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Health plan changes mean more flexibility for employees and families

Open Enrollment runs from Nov. 1 through Nov. 12
MIT Human Resources today announced changes to the Institute’s health insurance offerings for employees, effective Jan. 1, 2011 — changes that will make it easier for all employees to choose the convenience of having a primary care provider (PCP) at MIT Medical, even if covered family members choose to stay with outside doctors and pediatricians.

For 2011, employees will be able to choose between two health-plan options: the MIT Traditional Health Plan and the new MIT Choice Health Plan. During Open Enrollment, employees and covered family members in both plans will be required to confirm their current PCPs or select new PCPs:

With the MIT Traditional Health Plan, PCPs for the employee and all enrolled family members must be at MIT Medical.

With MIT Choice, each family member can choose a PCP from the extensive Blue Cross Blue Shield of New England network, which includes PCPs at MIT Medical. So, for example, if you work at MIT or Lincoln Laboratory, you can get your primary care at MIT Medical while your children stay with their pediatrician closer to home and your spouse selects a PCP near his or her workplace.

“It’s the best of both worlds for MIT employees and their families, especially those who don’t live close to campus or Lincoln Laboratory,” said William M. Kettyle, M.D., medical director at MIT Medical. “People who work here can get great care at MIT Medical, and family members can have the convenience of keeping providers close to where they live or work.”

Most clinical visits at MIT Medical will require a $10 copay — as opposed to $20 copays for visits with PCPs outside MIT — but individuals with MIT Medical PCPs will enjoy lower copays for all medical visits, even when referred to an outside specialist. Copays will remain at $10 no matter where the visit takes place.

A 'no-risk trial' of MIT Medical

Although employees need to confirm the selection of a PCP during Open Enrollment, changes can be made at any time during the year. That means employees on the MIT Choice plan can switch to a PCP at MIT Medical at any time during the year — or switch from MIT Medical to an outside provider if they wish. “We often hear people say they’d love to have a ‘no-risk trial’ of MIT Medical,” Kettyle notes. “Now you can have exactly that.”

Choosing a PCP

During Open Enrollment (Nov. 1–12, 2010), employees should review the Open Enrollment checklist from HR, then go to the Employee Self-Service website to choose either the MIT Traditional or MIT Choice health plan. If you enroll in MIT Choice, you can select a PCP at MIT Medical for one family member and different PCPs (at MIT Medical or elsewhere) for other family members.

After Jan. 1, 2011, employees enrolled in one of MIT’s health plans can switch PCPs for themselves or other family members by using the Blue Cross website.

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