Open enrollment for benefits changes begins


Open enrollment for changes effective January 1, 1997, will be held from Tuesday, Oct. 29 through Sunday, Nov. 17. Personal Enrollment Guides that explain how to make changes are being distributed this week to eligible individuals.

During open enrollment, eligible employees may enroll in or change their health plan; change to individual or family, or cancel health or dental coverage; enroll in FRAP; or increase the level of life insurance coverage without evidence of insurability.

HEALTH RATES FOR 1997

The health plan rates for 1997 are shown below. Employees and MIT share in the cost of this coverage by each paying half of the weighted average increase or decrease in the cost of the plans.

There have been several changes to MIT's health coverages for 1997 and many of the plans have expanded their physician networks and enrollment areas. The most significant changes are the combining of Bay State Health Care and Blue Cross Option 2 into the Blue Choice plan and the expansion of Harvard Community Health Plan to Harvard Pilgrim Health Care.

The further expansion of Tufts, Blue Choice and Harvard Pilgrim offers broader choices to employees living in western Massachusetts, Rhode Island, Maine and New Hampshire. This growth also benefits employees living in eastern Massachusetts, since many physicians now participate with more than one physician network.

BLUE CROSS II/BAY STATE CHANGES

Blue Cross has decided not to offer Bay State Health Care for 1997. After discussions with Blue Cross, MIT has decided to combine Bay State and Blue Cross Option II to form the Blue Cross product called Blue Choice Plan 2 (Plan 2 indicates a self-insured plan). Current Option II and Bay State members will automatically be enrolled in Blue Choice during open enrollment unless they elect to enroll in another of MIT's health plans.

The Blue Choice offering combines the best of both plans. Former members of Option II will get a significant reduction in rates and an opportunity to participate in a managed care product as well as maintaining the freedom of choice they currently enjoy. Former members of Bay State will be able to use their same primary care physicians through the Blue Choice Plan.

In Blue Choice, members may visit their physician (in-network) and pay a $5 copayment or they may choose to go outside the network to seek medical care. Those who seek care outside the network will pay a deductible and a portion of the covered expenses. In addition, the plan covers dependents until age 25 without regard to their student status.

For more information about Blue Choice primary care physicians, consult the Benefits Office Web site at . To request a complete physician directory in print and a Blue Choice brochure, send e-mail to the Benefits Office at .

HARVARD NETWORK

Beginning in January, MIT will offer a new integrated HMO product made possible by the recent merger of Harvard Community Health Plan (HCHP) and Pilgrim Health Care. The new Harvard Pilgrim Health Care plan will include all the current HCHP health centers in addition to all the independent physician and multispeciality group practices that are currently part of the Pilgrim Health Care plan. The enrollment area for the expanded network now extends well into western Massachusetts and Rhode Island. Southern New Hampshire and portions of Connecticut, New York and Vermont are also included. For more information, contact the plan directly at (888) 333-4742.

Other Harvard Pilgrim announcements for 1997 include:

  • Emergency room copayment will be $30 (currently it is $25). This copayment is waived if the patient is admitted to the hospital.
  • The prescription drug benefit will be $5 copayment for Formulary (medications commonly prescribed for certain medical conditions), $10 copayment for non-formulary prescriptions at any HPHC designated pharmacy. Currently the benefit is $5 per prescription.
  • There are new fitness options including YMCA, Fitness Network and some alternative fitness choices.
  • There is a new eyewear discount program of 20-40 percent depending on the provider and service selected.

TUFTS PLAN

The Tufts Associated Health Plan (TAHP) has expanded to include most of Massachusetts including the Cape and Nantucket, a significant portion of both New Hampshire and Maine, and parts of Vermont and Connecticut. If you have questions, call the plan directly at 466-1000.

COVERAGE FOR DEPENDENTS

All of MIT's health plans, except for Central Massachusetts Health Care (CMHC), now offer coverage for dependent children until age 25 regardless of student status. CMHC provides coverage to full-time students beyond age 19 to age 26.

BENEFIT MEETINGS AND FAIRS

The Benefits Office will sponsor Information Sessions, Benefit Fairs and Information Tables to assist members of the community in making decisions about their benefit choices. Representatives from the health, dental and life insurance plans as well as members of the Benefits Office staff will be available to help answer questions at these events. Representatives from the Benefits Office will also be on hand at Information Sessions and Tables.

Sessions on Blue Choice/HPHC will be held at the following times:

  • Wednesday, Oct. 30-Harvard Pilgrim Health Care, 12:15-1:15pm, Student Center Rm 407
  • Wednesday, Oct. 30-Blue Choice, 3-4 pm, Student Center Rm 407.
  • Thursday, Oct. 31-Blue Choice, 12:30-1:30pm and 3-4pm, Lincoln Lab South Auditorium
  • Wednesday, Nov. 13-Blue Choice, 12:15-1:15pm, Killian Hall (Building 14W)
  • Wednesday, Nov. 13-Harvard Pilgrim Health Care, 1:30-2:30pm, Killian Hall

There will be four Benefit Fairs on:

  • Monday, Nov. 4-10am-3 pm, Bush Room (10-105)
  • Wednesday, Nov. 6-10am-4 pm, Lincoln Lab East Atrium
  • Thursday, Nov. 7-10-11am, Haystack Observatory Conference Room A
  • Thursday, Nov. 7-2-3pm, Bates Linear Accelerator Cafeteria

Information Tables will be set up on:

  • Friday, Nov. 1-10am-noon, Lobby 10
  • Tuesday, Nov. 5-1:30-3:30pm, Building E25 atrium
  • Tuesday, Nov. 12-noon-2 pm, Lobby 10
  • Thursday, Nov. 14-noon-2 pm, Building E25 atrium

FRAP

The Flexible Reimbursement Account Plan (FRAP) is comprised of two spending accounts; eligible employees may enroll in either or both. These accounts offer a way to set aside before-tax dollars to pay for medical expenses not covered by health and dental plans and for the care of a dependent family member. The medical/dental account offers a yearly maximum of $3,000, while the dependent care account offers a yearly maximum of $5,000. Remember that the dependent care account maximum is $5,000 per household and that employees must re-enroll in the FRAP program each year.

LIFE INSURANCE

MIT offers fully paid basic life insurance in the amount of $50,000 for full-time employees as well as employee-paid supplemental life coverage. Supplemental coverage is available in multiples of an employee's annual salary up to five times his or her annual pay.

Open enrollment is the time to increase your supplemental life insurance coverage without evidence of good health. Employees may increase coverage by one multiple of pay as long as that amount does not exceed three times the annual salary or $200,000, whichever is the greater. Increases larger than this, as well as amounts of coverage applied for outside of open enrollment, will be subject to medical evidence of insurability.

DENTAL INSURANCE

The eligibility for dental coverage has been revised. Employees must have a minimum one-year appointment in order to be eligible to enroll in the Delta Dental Plan. This revision was effective on January 1, 1996 and replaced the previous requirement of at least a three-month appointment. The eligibility criteria were changed to protect long-term employees whose premiums are adversely affected by the claims experience of short-term employees who terminate employment after less than a year.

Anyone with questions about open enrollment or benefits may contact the Benefits Office at x3-0500, Rm E19-411, . At Lincoln Lab, the location is Rm A-125, x7060. To order plan brochures, call BenTalk at x3-5000.

Further information on open enrollment, links to health plan Web pages (including access to physician listings) and other benefits news can be found on the Web at .

Health Plan Rates As Of January 1, 1997

Level of Faculty/Staff Support/Service
Plan Coverage Monthly Rate Weekly Rate

Blue Choice Individual $109.65 $23.07
Family $277.30 $58.25

Blue Cross/ Individual $152.22 $32.90
Blue Shield Family $390.92 $84.47
Option 2
(out-of-state)

Traditional Individual $36.82 $6.27
MIT Health Plan Family $134.47 $25.58

Flexible Individual $131.82 $28.19
MIT Health Plan Family $350.47 $75.13

Harvard Pilgrim Individual $35.71 $6.01
Health Care Family $135.59 $25.55

Tufts Assoc. Individual $48.19 $8.89
Health Plan Family $166.28 $32.63

Central Mass. Individual $34.08 $5.64
Health Care Family $110.56 $19.77

A version of this article appeared in MIT Tech Talk on October 30, 1996.


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