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2013 PASSHE Health Care Plan Open Enrollment

PASSHE Health Care open enrollment for the 2013–2014 plan year for faculty, managers, coaches, and OPEIU and SPFPA employees begins on Monday, May 6, 2013, and ends on Friday, May 17, 2013.

Open enrollment is your annual opportunity to change your health plan and add or remove dependents from your health and prescription drug coverage and your vision, dental, and hearing coverage (applies only to coaches, managers, and OPEIU and SPFPA employees). To continue with your current plan with current dependents (if applicable), no action is necessary.

If you are electing to make changes to your health plan during open enrollment, all changes will be effective July 1, 2013. Detailed information is available in the 2013 PASSHE Open Enrollment Newsletter. Please take the time to read this newsletter as it contains important information that impacts your health care coverage including, but not limited to:

PPO, HMO, and Prescription Drug Plan Design Changes

  • Office visit copayments for specialists will increase from $15 to $25 (including urgent care facilities). The office visit copayment for primary care providers remains at $15.
  • The copayment for Emergency Room visits will increase from $50 to $100. This copayment will be waived if admitted.
  • Prescription drug copayments will increase as follows:
    • Retail purchase (30-day supply): $5/$18/$36
    • Mail order purchase (90-day supply): $10/$36/$72

Dental and Vision Benefits for Managers, Coaches, and OPEIU and SPFPA Employees

  • Nominal annual participant contribution of $5.00 ($.019 per pay) assessed to remain in compliance with health care reform.
  • To retain these benefits, you must elect coverage through Employee Self-Service (ESS) during open enrollment, which ends on May 17, 2013.

Coverage for Adult Children (ages 19–26)

Effective July 1, 2013, adult children ages 19–26 can be covered/enrolled on any PASSHE health plan regardless of whether they have health plan coverage available through their own or their spouse’s employer.

Same-Sex Domestic Parnter Eligibility for Annuitants

  • Upon retirement, faculty, coaches, and managers will be permitted to enroll a same-sex domestic partner in the Annuitant Health Care Program (AHCP) with an approved PASSHE Annuitant Same-Sex Domestic Partnership Certification.
  • There may be potential tax ramifications as a result of adding a domestic partner to coverage, and it is recommeded that a qualified tax professional be consulted for guidance regarding the tax issues involved.

Plan Costs for the 2013–2014 Plan Year – Effective July 1, 2013

See the Open Enrollment newsletter for bi-weekly health care contributions effective July 1, 2013. Please note that although the percentage paid by employees remains the same, the healthcare premium costs for the PPO and HMO plans have increased over the 2012–2013 plan year. Therefore, your contribution for the 2013–2014 plan year will be more regardless of whether you are paying 15 percent of the cost or 25 percent of the cost.

To change health plans and/or to add or remove dependents from your plan, you must enter your benefit changes through Employee Self-Service (ESS), and, if applicable, submit the required documentation to the Office of Human Resources, G-8 Sutton Hall, no later than Friday, May 17, 2013. Questions can be directed to the Benefits Office at (724) 357-2431.

  • Human Resources Office
  • Sutton Hall, Room G8
    1011 South Drive
    Indiana, PA 15705
  • Phone: 724-357-2431
  • Fax: 724-357-2685
  • Office Hours
  • Monday through Friday
  • 8:00 a.m. – 4:30 p.m.