All UAB plans cover preventive care at 100 percent, with no deductible for physicals, immunizations, routine screenings and preventive generic prescriptions.Eligible employees of UAB, UAB Hospital, and UAB Hospital Management LLC will have the option to choose or decline health care coverage during the annual open enrollment Oct. 27-Nov. 13. In addition to a new consumer-driven health plan, the traditional health plans from Viva Health and Blue Cross/Blue Shield will be continue to be available for 2018.
Those already familiar with UAB’s existing traditional health plans will note there are no plan design changes for 2018. Nonetheless, you must participate in open enrollment if you want to secure or retain medical insurance through UAB.
Changes are being implemented that raise premium costs for employees whose spouses are covered under a UAB plan, as was announced this past year, but a new bridge rate will temper the impact of increases for those affected. Additionally, some affected employees may be eligible for premium assistance, a new benefit that will be explained in greater detail next week when premium rates for all plans are released.
Traditional plan choices for 2018
Traditional plans are characterized by lower out-of-pocket costs — copays and deductibles — for covered services when compared to the consumer-driven health care plan and do not include a high annual deductible that must be met before insurance begins paying.
Viva Health offers two traditional plans for employees: Viva UAB and Viva Access.
Viva UAB offers the least expensive traditional plan premium for employees. The negotiated rates are for using providers within the UAB health care network. The maximum out-of-pocket expenses for medical and pharmacy services is $5,000 for single coverage and $10,000 for family coverage.
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Viva Access enables subscribers to go outside the UAB network to other participating providers as needed or desired with slightly higher co-pays for out-of-network services, including hospitalization. Out-of-pocket expenses are lower when using providers in the UAB network. The maximum out-of-pocket expenses for medical and pharmacy services is $6,600 for single coverage and $13,200 for family coverage.
Both Viva plans plan provide coverage for one annual eye exam and a student and sabbatical rider for out-of-network services up to $1,500 per year.
Blue Cross/ Blue Shield has an established nationwide preferred provider organization (PPO) network that offers more latitude in selecting physicians and facilities. This plan does require a higher co-payment for services compared to the other traditional plan options. The maximum out-of-pocket expenses for medical and pharmacy services is $6,600 for single coverage and $13,200 for family coverage.
All plans cover preventive care at 100 percent and premiums are tax-sheltered. A chart outlining the plan details and networks is available in the UAB for Me portal.
Tier changes for 2018
As the cost of providing health care rises, UAB makes adjustments to balance the impact of these costs on its employees and the institution.
Other than single and family coverage, UAB plans historically have offered an additional tier — employee plus up to 2 — which could accommodate two children or a spouse and one child for the same premium rate. But the difference in costs between claims for children and adults has made that tier financially unbalanced when compared to the other tiers.
“In 2015, the UAB Benefits Committee established a three-year plan to implement changes that would reverse the historical deficit by the end of 2018 and ensure UAB can continue offering a fiscally sound and competitive benefits program for all employees with a continued focus on plan choice,” said Chief Human Resources Officer Alesia Jones. “Those changes have reversed a downward spiral, but the tier structure related to spousal coverage needed to be adjusted.”
The 2016 UAB Benefits Committee approved changing existing tier level offerings beginning January 1, 2018, to reflect those costs, and the change was announced this past year. In the proposed restructuring, the employee plus up to 2 tier would become employee plus children, regardless of the number of children covered, and spousal coverage would only be provided under the family tier.
Jones said the 2017 Benefits Committee, which reviewed the impact of this change during its deliberations, discovered approximately 24 percent of currently covered employees — nearly 3,200 — would pay more due to moving a spouse to the family tier.
“The committee was concerned about the sudden additional cost to employees, in some cases as much as $200 more per month, and suggested a stop-gap measure — a temporary tier — to ease the transition to the family tier,” Jones said.
So, in 2018, employees will choose coverage from among four cost-adjusted tiers
- Single
- Employee plus children (no limit on number of children)
- Employee plus spouse, or employee plus spouse plus one child (a temporary, transitional tier)
- Family
“This option will provide a tier that falls between employee plus children and family in pricing while more appropriately pricing premiums for covered spouses. Over time, this tier would be phased out as pricing meets family tier.”
