2006 OPEN ENROLLMENT
APRIL 24 – MAY 12

Click on the button above to enroll or change plans or to make changes to information about your dependents.

The information provided on this page will enable you to increase your awareness and knowledge regarding key open enrollment information and benefit updates. Please click on the topic below to be directed to that section.

• Benefits Updates
• Comparison Chart
• Dependent Eligibility Verification
• Formulary Comparisons
• Health Plan Contact Information
• Open Enrollment Fair Schedule
• Pathways
• Premium Rates

BENEFITS UPDATES

The following updates are effective July 1, 2006. Review the 2006-2007 Comparison Chart & Guide to see employee benefits and health plan information.

Drug

• Ohio Med: Two prescription fills (1 original + 1 refill) will be allowed before required use of mail-order plan for maintenance prescriptions.
• Pneumococcal for high-risk individuals, meningococcal and rubella vaccines have been added to coverage (all plans).

Medical

• Employees enrolled in Ohio Med, Aetna and UnitedHealthcare will receive a rate holiday during the fall 2006. No health care payroll deductions will occur during October for November coverage. The rate holiday is a result of health care resource conservation among the self-insured plans (i.e. utilization of generic drugs, using network
  providers and urgent care other than the emergency room, etc.).
• Premiums will decrease by 20 cents for employees enrolled in Aetna or Ohio Med. UnitedHealthcare plan rates will be decreased by $8.88 (single plan) and $30.47 (family plan).
• Durable medical equipment, skilled nursing home and home health care benefits will be paid at 80% (all plans).
• Preventive care services will be paid at 100%. Copays may apply to some benefits (all plans).
• Hearing aids for natural hearing loss will be covered at 50% up to a $1,000 maximum. Some plans have additional coverage.
• Aetna: No longer uses a gatekeeper model. Employees will be able to see a specialist without referral from their primary care physician.
• Aetna: New long term care insurance plan will be introduced.
• Ohio Med: Non-network deductible will increase to $400 (single); $800 (family).

Mental Health & Substance Abuse

• Copay will increase to $15 to be in alignment with the health plan office copay.

Vision

• Routine exam, frame and lens frequency will increase to 1 every 12 months.
• Frames will be paid at 100% up to $120 retail (VSP and Cole In-Network).
• Click here for more information.

Dental

• Fluoride will be covered at 100% up to age 19 and for individuals aged 55 and older.
• Sealants will be covered at 100% up to age 19.
• Periodontic cleanings will be covered 4 times per year.
• Orthodontia maximum will increase to $1,500.
• Click here for more information.

COMPARISON CHART

The 2006-2007 Comparison Chart & Guide is a helpful tool for selecting the best health plan for you and your family. Included is information on open enrollment, health plans, co-payments, deductibles, etc.

DEPENDENT ELIGIBILITY VERIFICATION

This year the state is requesting all state employees to re-enroll, enroll or decline coverage by positively confirming their personal and coverage information as well as verifying the eligibility of their dependents. The open enrollment period has been extended to three weeks to increase the opportunity for employees to verify their dependents’ eligibility. It will take approximately 5-10 minutes to complete the open enrollment process.

All employees will be subject to random eligibility audits during this benefit year. Those individuals who do not complete the open enrollment process will have an increased probability of being audited. In the event of an audit, employees will need to show proof of eligibility. Click to read the Pathways article “Are Your Dependents Eligible?” or the dependent eligibility information in the Employee Benefits Handbook (purple book).

FORMULARY COMPARISONS

Each health plan has a formulary, which is a preferred drug list from which your physician may prescribe. When possible, discuss with your physician about having medications prescribed that are included in the formulary – this will ensure that you pay the lowest possible cost. The formulary applies to both retail and mail-order prescriptions. Click below on the specific health plan for their formulary.

• Ohio Med: Search by drug name or treatment category.
• Aetna: Select Prescription Drug Program, follow instructions.
• UnitedHealthcare: Select Prescription Drug List, 2006 Drug List
• Paramount: Select Member Services, Prescription Drug Program, Preferred Drugs, 2006 Preferred Drug List
• QualChoice: Select Searchable Drug Formulary
• The Health Plan: Search by drug name or treatment category.

HEALTH PLAN CONTACT INFORMATION

Contact information for the six health plans can be found in the 2006-2007 Comparison Chart & Guide and through this information page. Click below to be directed to your health plan’s web page.

• Ohio Med
• Aetna
• UnitedHealthcare
• Paramount
• QualChoice
• The Health Plan

OPEN ENROLLMENT FAIRS

Click for the 2006 Open Enrollment Fair Schedule.

PATHWAYS

There are two open enrollment editions of the Pathways newsletter – April 14 and April 28. Both editions have key open enrollment information, benefits updates, prescription drug information, student status verification, etc.

PREMIUM RATES

See the Comparison Chart & Guide for the 2006-2007 premium rates for the six health plans.