacy vendors will be available to answer questions and provide information about the benefit plans. Care Management Solutions, our Health Enhancement Program (HEP) administrator, will be attending each fair to answer HEP questions, provide information on 2014 HEP requirements, and to assist members with chronic disease education and counseling requirements.
Cholesterol Screenings – We are pleased to announce that cholesterol screenings will be available this year at many open enrollment fairs. Members can take advantage of the cholesterol screening at the open enrollment fairs to automatically get credit for completing their HEP cholesterol screening requirement (if applicable). The HEP nurse team will review test results and reach out to members whose results are outside the normal range. Refer to the 2014-15 Open Enrollment Fair schedule to see which locations will offer cholesterol screenings.
Representatives from ING, Progressive Benefit Solutions, and Trans America will also be in attendance to provide information and answer questions about the programs they administer for the State.
C. Health Care Options Planner
The 2014-15 Active Employee Health Care Options Planner is available on the Comptroller’s website:
The Planner contains important information including benefit summaries, applicable employee premium shares, and offers certain general guidelines to assist employees in making their choices. In addition, there is information about the Health Enhancement Program (HEP). Contact information for each carrier, including the State’s HEP administrator, Care Management Solutions, is included.
D. Enrollment Statements
Enrollment statements will not be included in the Planner or in any marketing material sent to employees; nor will carriers have enrollment statements available at the open enrollment fairs. Enrollment Statements must be system generated by Core-CT. Employees electing or changing coverage may do so only through their agency Payroll/Human Resources office.
E. Health Enhancement Program and New Enrollment
Participation in the Health Enhancement Program (HEP) provides incentives (i.e. reduced premiums and co-pays, waived deductibles, etc.) for employees and dependents that have completed age-based health screenings and exams. HEP guidelines are described in detail in the 2011 SEBAC Agreement.
Care Management Solutions, the state’s Health Enhancement Program (HEP) administrator, is available to employees and family members regardless of which carrier they have selected for medical and/or dental insurance.
A key feature of HEP is an online portal at www.CTHEP.com. This portal allows participants to easily and securely access information throughout the year. The portal contains an outline of 2014 HEP requirements. In addition, employees may communicate with HEP nurses and representatives through the portal’s online message center. Members accessing the HEP portal for the first time need to complete a short registration process.
Employees who are not currently enrolled in HEP may elect to join during open enrollment by completing a Health Enhancement Program Enrollment Form (CO-1314). The form is available on the Comptroller’s website www.osc.ct.gov. Employees can submit completed forms to their agency Payroll/Human Resources office. Forms must then be forwarded to the Healthcare Analysis Unit of the Office of the State Comptroller. All new HEP enrollments must be completed by June 6, 2014.
The 2014-2015 Health Care Options Planner provides full details of plan choices and premium shares, and is available online at www.osc.ct.gov. Monthly rates for COBRA continuation coverage will be transmitted to agencies through subsequent communications. Personnel or payroll staff members who have questions concerning the Open Enrollment process should contact the Comptroller’s Healthcare Policy & Benefit Services Division at (860) 702-3535.
Very truly yours,
Thomas Woodruff, Ph.D.