TTU HR News
ERS Selects UnitedHealthCare Services, Inc. to Administer HealthSelect of Texas as of September 1, 2012
4/24/2012
(Click here for a PDF document containing the following questions and answers.)
1. Why are we switching?
ERS rebids all of the Texas Employee Group Benefits Program (GBP) contracts regularly to ensure members get quality benefits at a reasonable cost. ERS selected United HealthCare Services, Inc. after a rigorous eight-month review process. The new contract is expected to save the health plan money, while still providing quality benefits. Because the health plan is self-funded, saving money for the plan benefits all HealthSelect members by helping to offset some of the plan costs.
2. What do I need to do?
Starting September 1, 2012, United HealthCare Services, Inc. will take over the administration of HealthSelect. UnitedHealthcare will process claims, provide customer service, offer health and wellness programs, and manage the HealthSelect network starting September 1, 2012. You just need to show your new medical ID card to your doctor or other medical provider starting September 1, 2012. You will receive your new cards before September 1, 2012.
3. Can I still see my doctor?
Go to the website to find out if your doctor is in the network. UnitedHealthcare will be reaching out to providers who are not currently part of the network and asking them to join. The online directory is the most current source of information on network providers.
If you are a retiree age 65 or older in the HealthSelect plan, you continue to have out-of-area benefits and can continue to see your current providers.
All other HealthSelect members can see any provider, but an out-of-network provider will cost you more in out-of-pocket expenses.
If your doctor decides not to join the network, you may want to switch to a network provider; otherwise, you will receive non-network benefits.
4. Am I going to pay more because of the switch?
The legislature and/or the ERS Board of Trustees determine the plan design and premium changes. ERS examines the benefit design and premiums and determines if changes are necessary on an annual basis at the May Board of Trustees meeting. We will provide information on any changes after the May board meeting.
5. Are the copays, deductibles, or out-of-pocket maximums changing?
No. Copays, deductibles, and out-of-pocket maximums are not changing due to this transition; however, the ERS Board of Trustees re-evaluates the plan's expenses and funding to determine if plan design changes are necessary at the May board meeting. At this point, we do not anticipate plan design changes for Plan Year 2013 that starts September 1, 2012. We will provide information on any changes after the May board meeting.
6. Will my premiums increase?
HealthSelect premiums are expected to increase on September 1 as part of the annual premium review process. The premium increase was projected during the last legislative session as part of the state budget for health insurance programs. Employers absorb most of the increased cost since full-time employees and qualified retirees are provided health insurance at no cost. If you are covering any family members, your cost for coverage will increase since you are paying 50% of the cost for their coverage. The ERS Board of Trustees will determine the rates at the May 22 board meeting. We will provide information on any changes after the May board meeting.
7. Is the HealthSelect plan changing to the UnitedHealthcare Choice Plus plan?
No. United HealthCare will manage the HealthSelect network using their UnitedHealthcare Choice Plus network. The benefits are the same HealthSelect benefits. If you'd like a reminder of what the HealthSelect plan covers, take a look at the HealthSelect webpage on the ERS website.
8. What about my prescriptions?
Your prescription drug benefit is not changing as part of this transition. Caremark will continue to manage the HealthSelect prescription drug program.
9. Where is UnitedHealthcare located?
UnitedHealthcare's call center and claims processing unit is located in San Antonio, Texas.
10. Where can I get more information?
ERS will provide full details on this transition during Annual Enrollment. In the meantime, ERS will provide monthly updates and post information on our website.
11. The provider search tool looks different than it did previously. What happened?
ERS worked with UnitedHealthcare to enhance the provider search tool to make it easier for you to find out if your doctor is in the network. There are three easy ways to search:
• Find a doctor
• Find a hospital or other facility
• Find a mental health provider
12. Can I use the online provider search tool to see if my behavioral health provider is in the network?
Yes. Click on "Find a Mental Health Provider" to search for a provider by name or behavioral health specialty.
13. What is liveandworkwell.com?
If you are using the online provider search tool for a mental health specialist, you will be redirected to United Behavioral Health (UBH) clinicians and facilities at liveandworkwell.com.
14. Can I search for a provider by zip code using the online search tool?
Yes. Click on "Find a physician near you," then click on the type of doctor you want to see under "Physician Specialty." Then, you can enter a zip code and a radius of miles to include in your search.
15. If I don't see my doctor listed, can I ask UnitedHealthcare to contact my doctor to join?
Yes. Provider nomination instructions have been added to the provider search webpage at www.healthselectoftexas.com.
16. Will I have to re-enroll myself and my dependents because we are switching to UnitedHealthcare?
No. HealthSelect members are not changing health plans; therefore, there is no re-enrollment process for you or your dependents.
17. Is a PCP and a referral to a specialist still required for network benefits?
Yes. You must designate a PCP for network benefits to apply to your office visit. You will continue to get referrals to most specialists. You will not need a referral for your annual eye exam or any OB/GYN appointments.
18. Do I still have to get pre-certifications for hospital stays?
Yes. Your provider will need to get pre-authorization for any planned hospital stay.
19. Will I still have my Basic Term Life Insurance?
Yes, this coverage is not changing. The transition to UnitedHealthcare has no effect on your life insurance options.
20. Will my Blue Points transfer?
No. Blue Points are specific to Blue Cross and Blue Shield of Texas (BCBSTX). They are not transferrable to UnitedHealthcare. You will need to redeem your Blue Points by August 31, 2012 or you will lose them. Visit www.bcbstx.com/hs/ or call BCBSTX toll-free at (800)252-8039 for more information on how to redeem your Blue Points.
21. Can I continue in the Bariatric Program?
During the transition, members who are currently in the Bariatric Program can continue in the program at the same clinic. Those who have a planned surgery at the time of transition can proceed with their surgery as planned at those locations.
22. Are the qualifications for the Bariatric Program changing with the transition to UnitedHealthcare?
No. The qualifications for the program are not changing for current or new Bariatric Program participants due to the transition. However, the facilities approved to perform the procedure may change in the future. Those who have already started the program and have a planned surgery at the time of transition can proceed with their surgery as planned at those locations.