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Insurance options added; some plans dropped

The state Public Employees Benefits Board (PEBB) approved a number of changes that will affect employees enrolled in state health insurance plans beginning Jan. 1, 2007.

New options: “Value plans,” previously requested by employees, will feature lower monthly premiums with higher co-payments and a small deductible. Traditional managed-care plans with a higher premium, lower co-payments and no deductible still will be available.

No longer available: UMP Neighborhood and Group Health Options will not be available in 2007. PacifiCare will not be available to active enrollees and non-Medicare retirees; however PacifiCare’s Medicare plan (Secure Horizons) will continue to be available.

Benefit improvements: The vision benefit will increase (routine exams offered annually, and $150 every two years for hardware). Orthodontia coverage will increase for the Uniform Dental Plan only (a lifetime maximum benefit of $1,500).

Prescription drugs: Uniform Medical Plan’s prescription drug deductible no longer will apply to Tier 1 (generic) drugs. Other incentives to purchase Tier 1 drugs include an increase in the mail-order co-pay for Tier 2 drugs from $40 to $50 and a requirement that enrollees pay more for Tier 3 drugs that have a generic equivalent.

Open enrollment for the 2007 plan year begins in October and will run until Nov. 30. This is the one time each year that employees can change health plans. A few weeks in advance, information will be mailed to employees about plan options, changes and how to adjust coverage online.

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