BULLETIN 2005 - 07
TO ALL BENEFIT CONTACTS
Via Fax

Next week, State employees who are eligible for health care benefits will receive a letter at their homes announcing changes for the upcoming benefit year. Benefits Administration Services (BAS) wanted you to be aware of these changes in advance.

BAS, in conjunction with the Joint Health Care Committee, has issued Requests for Proposals for Health Maintenance Organizations (HMOs), the Ohio Med PPO Third Party Administrator (TPA) and the Ohio Med Pharmacy Benefit Manager (PBM).

As a result of this year’s competitive bid process for HMOs, many employees will have more HMO options from which to choose during the spring open enrollment process. The spring open enrollment period is scheduled from May 2 through May 13. Subject to Ohio Controlling Board approval, the following is a summary of the HMO changes that will be effective on July 1, 2005:

Aetna will be added as an HMO option in 70 counties.

United Healthcare will be unavailable in 11 counties that it now serves, and will be an option in one county that it does not currently serve.

Kaiser Permanente and Summacare HMOs will no longer be available. The counties that they serve will continue to have two HMO options as well as the Ohio Med PPO. Most Kaiser enrollees will need to select a new physician since Kaiser physicians are employees of Kaiser. Employees currently enrolled in Kaiser will have the choice of Aetna and QualChoice. Special information for these enrollees will be posted soon on the Benefits Web site at www.ohio.gov/employeebenefits

Forty-four additional counties will have two HMO options from which to choose instead of one and the number of counties having no HMO options will decrease from five counties to two.

Additionally, please remember that the employee monthly share for health care will change from 10% of the PPO or average HMO premium to 15%, pursuant to collective bargaining agreements.

The TPA and PBM for the Ohio Med plan are currently being reviewed. When they are selected, the information will be posted on the Benefits Web site along with other important enrollment updates. Special editions of the Pathways newsletter and an April 12th open enrollment conference for agency personnel are being planned as well.

If you have any questions, please contact Benefits Customer Service at (614) 466-8857 or send an E-mail to benefits@das.state.oh.us.