Open Enrollment News

By Mika Ono

In anticipation of Open Enrollment, the annual opportunity for employees to select new benefit options, The Scripps Research Institute's Human Resources Department has announced that core aspects of employee health care plans—including carriers, networks, and premiums—will remain the same in 2011, while incorporating a few initial changes to the medical plans as required by the federal health care reform act.

"We are pleased to have avoided raising employees' health care premiums for 2011," said Cindy Scott-Lunau, vice president of Human Resources. "With regards to health care reform, our strategy for the coming year has been to keep major aspects of our health care plans in place to give us time to evaluate the impact of the legislation."

By invoking the "grandfather" provision of the new law, Scripps Research will be subject to only a portion of the new requirements as many aspects of the legislation are yet to be clarified.

New Benefits

Starting January 1, 2011, Scripps Research employees will benefit from the following changes:

• Children up to age 26 (through age 25) will be eligible for medical and vision coverage. The child will NOT need to be: financially dependent, residing with the parent, a student, or unemployed. However, if children are eligible for medical coverage through their employer, regardless of cost or plan type, they will no longer be eligible for coverage on a Scripps Research plan. Please note this eligibility does not apply to the dental plan.
• Lifetime limits on total payouts (formerly a rarely applied part of the Comprehensive PPO and Catastrophic Medical Plans) and any annual dollar limits on "essential benefits" will be eliminated.
• Pre-existing condition limitations (formerly part of Comprehensive PPO and Catastrophic Medical Plans) for covered children under the age of 19 will be lifted.

In addition, in a change unrelated to federal legislation, Scripps Research will offer a new optional Accidental Death and Dismemberment benefit for employees and family members. This program enables employees under the age of 70 the chance to obtain affordable worldwide insurance. The benefit can be elected in 2011 as part of the Open Enrollment process.

Other Changes

In addition to affecting health care plans per se, new legislation and regulations will influence administration of Health Care Flexible Spending Accounts, tax reporting, and mental health benefits.

For the Health Care Flexible Spending Account, as of January 1, 2011, over-the-counter drugs and supplies will no longer be eligible for reimbursement without a prescription.

"Employees need to submit claims for over-the-counter drugs and supplies by the end of this year to be eligible for reimbursement," said Christy Attebury, director of Benefits. "It's not just a matter of making a purchase by December 31, but actually submitting it for reimbursement by this date."

A previous law, the Federal Mental Health Parity Act, has also been clarified, so in 2011 qualified mental health and substance abuse treatment will be considered the same as physical illness not only in terms of coverage, but also in terms of deductibles, copays, and out-of-pocket accumulations.

Looking ahead, Attebury also notes that federal legislation has changed the tax reporting requirements for health plans, which will affect W-2s received in early 2012 for the 2011 tax year.

"For now, this is just a reporting requirement," said Attebury. "It won't affect your tax returns in any other way."

Mark Your Calendar: Open Enrollment Will Be Held October 25 to November 5

Scripps Research employees on both campuses will have the opportunity to choose among the health plans, sign up for 2011 flexible spending accounts, and make other changes to benefits selections (including dental insurance, life insurance, long-term care insurance, and accidental death and dismemberment insurance) as part of Open Enrollment—which will be held this year from Monday, October 25 to Friday, November 5, 5 PM, Pacific time.

Open Enrollment will again be held via an online system, available at https://openenrollment.scripps.edu from any computer with Internet access. Kiosks are available in Human Resources for employees who do not have access to a computer.

More details on the health care plans, insurance options, and other benefits elections will be sent to employees via Scripps Research email on October 11. The booklet includes a description of the Open Enrollment process, as well as a list of seminars where employees can come and ask questions.

If you have further questions, contact Human Resources at the Benefits Line, x4-8487 or benefits@scripps.edu.

Send comments to: mikaono[at]scripps.edu

— Cindy Scott-Lunau