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The Texas A&M University SystemBenefitsAdministration

Dec 2016

Issue 53

DependentSocialSecurityNumberReminder

AspartofcompliancewiththeAffordableCareActtheA&MSystemBenefits OfficeisrequiredtorequestSocialSecurity Numbers (SSNs)for covered dependents.Thisinformationwillremainconfidential.

IfyouhavedependentscoveredthroughyourA&MSystemhealthplanforwhom

BenefitBriefs

youhavenotprovidedanSSNorifyou are unsureastowhetheryouhavepreviouslyprovidedyourdependent’sSSN,goonlinethroughHRConnect,( sso.tamus.edu/)tocheckandenteranSSN.AfterloggingintoHRConnect,clickontheCurrentBenefitstabnearthetopofthepage.ChecktheMyDependentsboxonthebottomrightandifanSSNismissingitwillsay“ActionRequired;SupplySSN.”SeetheHow-ToDocumentforfurtherinstruction.

Electronic1095-COption

Ifyoudidnotdosolastyear,youcanelecttoreceiveyourtax Form 1095-CelectronicallythroughHRConnectat sso.tamus.edu.Form1095-Cisataxformrelatedtoyourhealthcoverage.

IfyouhavequestionsaboutyourForm1095-C, refertotheinformationprovidedat:

Injectable Drugs and Prior

Authorization

Inordertoensurethatmedicationsaretakensafelyandappropriately,somedrugsrequireyourphysiciantoobtainpriorauthorizationbeforeaprescriptioncanbefilledandcoveredbyyourinsurance.Injectabledrugsareadrugclassinwhichalmostallmedicationsrequirepriorauthorization.Somemedicationsrequireacoveragereviewbasedonwhethercertaincriteriahavebeenmet,suchasage,sex,orconditionand/orwhethertreatmentofanalternatetherapyorcourseoftreatmenthasfailedorisnotappropriate.Othershavequantityrestrictionsbasedonproductlabelingorclinicalguidelines.

Duringplanyear2016,1.6%ofallA&MSystememployeeandretireeprescriptionsprocessedbyExpressScriptsrequiredacoveragereview.Ofthoseprescriptions,theprescribingphysiciansonlypursuedacoveragereviewfor1/3asopposedtoprescribinganalternativemedication.Onceadditionalinformationwasprovidedbythephysician,82%ofthoseclaimswereapprovedtobedispensed.

ParticipatingRetailPharmacies:

1.Youtakeyourprescriptiontoyourlocalpharmacist,whowillsubmititelectronicallytoExpressScripts.

2.Youwillbenotifiedbyyourpharmacistiftheprescriptionneedstobereviewedforpriorauthorization.

3.YourdoctorwillneedtocontactExpressScriptsonlineatesrx.com/paortoll-freeat800-753-2851,7:00a.m.to8:00p.m.,CentralTime,Monday through Friday. Your doctor will

providefurtherdetailsaboutyourtreatmentthat

isnotavailableonyouroriginalprescription.

4.ExpressScriptswillnotifyyouandthedoctor,usuallywithin1to2businessdays,toconfirmwhether or not the coverage has beenauthorized.

5.If coverage is authorized, you will payyournormalcopayment.Ifcoverageisnotauthorized,youmayberesponsibleforthefullcostofthemedication.Atthispoint,youmaywanttotalktoyourdoctoraboutalternativesthatmaybecoveredorconsideranappeal.

Mail-OrderService:

1.YoumailtheprescriptiontoExpressScripts.

2.Ifacoveragereviewisnecessary,ExpressScriptscontactsyourdoctor,requestingmore

information.

3.ExpressScriptsnotifiesyou and the doctorconfirmswhetherornotcoveragehasbeenapproved,usuallywithin1to2businessdays.

4.Ifcoverageisauthorized,you’llreceiveyour

medicationandpayyournormalcopaymentfor

themedication.Ifcoverageisnotauthorized,ExpressScriptswillsendyounotificationinthemail,alongwithyouroriginalprescription

ifitwasmailedtotheExpressScriptsPharmacyandinformationregardingtheappealprocess.

TDA/DCP Contribution Limits for 2017

ThemaximumcontributionlimitforparticipantsundertheTax-DeferredAccountProgram(TDA)andtheTexa$averDeferredCompensationPlan(DCP)willstaythesameat$18,000in2017foreachplan.Thecatch-upcontributionlimitforeachplanforparticipantswhoare50andolderwillalsoremainat$6,000in2017.

AdditionalinformationregardingTDAorDCPcontributionlimitsandotherretirementprograminformationcanbefoundontheSystemBenefitsAdministrationwebsiteat

edu/business/benefits-administration/retirement-programs/.

VisionBenefits Explained

TheA&MCareplansandtheGraduateStudentEmployeeHealthPlanareadministeredbyBlueCrossandBlueShieldofTexas(BCBSTX)andprovidecoverageforonepreventiveeyeexamperperson,perplanyear.Copay,ifin-network,willapply.Theseplansdonotcovervisioncorrectionmaterials. However,BCBSTXoffersdiscountsonexams,frames,lensesandlaservisionservicesthroughDavis Vision,Inc.

Theoptional vision plan is administered by EyeMed Vision Care.Itprovidescoverageforeyeexams,eyeglassframesandlenses,andcontactlenses.ThevisionplanalsoprovidesdiscountsonsomeeyesurgeriessuchasLASIK.Youmayuseeitheryourhealth plan or your vision plan exam benefit.

Whendeterminingthebestplacetogetyoureyeexam,considerwhereyouplantopurchaseyourlensesorcontacts.Uponyourrequest,yourphysicianoroptometristshouldprovideyouwithyourprescription,allowingyoutohaveitfilledattheproviderof yourchoice.

Didyouknowthatyoucanuseyourflexiblespendingaccount (FSA)spendingdollarstopurchaseprescriptioneyeglasses,prescriptioncontactlensesandprescriptionsunglasses?Thesefundscanbeusedfortheportionoftheexpensenotpaidbyinsurance.

MedicarePart A and B Increasesfor 2017

TheCentersforMedicareMedicaidServiceshasreleasedindexed2017valuesforMedicarePartsAandB.Theindexedamountsincludeincreasesindeductibles,coinsurance,andpremiums-includingtheincreasedPartBpremiumsforindividualswithincomesthatexceedspecifieddollaramounts. MedicarePartAcost-sharingvalueincreases for2017 include:

•Inpatient deductible - $1,316 (was $1,288).

•Coinsurance for the 61st – 90th day - $329 (was $322).

•Coinsurance for lifetime reserve days - $658 (was $644).

•Skilled nursing facility coinsurance - $164.50 (was $161).

WithrespecttoMedicarePartB,thecalendaryeardeductibleis$183for2017,comparedto$166for2016.Beneficiaries withincomesabovespecifiedamountsarerequiredtopayan additionalincome-relatedadjustmentamount.Theincome-related monthlyadjustmentamountvariesbasedonincomeand.filingstatus. For more information, see the chart here.

DecodingMonthlyPremiums

Howismyemployercontributing,andhowmuch?

Reportinginanationwidesurvey,theKaiserFamilyFoundationfoundthatmostemployerspaid83percent ofthepremiumforsinglecoverageand72percentofthepremiumforfamilycoverageonaverageinFY2015.Incomparison,forFY17,theTexasA&MUniversitySystempays100percentofthepremiumforsingle,full-timeemployeesworkingmorethan30hoursperweekand71to79percentofthepremiumforfamilycoverage,dependentupon the plan.

Thechartbelowreflectstotalpremiumsandemployercontribution

amounts by plan and tierforthose enrolledinfull-timecoverage.

Plan / Tier / TotalPremium / EmployerContribution
A&MCare / Single / 593.77 / 593.77
Spouse / 1155.88 / 874.83
Children / 984.27 / 789.02
Family / 1384.71 / 989.24
A&MCare65+ / Single / 531.42 / 531.42
Spouse / 1033.24 / 874.83
Children / 880.02 / 789.02
Family / 1237.56 / 989.24
JPlan / Single / 593.77 / 593.77
Spouse / 1155.88 / 874.83
Children / 984.27 / 789.02
Family / 1384.71 / 989.24

WhatDoestheElectionOutcomeMeanforEmployeeBenefits?

Followingtherecentelection,therehavebeenconcernsovertheAffordableCareAct(ACA)andwhatwillhappentoinsurancepremiums.TheelectionisstilltoorecenttobeabletotelliftheACAwill be repealed, andif sotowhat degree. Inthemeantime,A&MSystemBenefitswillcontinuetooperateincompliancewith applicable stateregulationsand federalACArules.

Ifchangesoccurthatwouldimpactthebenefitplans,theywill becommunicatedwiththeA&MSystemcommunityassoonaspossible.

FY16FlexibleSpendingAccountDeadline

AllclaimsrelatedtoyourFY16FlexibleSpendingAccountmustbefilebyDecember31,2016.InformationabouthowtofileyourFSAclaimsandacopyoftheFSAclaimformcanbefoundat

employeeretiree-benefits/fl