Town hall meetings on 2012 health care plans scheduled

The meetings will include slide presentations and question-and-answer sessions with experts from Stanford Benefits. Open enrollment is Oct. 24-Nov. 15.

The Benefits Office is holding town hall meetings this week to discuss changes to employee health care plans in 2012, including the decision to replace Health Net and PacifiCare with the new Blue Shield Exclusive Provider Organization (EPO).

The town hall meetings, which will include slide presentations by Benefits staff, as well as question-and-answer sessions, will be held:

  • Wednesday, Sept. 14, 10-11 a.m., in the auditorium of the Clark Center, located at 318 Campus Drive West.
  • Thursday, Sept 15, noon-1 p.m., in the Oak West meeting room on the second floor of Tresidder Memorial Union, located at 459 Lagunita Drive.

The Benefits Office also has posted a narrated slide presentationMedical Plans for 2012 – on its website for employees.

In addition, the university has scheduled two WebEx Workshops for active employees: from 10-11 a.m. today and from 10:30 -11:30 a.m. on Tuesday, Sept. 20. To participate, go to the website; enter "Enrollment" in the search box; and click on the 2012 Open Enrollment meeting you want to attend. Your password is "Health."

The Benefits Office will hold three more Open Enrollment Town Hall meetings this month: in the San Francisquito Building on Porter Drive (Sept. 21); at SLAC National Accelerator Laboratory (Sept. 22); and at Hopkins Marine Station (Sept. 28).

Open enrollment is Oct. 24-Nov. 15.

At the first open enrollment town hall meeting, which was held in late August, Agnes Miller, a benefits analyst at Stanford, urged employees currently enrolled in Health Net and PacifiCare to "start thinking and planning" for 2012, since those plans will be replaced on Jan. 1 by the Blue Shield EPO.

Miller said the first step for those employees was to find out if their doctors are part of the Blue Shield PPO Network, by contacting their doctors; calling Blue Shield Member Services at (800) 873-3605; or searching Blue Shield's Provider Directory.

The second step was to find out if their prescriptions are included in Blue Shield's Drug Formulary, by calling Blue Shield or searching its drug formulary database.

Like those enrolled in an HMO, employees who participate in the new Blue Shield EPO must use doctors and facilities within Blue Shield's network.

Employees who enroll in the new Blue Shield EPO do not need to select a personal care physician; they have the freedom to go to any Blue Shield PPO Network doctor or specialist without a referral. However, employees who enroll in the new plan must contact Blue Shield to obtain preauthorization for non-emergency and elective procedures, such as MRIs, outpatient procedures and CT Scans.

"Don't assume your doctor will obtain the pre-authorization," Miller told the audience. "Make sure he or she does it. You have to pay a little more attention with an EPO than with an HMO."

Next year, Stanford will continue offering the Blue Shield PPO and Blue Shield High-Deductible PPO health care plans, as well as a Kaiser Permanente HMO.

Among the other topics that will be covered in the town hall meetings:

  • Blue Shield will provide an expanded care management program that will focus on more health issues and conditions and, when appropriate, will assign a trained nurse to provide extensive patient education and care.
  • Employees enrolled in the Blue Shield High-Deductible PPO will be able to open a Health Savings Account (HSA). Employees who open such accounts through Blue Shield's financial partner, Health Equity, will receive contributions from Stanford.
  • Flexible spending account claims administration will move to the Stanford Benefits Service Center.
  • Employees who complete the SHALA and Wellness Profile with the BeWell Employee Incentive Program by Nov. 30, 2011, will be eligible for discounts on their 2012 health care plan premiums.

The Benefits Office will be mailing the third (of four) newsletters about the upcoming health plan changes at the end of this week.

The third newsletter will provide more details about the new Blue Shield EPO; review the Blue Shield High Deductible plan and how it works; describe the process for opening a Stanford-sponsored Health Savings Account; and present more details about the new customized care management program that will be available to all Blue Shield plan participants.