Friday, December 01, 2006

Sandra Knoesel to Shirlee Zerkel; RE: Still on 2007 health care questions

From Sandra Knoesel/Beth Coffey, December 1, 2006
Subject: RE: Still on 2007 health care questions
Dear Mrs. Zerkel:
Thank you for your patience as we compiled the information you've requested over the last several days about associate health insurance for 2006 and 2007.
In reply to your requests for information about STRS Ohio associate health care premiums and benefits for 2006, a copy of the letter Dr. Asbury sent to you on Nov. 28, 2005, with this information is being mailed via the U.S. Postal Service today. In addition to Dr. Asbury's letter, we're sending copies of the 2006 Benefits Summary he previously provided. Similar information for 2007 health care benefits is also being mailed to you. In the interim, below are replies to your questions/requests about 2007 associate health care. As you know, health care is complex. We hope this additional written information is helpful; however, we are also available by telephone to answer any outstanding questions.
Questions/requests - A less vague list of the premiums for 2007 and a list of the staff health care benefits for 2007; Do the staff for 2007 have a choice of a no deductible policy or one with a deductible? Does the staff have single, employee and spouse, employee and children, and family as choices for 2007?
Reply - For 2007, STRS Ohio associates currently participating in UnitedHealthcare (UHC) will have a choice of which plan they want to participate in: the current no-deductible plan or new deductible plan with lower out-of-network benefits. These associates' premiums will be based on who is covered under a four-tier rate structure. These four tiers include: single; associate plus spouse; associate plus child(ren); or family. The specific rates for the no-deductible plan and new deductible plan have been provided to you under separate cover.
With the deductible plan, if an associate receives services that were subject to the 20% coinsurance for in-network providers (or 40% out-of-network), the associate pays the deductible first and then the coinsurance. The associate is responsible for the coinsurance to the maximum out-of-pocket.
Both plans include an annual "out-of-pocket" maximum. Under the deductible plan, the out-of-pocket maximums for in-network services are $1,000/individual and $2,000/family and do not include the deductible ($500/individual or $1,000/family).
Questions - What is that deductible? Is that deductible for each person on that policy?
Reply - The deductibles are $500/individual and $1,000/family (three or more people) for network providers and $1,000/individual and $2,000/family for out-of-network. The network and out-of-network deductibles accumulate separately during the calendar year and start over the first of each year.
Question - Do staff still get family dental free?
Reply - Dental coverage is an employer-paid benefit for STRS Ohio associates and their dependents.
Beth M. Coffey
Member Resolution Liaison
(614) 227-4031
(888) 227-7877
Larry KehresMount Union Collge
Division III
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