SURS/HMO Changes for Employees
April 7, 2011
From WIU Benefits:
SURS Changes Effecting Your Retirement Annuity
• In March 2011 the SURS Board of Trustees adopted the results of the recent study presented by the SURS actuary. At the June 2011 SURS Board of Trustees meeting, the Board will determine the effective date of these changes, which is expected to be no earlier than January 2012.
• These results will cause a downward adjustment in the annuity amount calculated for the Money Purchase Formula.
• It is estimated that the monthly annuity benefit paid from the Money Purchase Formula will be reduced on average by 7% to 8% when the new factors take effect.
• SURS estimates that active participants can recover this monthly reduction by delaying retirement for approximately 10 to 11 months.
• The actual reduction in a monthly annuity calculated using the Money Purchase Formula is unique to each individual participant.
• SURS encourages all participants to log on to their account on the SURS Member Website www.surs.org and utilize the Benefit Estimator. Applying the estimated reduction to the resulting monthly Money Purchase Formula benefit will better reflect the effect on each participant's personal situation.
• The WIU HR Benefits Department encourages all employees planning on retiring in 2012 to contact or office at (309) 298-1853 or call SURS at (800) 275-7877 ext. 2 for assistance reviewing retirement annuity payouts.
The State of Illinois has selected four managed care plans to provide benefits to state employees, dependents and retirees starting July 1. Health Alliance was not one of the providers selected. Options available to employees will be released May 1.
Letters regarding the annual Benefit Choice Period, which will include information about these changes, will be sent later this month. We will work together to help all affected members select a plan that continues to meet their needs.
The Benefits Office will update the Benefits bulletin board on the situation as we receive information.
Benefit Choice informational meetings will be held at the Macomb campus on May 3 and 4 and at the Quad Cities Campus on May 6. Times and location will be announced later.
From the Illinois Department of Healthcare and Family Services
April 6, 2011
State Announces Selection of Managed Care Plans for FY12 Award estimated to save taxpayers $1 billion over 10 years
SPRINGFIELD – April 5, 2011. The Illinois Department of Healthcare and Family Services (HFS) today announced that it has selected four managed care organizations to provide benefits to state employees, dependents and retirees starting July 1. The plans will also provide care to members of the Local Government Health Plan, the Teachers' Retirement Insurance Program and College Insurance Program. State officials estimate that the award of these four contracts will result in a savings of approximately $102 million in FY12, and a savings in excess of $1 billion over the life of the contracts.
"Providing high quality health care is our highest priority. Through these plans, we are also able to realize significant savings for taxpayers and improve our state's fiscal health," said HFS Director Julie Hamos. "At the end of a thorough evaluation of the bids we received, we are confident that the managed care plans selected will provide the quality health care that members of the state group insurance system expect to receive as well as significant savings."
The selected managed care plans will replace the incumbent plans, whose contracts expire June 30, 2011. Members of the State's four group insurance programs will have the option to select a health plan that meets their needs during the annual Benefit Choice period in May. As a result of a competitive Request for Proposal (RFP) process, the State gave notice that
it intends to award the contracts for administering HMO services to two plans that are part of BlueCross BlueShield (BCBS): BCBS HMO Illinois and BCBS Blue Advantage. A separate RFP for Open Access Plan (OAP) services led to the selection of HealthLink OAP and PersonalCare OAP.
Five proposals were received and evaluated for HMO services, with the two BlueCross BlueShield proposals receiving the highest scores based on a combination of technical responsiveness and price. For the OAP service, four proposals were received and scored, with HealthLink OAP and PersonalCare OAP receiving the highest scores based upon a combination of technical responsiveness and price.
Letters will be sent to members later this month which outline the steps they must take if they are enrolled in one of the incumbent plans that is being replaced. Additionally, information regarding all of these changes will be included in the Benefit Choice Options book available on the Benefits web site: www.benefitschoice.il.gov, beginning May 1, 2011.
Q & A
Q: Will members be able to continue to receive care from their existing primary care physician?
A: Members will continue to have access to their trusted family health care providers, although for some it will be through different health plans. While some current family health care providers may only be available initially through the Tier 2 level benefit within the OAP plans, we expect that over time, these providers will adjust to market needs. The providers impacted by these changes can choose to immediately contract with the new vendors in order to expand their
Q. What does a member need to do if he or she is enrolled in one of the health plans that will no longer be available after June 30, 2011?
A. Members enrolled in any managed care plan that is no longer available under the Program must elect a new carrier during the Benefit Choice Period. Members who fail to make an election will be automatically defaulted to the Quality Care Health Plan effective July 1, 2011. Contact information for the vendors (including phone numbers and email addresses), enrollment forms, county coverage information and costs will be provided in the Benefit Choice Options book
available on the Benefits website (www.benefitschoice.il.gov) beginning May 1.
Q: Why are the savings not being shared with group members?
A: Contribution levels for the State plan are set by the Collective Bargaining Agreement and are not subject to increase, or decrease, unless agreed to by all parties. For the state employee plan, the State pays approximately 90 percent of the costs associated with health care.
Q: How were the proposals scored and ranked?
A: Proposals were received and evaluated according to the procurement laws and rules. Under the RFP for the HMOs, technical scores accounted for 30 percent of the total, and pricing accounted for 70 percent. For the OAP RFP technical scores accounted for 72 percent of the total while pricing accounted for 28 percent. The difference in scoring for the 2 different plans is based on the fact that the HMO is an insured plan, whereas the OAPs are self-insured.
Q: How can the state change benefit plans for bargaining unit members without going through the collective bargaining process?
A: The Collective Bargaining Agreement says, "the State shall continue to offer enrollment in Managed Care Health Plans (MCHP) — OAPs and HMOs are both MCHPs." The State continues to meet this obligation under this contract award.
Q: What is the difference between and HMO and OAP?
A: HMO plans provide benefits on an in-network basis. Out-of-network services are generally not covered. OAP plans offer a three-tiered benefit structure, thereby offering more flexibility of coverage options. Tier 1 is an HMO; Tier 2 is a PPO, which requires a deductible; Tier 3 is Out-of-Network.