 |
 |
| Get help in determining which health plan is best for you and your family, learn more about
Duke's new vision care plan, or learn how you can save money through a reimbursement account during any of
these information tables
and sessions. |
|
|
|
|
|
 |
Duke covers more than 80 percent of the total premium for employees and about 50 percent of the total premium for family members enrolled in Duke Select, which is Duke's most popular health plan. |
|
The average annual health care cost per person covered by one of Duke's four health plans is about $2,800, but with Duke's health benefits, participants only pay a small portion of that cost. |
|
The average annual cost of prescription drugs is about $747 per person. But participants only pay an average of $174, with Duke's pharmacy benefits covering the majority of the cost. |
|
This year, Duke expects to pay out $144 million in health claims for faculty, staff and their family members - which is $14 million more than the previous year. |
|
|
|
|
|
|
How do health insurance costs for Duke employees
compare
to other area
employers? |
|
|
|
|
Enroll for Health, Dental, Vision Benefits Oct. 3 - Oct. 15
Mark your calendar - Duke faculty and staff will have the opportunity to enroll for health, dental and vision care benefits
as well as cost-saving reimbursement accounts during the annual open enrollment period from Oct. 3 - Oct. 15.
During this period, all faculty and staff should review their health, vision and dental benefits to ensure their selections
continue to meet their needs during the coming year. Those who wish to take advantage of tax savings through the health care or
dependent care reimbursement accounts for 2006 must enroll for these accounts, as participation does not automatically continue
from year to year.
Participation in Duke's health plans have grown steadily the last few years as its premiums have increased less than most other
employers regionally and nationally. Currently, nearly 90 percent of eligible faculty and staff participate in one of Duke's health
plans, compared to the national average of 56 percent participation in employer-sponsored health plans.
"At Duke, we are fortunate to be able to offer employees comprehensive coverage at a lower cost than what is available in the
market or at most local and regional employers," said Green. "We also benefit from the inherent advantages of being one of the top
medical centers in the country. Through Duke's health care plans, our employees and their families have access to many of the
world's best physicians, the most advanced technology, and leading research facilities right here within Duke University Medical
Center and Health System."
For 2006, Duke will continue to offer four health plans from which to choose - Duke Select (HMO), Duke Basic (HMO), Blue Care
(HMO), and Duke Options (PPO). Each health plan includes pharmacy and mental health coverage as well as innovative health promotion
programs such as Duke Prospective Health. In addition, while Duke's health plans have provided benefit coverage for annual eye exams,
Duke is introducing a nationwide vision care plan to help manage the cost of eyeglasses (lenses and frames), contact lenses as well
as eye examinations. Faculty and staff will receive personalized open enrollment packets in September that include detailed information
on Duke's health, dental, vision and reimbursement benefit selections for 2006.
Lois Ann Green, director of Benefits, said that employees should review this information closely and, if desired, make any changes
necessary during open enrollment.
"Since each employee's situation and needs are different, Duke offers a wide range of choices and coverage options to help meet the
diverse needs of our workforce," said Green. "When reviewing Duke's health plans, it is important to compare coverage, out-of-pocket
expenses as well as premiums and pharmacy benefits to be sure you make the best choices for you and your family. In addition, faculty
and staff should consider their co-pays, co-insurance and other medical or dependent care expenses not covered by insurance to determine
whether they may benefit from enrolling in a reimbursement account for 2006."
Changes for 2006
- New Vision Care Plan: introduction of a nationwide vision care plan to manage the cost of eyeglasses (lenses and frames) and
contact lenses, as well as eye examinations.
- Dental Plan: introduction of a limited network of providers who have agreed to accept usual, customary, and reasonable (UCR)
for covered services. Participants can still visit any licensed dentist.
- Monthly Premiums: moderate premium increases - between $0-5 per month for individual coverage and between $0-30 per month for
family coverage - depending on the plan selected (no change to the premiums for Duke Basic).
- Duke Options: introduction of an annual deductible of $100 per individual and $300 per family for all in-network services with
co-insurance.
- Duke Basic: enhanced contribution to participants' health care reimbursement account based on the level of coverage selected:
$200 for individual, $300 for employee/child, $400 for employee/children, $400 for employee/spouse or employee/same-sex spousal
equivalent, and $600 for family.
New Duke Vision Care Plan
While Duke's health plans have provided coverage for annual eye exams, Duke is pleased to announce the introduction of a nationwide
vision care plan to manage the cost of eyeglasses (lenses and frames) and contact lenses, as well as eye examinations. This new plan
is a voluntary employee-paid plan for active employees and their eligible family members. The vision plan, administered by Spectera,
one of the largest vision care programs in the country, allows you to pay for vision benefits on a pre-tax basis. You do not need to
be enrolled in any of Duke's health plans to participate in the vision plan.
The vision care plan provides coverage for prescription lenses and frames, contact lenses (in lieu of eyeglasses), and a complete
annual eye exam for a low monthly premium of $8.85 for an individual and $27.47 for family coverage. Under the plan, you can visit
an optometrist or ophthalmologist within the Spectera network or you may choose to visit an out-of-network provider, which may result
in higher out-of-pocket costs. Anyone enrolled in one of Duke's health plans can continue to receive coverage for an annual eye
exam with the health plan's co-pay. If you enroll in the vision plan, Spectera will reimburse you for your health plan's vision
examination co-pay if you visit a provider outside of Spectera's network.
Pharmacy Benefits
For Duke's pharmacy benefits, co-pays for generic drugs will remain the same as 2005. Co-pays for a 34-day supply of non-generic
prescription drugs will increase $5. Home delivery co-pays (which provide a three-month supply) will remain the same as 2005 for
generic drugs, while the co-pay for non-generic formulary medications will increase $12 and the co-pay for non-formulary medications
will increase $10.
One of the best ways to save money on your recurring, long-term prescriptions
is through home delivery. Home delivery medication can be ordered in a
three-month supply for approximately the same price you would pay for a
two-month supply at a pharmacy. Simple instructions for submitting home delivery
prescriptions are available on the
Pharmacy Benefits Web Site.
Dental Benefits
For 2006, Duke is introducing a limited network of providers who have agreed to accept usual, customary, and reasonable (UCR)
for covered services. Under the dental plans, participants will still be able to visit any licensed dentist.
There will be a slight premium increase for Plan A, the more comprehensive plan, of less than $1 per month for individuals and
just over $4 per month for family coverage, while the cost for Plan B, the basic dental plan, will remain unchanged.
Reimbursement Accounts
One of the best ways to save money on health care or child care expenses is through Duke's reimbursement accounts. Reimbursement
accounts help Duke faculty and staff manage their health care and dependent care costs by setting aside pre-tax money each month to
pay for eligible expenses incurred during the year that are not covered by insurance.
Reimbursement accounts enable employees to take advantage of tax savings on eligible expenses including co-pays, deductibles, dental
care, over-the-counter medicines, and child care - and the savings can add up quickly. For example, an individual in a 30 percent tax
bracket would save $105 on a $350 inpatient co-pay.
Employees currently enrolled in a health or dependent care reimbursement account
must renew their participation during open
enrollment to receive the tax savings in 2006.
Additional details about these changes and how to enroll are included in the
open enrollment web site
or the open enrollment packet being mailed to employees
in September. Faculty and staff can also learn more about Duke's health, dental and vision coverage or reimbursement accounts at
one of the information sessions that will be held during the Open Enrollment period (see sidebar). Representatives from the Duke
Open Enrollment Service Center will be available at 1-877-371-9963, Monday - Friday, October 3 through October 14 from 8 a.m. to
8 p.m. and on Saturday, October 8 and Saturday, October 15 from 8 a.m. to 5 p.m.
|
