Health-care plan options changing, along with new benefits and rules, for 2007
BY MICHAEL PEÑA
Only@Stanford, 3-Choice Health Plan and Lumenos will be discontinued as medical plan choices this year, and two Blue Shield preferred-provider plans will be offered as new health-care options for the 2007 calendar year. The change was prompted largely by feedback from staff surveyed by the Benefits Department, according to Leslie Schlaegel, director of benefits.
"We surveyed employees last year and the response was clear," Schlaegel said. "Employees want medical plans that are easier to understand and use, so these changes for 2007 move us toward that goal."
The two new medical plans are the Blue Shield PPO Plan and the Blue Shield High Deductible PPO Plan. Open Enrollment will take place Oct. 26 to Nov. 15, and Blue Shield and Lumenos participants will receive letters before then urging them to log on to the BenefitSU website and make new medical coverage choices during Open Enrollment. If they don't, their coverage will default to the Blue Shield PPO Plan for 2007.
The Blue Shield PPO Plan will allow members to see any doctor they choose, but they can reduce their out-of-pocket costs if their doctor is in the Blue Shield network. The plan provides comprehensive medical coverage and features simple co-payments when seeing a doctor or filling a prescription, plus deductibles and co-insurance for other services.
The Blue Shield High Deductible PPO will work just like the Blue Shield PPO, but the amount that a member pays out of pocket before the plan starts paying benefits will be higher. Members will be able to set up a health savings account (HSA) that will allow them to pay deductibles and other medical expenses with pre-tax dollars. The university has opted for this plan to give employees the option of putting aside money on a tax-favored basis for the payment of medical needs now and when they retire.
An HSA is funded by the participant with pre-tax dollars and used to pay medical expenses, just like a healthcare flexible spending account (FSA). But the HSA has certain key features that make it different: There's no "use it or lose it" rule with an HSA, which means unused funds at the end of each calendar year roll over to the next year, allowing the participant to continue to accumulate pre-tax dollars for medical expenses.
Also, an HSA belongs to the person who opens and uses it, so there is no risk of forfeiting the funds if the account holder's employment status changes or ends. Depending on the financial institution the participant chooses, he or she may have options for how to invest the funds and access them when needed.
Members in the High Deductible PPO plan may set up a personal HSA account with a financial services company of their choice. These types of accounts have some restrictions, and more information about HSAs is available at the Department of the Treasury website at http://www.treasury.gov/offices/public-affairs/hsa/.
To set up an HSA, the participant will have to go to a financial firm that offers this type of account. Additional information will be available in the Open Enrollment packages to be sent out in mid-October and at the Benefits Fairs, which will take place the week of Nov. 7 at Tresidder Union, Fairchild Auditorium and Stanford Linear Accelerator Center.
Both of the new Blue Shield plans will continue to allow open access to the national network of Blue Shield doctors, hospitals and other health-care facilities. The network includes Stanford Hospital and Clinics, Menlo Medical Clinic, Palo Alto Medical Foundation and Lucile Packard Children's Hospital.
Also new for the coming calendar year will be the inclusion of prescription-drug benefits in the medical plans. For the past several years, prescriptions were administered by Express Scripts, a separate pharmacy vendor. The decision to place prescription drug benefits back into the medical plans was made to allow doctors and the plans to better manage their members' overall health care, Schlaegel said.
In addition, the Benefits Department is introducing the Medical Contribution Assistance Program, also beginning in 2007. The university-sponsored program will provide an additional subsidy in 2007 toward the cost of medical coverage for employees who work 75 to 100 percent time and whose family income is $60,000 or below.
"The Medical Contribution Assistance Program, or MCAP, is designed to address the impact of rising health-care costs on families who earn less," Schlaegel said. For those who think they may qualify, complete details and an application form can be obtained online at http://benefitsu.stanford.edu/ under "BenefitSU News" or in the Benefits Department offices at 655 Serra St. and at the Stanford Linear Accelerator Center. Applications must be submitted by Oct. 6.
Finally, the university will require domestic partners to register with the California Secretary of State's office in order to continue receiving benefits in 2007. This change is the result of the university's interpretation and application of California statutes associated with domestic partnerships and the California tax treatment of domestic partner benefits provided under the university's plans.
The university allows employees to enroll their same-sex domestic partner and any eligible dependents in the benefit plans. With a change in California law, opposite-sex domestic partners also will be allowed to enroll for benefits as long as one of the partners is at least age 62 and eligible for Social Security benefits.
Only those partnerships registered with the state of California will be recognized by the university. Registrations in other states or local government entities will not be eligible. However, those living outside the state may register in California. Those affected—approximately 100 faculty and staff—will receive a letter of explanation this week.
For more information, instructions and a Declaration of Domestic Partnership form, go to http://www.ss.ca.gov/dpregistry/. Forms also will be available at http://benefitsu.stanford.edu/, under "BenefitSU News," or in one of the benefits offices.