Proposed health insurance changes
elicit concern among state employees

Central Management Services, the agency that administers health plans for state employees, last week announced significant changes in insurance options available during the upcoming benefits choice period.

Of particular concern to many NIU employees were CMS plans to drop Health Alliance HMO, a longstanding managed care provider covering more than 1,000 NIU staff and 5,000 of their dependents. Another managed care program CMS chose to drop was OSF Health Plans, a Rockford-based provider covering about 60 NIU employees and their families.

Statewide, the CMS decision raised substantial protest. A special legislative hearing is scheduled for 2 p.m. today in Springfield, and state employees from across Illinois are expected to testify. Because the CMS decision must be confirmed by a joint House and Senate committee called the Economic and Fiscal Commission, opponents hold out hope that it might be overruled this week.

(Click here to read a story from Monday's Springfield State Journal-Register.)

Nonetheless, NIU officials have moved quickly to explain the proposed changes and help employees prepare for the scenario described in CMS’s new plan. Late last week, Associate Vice President for Human Resources and Enterprise Planning Steve Cunningham issued the following memo explaining both the proposed changes and the preparations NIU is making to meet those changes:

The State of Illinois Department of Central Management Services (CMS) has announced several changes effective for this year’s FY05 Benefits Choice process. The public universities were also recently informed of substantial changes in the availability of Health Maintenance Organization (HMO) or managed care options that CMS will authorize beginning in FY05. President Peters updated the campus community on many of these subjects in his message of April 28. As expressed by President Peters, NIU and the other universities are reacting with surprise to the most recent announcement made by CMS concerning long-standing HMO option eliminations. We know that many employees have become accustomed to these options, which help them afford locally provided health care. Also as indicated by President Peters, NIU is committed to work at every level to influence decisions made by CMS that negatively affect the affordability and scope of employee health care benefits. Additionally, we are committed to providing you with as much information as possible concerning Benefit Choice changes and we will keep you updated on the most current basis possible as new information is forthcoming from CMS.

CMS has recently posted an information announcement concerning the Benefits Choice changes.

Please refer to this on-line announcement at: http://www.state.il.us/cms/3_servicese_ben_choice/.

The information outlined below is intended to provide you with a summary of Benefit Choice and CMS health insurance changes that have been announced to date. This information is divided into three categories concerning a two-phase benefits choice process, managed care HMO program revisions, and new procedures for obtaining CMS-provided Benefits Choice information.

Summary of Announced Changes

Initial information provided by CMS concerning FY05 benefit changes includes the following information:

• Benefits Choice Phase One: May 31 - June 18, 2004.
• Benefits Choice Phase Two: CMS has stated that “there will likely be a second [Benefits Choice] period” at a future date yet to be announced (probably the September, 2004 time frame).
• Health Alliance, Order of Saint Francis, and Unicare HMOs will no longer be available.
• HMO Illinois will continue to be available and new HMO vendors will include United Health Care and John Deere HMO.
• CIGNA remains the health care administrator for the State of Illinois Quality Care health benefit program.
• Spectera Vision Plan will replace the Vision Care Program.
• Benefit choice forms will be made available on-line through CMS at www.benefitschoice.il.gov, through the HRS website, and at the HRS facility.
• Benefit plan changes are in effect as of July 1, 2004.

Two-phase FY05 Benefits Choice Process

Benefits Choice will presumably be conducted in two phases this year. The first phase will start on May 31, 2004, and extend until June 18, 2004. CMS has stated that a second phase is “likely.” The dates for the second phase will be announced when benefit program details are finalized by CMS. Based upon information that CMS has provided to the university Group Insurance Representatives, Phase Two would reopen these choices (except for DCAP enrollment) when CMS finalizes its new premium/deductible/co-payment schedule.

• Phase One (May 31 through June 18) will provide an opportunity to change health or dental plans, add/change eligible dependents, elect/adjust optional life insurance coverage, and to enroll in a Medical Care Assistance Plan (MCAP) or Dependent Care Assistance Plan (DCAP). CMS has announced the elimination of several HMO programs as of July 1 (see below).
• Phase Two (when announced by CMS) would reopen these choices (except for DCAP enrollment) when CMS finalizes its new premium/deductible/co-payment schedule. CMS has indicated that modifications to choices made during Phase One would be permitted during Phase Two.

If no new elections are made during either Phase One or Phase Two of the Benefits Choice process, employees will remain enrolled in existing options that remain available; otherwise, the traditional Quality Care plan administered by CIGNA will be the default plan for those not exercising an alternative election in either phase of the Benefit’s Choice program.

Managed Care HMO Program Revisions

CMS has announced the termination of several HMO options as of July 1, 2004, in which several thousand NIU employees and their dependents participate. For NIU employees the most significant of these are:

Health Alliance HMO (includes DeKalb Clinic and the state-wide Health Alliance HMO network)

Order of Saint Francis HMO (includes Rockford area health care providers and the state-wide OSF HMO network)

Unicare HMO (includes Chicago area health care providers)

CMS has announced the substitution of different managed care plans in various regions. The programs mentioned include HMO Illinois, United Healthcare Select, Health Link Open Access, and the John Deere plan. These programs are not presently affiliated with many DeKalb-area providers and the HealthLink and John Deere plans are not available in DeKalb County. While negotiations are underway between these insurers and various physician groups, the present menu of providers available for DeKalb-area residents is very limited. Accordingly, in order to retain their current health care providers, many NIU and other state employees may find it necessary to move into the traditional and higher-priced state Quality Care program, administered by CIGNA. Finally, CMS is in the process of implementing a revised rate structure for the Quality Care Program that is likely to involve increases in monthly premiums, deductibles, and co-payments associated with the traditional plan. CMS will not announce these changes until later in the year when (presumably) the second Benefits Choice phase would be conducted in late summer/early fall. We will inform you as soon as CMS releases additional details concerning these options.

New Procedures for Obtaining CMS-provided Benefits Choice Information

CMS has also recently announced (in an effort to reduce printing costs) that employees will be required to access their Benefits Choice Option Booklet on-line through the Internet. CMS will establish a benefits website for this purpose. All benefit publications will eventually be published on this website. By May 2005, CMS intends to be entirely paperless and all benefit information will be accessed on-line.

When the website is established, you will receive a notice referring you to the CMS Benefits Choice website to read your Benefits Choice Option Booklet to learn about changes that will be effective July 1, 2004, including:

• Changes in employee costs for health, dental and life insurance
• Changes in plan benefits and change deadlines
• Changes in deadlines for enrollment in MCAP and DCAP

The availability of Benefits Choice information is very important and new procedures are being implemented at the same time as many other changes are being announced. Given the scope of these changes, it is very important that all eligible employees gain access to the CMS-published information. Accordingly, we will rely upon the assistance of all of our departments in helping to provide employees with access to the CMS on-line information. When CMS publishes the FY05 Benefits Choice Booklet, upon request, HRS will provide a copy of the FY05 Benefits Choice Booklet to any employee who does not have access to a computer capable of providing on-line access to the CMS information. HRS will also continue to make periodic announcements and to assist employees in evaluating the changes announced by CMS.

CMS Benefits Choice updates will also be available as follows:

• When CMS makes new information available, Human Resource Services will post the latest information on the HRS website (www.hr.niu.edu), which you may consult at any time.
• Additional internal announcements will be made to employees and departments.
• HRS will provide campus departments with a limited number of printed reference copies of the CMS Benefits Choice booklets.

Because many faculty and staff will be away from campus during this critical time period, it is important that all employees use every available method to inform themselves about CMS health plan benefit changes as they occur during both phases of the FY05 Benefits Choice process.

Additional Information

Employees are reminded that many benefit changes require documentation. A list of required documentation is available from HRS and will be made available at the HRS website.

Remember that Phase One of the annual Benefits Choice Period will begin on May 31, 2004 (when CMS will post the Benefits Choice information online). If you wish to make a change in your benefit selections during the Benefits Choice period, please be aware that the Insurance and Employee Benefits Office must receive your request in printed copy, fax, or online by the deadline announced in the Benefits Choice Option Booklet.

We will make every effort to keep the campus community informed of any new information as soon as it is available to us. HRS will also schedule Benefits Choice informational meetings when more details become available. We regret any inconvenience these changes may cause for you, and we appreciate your cooperation with these new state initiatives.

A hardcopy memorandum of this announcement will be sent to all employees.

5-4-03