Expanded health plan benefits, salary range changes aheadby John Howser | Sep. 28, 2017, 9:30 AM
For 2018, the Vanderbilt University Medical Center (VUMC) employee health plan will offer an array of insurance options and new wellness services.
In response to employee suggestions, several enhancements are being made to overall benefits options, including a new “Platinum” level benefit offered through the Go for the Gold program to offset the membership fees for the Vanderbilt University Recreation and Wellness Center, coverage for evidence-based therapies offered through the Osher Center for Integrative Medicine to help employees better manage back pain and insomnia, and a three-year approval for PTO rollover to the sick bank.
An additional change for fiscal year 2018, which goes into effect on Oct. 1, is the removal of caps on current salary ranges. Any employee eligible for the upcoming pay increase that is already at the current salary range maximum for their position, or would be at the maximum with this year’s increase, will receive a 2 percent base rate increase rather than a lump sum payment.
“As we continue to review salary ranges for the upcoming year and evaluate our salary grade structure, we hope this is a welcome change for our long-term employees,” said Traci Nordberg, Chief Human Resources Officer.
The “Platinum” benefit for fitness recognizes employees who use the Recreation and Wellness Center at least 30 times each quarter with funding to cover a portion of the membership fees.
Since VUMC does not own the center, the Internal Revenue Service requires this benefit to be taxed. Employees reaching the “Gold” GFTG level will be automatically eligible for the new “Platinum” benefit. More information will be available on the Health and Wellness website.
Accessing the newly covered benefits at the Osher Center for therapeutic yoga to treat back pain and insomnia will require a medical referral. Employees will pay a one-time $20 copay to participate in six weeks of treatment.
“Services like these are not usually covered by employee health insurance. However, we have established these services with the Osher Center based on employee interest and published medical evidence that yoga helps improve these conditions,” Nordberg said.
“The beneficial effects of yoga has been accumulating for a number of medical conditions. Our employees will be able to supplement the care they receive for established low back pain and insomnia through a personalized yoga program offered at Osher. We are pleased to offer a safe and effective addition to the management of these two conditions,” said Tom Elasy, M.D., MPH, Ann and Roscoe R. Robinson Professor of Clinical Research at the Diabetes Center and director of the Division of General Medicine and Public Health.
The popular option for staff to roll over up to 40 hours of unused PTO to banked sick time was approved for each of the next three fiscal years — 2018, 2019 and 2020 — with a cap added for the total number of sick hours to be 160 hours. If you currently have more than 160 hours in your sick bank, you will be able to keep those hours but not add any additional hours to it.
“We recognize the strong interest in knowing in advance about sick time rollover and the desire for staff to plan ahead to have a sufficient amount of sick time banked to be able to cover the waiting period for any short-term disability use or other unexpected sick time need,” Nordberg said. “However, we also have to be responsive to financial requirements that obligate us to limit the number of hours overall and ensure it is used for incidental time off due to illness.”
This year’s new options are in response to ideas submitted through the Employee Suggestion Box, the Medical Staff Advisory Council, a comparative survey of local market benefit offerings and through IdeaShare, the crowd-sourcing campaign held earlier this year where Medical Center employees submitted ideas and then voted on favorites.
“Our people provided great feedback regarding health plan options and about benefits that matter most to them. In response, we have been able to evaluate and incorporate new plan offerings, including these new wellness options,” Nordberg said. “Each year as we seek ways to provide new offerings we are always working carefully to keep premiums as low as possible.”
As enhancements are made, it is important to know that VUMC is self-insured; meaning that after employee premiums, copays, deductibles and out-of-pocket expenses, the Medical Center pays the cost for employee health care out of its annual operating budget.
During fiscal year 2017 this expense was more than $150 million. While Aetna serves as a third-party administrator, processing the Medical Center’s health plan claims, decisions on coverage are entirely those of VUMC.
After monitoring increases in the health plan’s overall cost, employees will see smaller premium increases in the Aetna Plus and Aetna HealthFund options, while those choosing the Aetna Select plan will see slightly higher increases. The change to monthly premiums will range from a $2 increase for single coverage for those earning less than $50,000 to up to $31 for family coverage for those earning in the highest income range.
A new dental option will be added in 2018 with Delta Dental joining the lineup with Blue Cross Blue Shield and Cigna. As a three-year contract cycle ended with Superior Vision, new rates were negotiated with just a small increase, starting at 25 cents per month for individual coverage and up to 72 cents per month for family coverage.
Employees will still be able to receive the best prices on prescription medications through Vanderbilt’s Pharmacies but an agreement will be in place for 2018 where medications can be purchased from Walgreens Pharmacies at Tier II pricing.
In an effort to limit use of the emergency department for non-emergency conditions, copays for emergency department visits will increase from $115 to $125.
Instead, for non-emergent care, employees are encouraged to use the free Express Care Clinic and Occupational Health Clinic on campus, as well as the growing number of Vanderbilt Health Walk-In Clinics located in Davidson and Williamson Counties. VUMC has also partnered with Walgreens to launch Vanderbilt Health Clinics at Walgreens, which are scheduled to open beginning Nov. 13. These clinics will offer employees an additional option through 14 convenient locations across Middle Tennessee.
To help employees understand that less expensive alternatives to Emergency Department care are almost always a better and less costly choice for non-emergency care, a new online resource will guide them through options about where to seek the appropriate level of care.
There is also a nurse triage line that can be called — 615-875-NRSE — for help with decisions about whether to seek care in an emergency department setting. And, a small rebate will be available for employees who consider other options before heading to the emergency department.
Additional benefits details for 2018 are:
• During Open Enrollment, if you aren’t making any benefit changes for the 2018 plan year, you won’t need to enroll.
• Those receiving the $20 tobacco-free credit for 2017 will automatically receive the credit for 2018.
• If the spouse coverage fee of $100 per month was paid in 2017, the same monthly fee will be charged in 2018.
• Staff can make changes to life insurance, long-term and short-term disability and retirement accounts at any time outside of Open Enrollment.
John Howser, (615) 322-4747