Are you ready for the EUTF Healthcare Open Enrollment Period?
The Hawaii Employer-Union Health Benefits Trust Fund, more commonly known as the EUTF, provides medical, chiropractic, prescription drug, dental, vision and life insurance benefits to all eligible State of Hawaii, City and County employees and retirees. Each year the EUTF holds an open enrollment period allowing for employees to modify their plan enrollments.
The open enrollment period for EUTF health plans will be Monday, April 3, 2017 through Friday, May 12, 2017.
The HSTA suggests that members take some of their spring break time to assess their current plan enrollment(s) and the health plans available. It is in every member’s best interest to analyze the health plans available and decide which plan(s) best meet member and their family’s health care needs, taking cost and coverage into consideration. You are not required to do anything if you wish to remain with your current plan.
Click here for more information: http://eutf.hawaii.gov/active/active-open-enrollment-2017/
EUTF and Health Benefits FAQs
What is open enrollment?
Open enrollment is a period of time where you may do any of the following without having to experience a “qualifying event”: enroll in a plan, change from one plan to another, cancel a plan, add or drop a dependent, change tiers (self to family, two-party to self, etc.). Open enrollment is a time period when you should analyze the health plans available to you and your family and decide which will best suit your needs when taking cost and coverage into consideration. You are not required to do anything if you wish to remain with your current plan.
What are the dates for the 2017 open enrollment?
Monday, April 3, 2017 through Friday, May 12, 2017.
What is a “qualifying event”?
A “qualifying event” allows you to make changes to your health plan outside of the open enrollment window. Common events include: acquisition of alternative coverage, birth of newborn, court order to cover child, death, divorce or termination of domestic partnership, guardianship decree, legal separation, leave of absence without pay for more than 30 days, loss of alternative coverage, marriage, newly eligible or ineligible full time student aged 19 through 23, new hire, new domestic or civil union partner.
What are the new rates and when do they go into effect?
The new rates go into effect on July 1, 2017. Coverage dates are from Saturday, July 1, 2017 through to Saturday, June 30, 2018. Premium deduction amounts will come from paychecks starting Thursday, July 20, 2017 through to Thursday, July 5, 2018. The rates can be found in the links below.
EUTF (Employer-Union Health Benefits Trust Fund): https://eutf.hawaii.gov/wp-content/uploads/2017/03/Active-Rates-for-Reference-Guide-Effective-July-1-2017-All-BU-except-05-07-12-s.pdf
What is the difference between EUTF and HSTA VB plans?
In 2010, the state Legislature opted to sunset the ability of all public unions to manage healthcare plans for their members. This resulted in the elimination of HSTA VEBA (Voluntary Employees Beneficiary Association) Trust health plans. The elimination of HSTA VEBA Trust plans was supposed to save the state money by consolidating HSTA members (with lower health care utilization rates) with all other state employees into the already existing EUTF. The state was sued over this move. In late 2010, Circuit Court Judge Karl Sakamoto ruled in Kono v. Lingle that the EUTF needed to offer those covered under HSTA VEBA plans with EUTF plans that had the “same level of coverage.” These plans are now listed as HSTA VB plans under the EUTF and are limited only to those who were in HSTA VEBA Trust plans at the time of the change to EUTF.
NOTE: HSTA VB plans are managed by EUTF and are not controlled by HSTA in any way.
Who can enroll in HSTA VB plans?
Only those currently under an HSTA VB plan may enroll in an HSTA VB plan. All others must enroll in EUTF plans. Those electing to switch from an HSTA VB plan to an EUTF may never return to an HSTA VB plan. Simultaneously being enrolled in an EUTF plan and an HSTA VB Plan is not allowed.
How are the EUTF premium rates determined?
The EUTF Board of Trustees, made up of five employer representatives and five employee representatives, is tasked with designing health benefit plans that are in compliance with federal and state regulations and then negotiating/determining premium levels with insurance carriers and pharmacy benefit managers to provide those services. Bargaining units can negotiate the employer/employee contributions toward the EUTF negotiated premiums, but not the actual premium rates.
Will the rates change under a new contract?
The rates themselves will not change, but the employer/employee contribution levels might change pending the outcome of the negotiations process. There is no guarantee, however, that negotiations will conclude prior to the end of the open enrollment window on April 28, 2017. If no agreement is reached, the employer will continue to fund health plans at current levels. As announced at Institute days in February, the employer is also proposing to fund health plans at the current levels.
Please refer to the handouts provided at Institute and emailed in a negotiations update on February 23 to see just how much more employees will have to pay to remain on most plans.
What types of things should I take into consideration when selecting my plan?
While HSTA can’t provide members specific advice on which plan to select, we do recommend that you take some basic things into consideration when selecting the plan which will best suit you and your family needs.
There are generally three areas you should analyze and review when selecting a plan.
1. What does the plan cover?
Information on EUTF plan coverage can be found starting on page 25 of the EUTF Health Benefits Reference Guide https://eutf.hawaii.gov/wp-content/uploads/2017/03/EUTFActiveReferenceGuide-s.pdf
2. How much will the plan cost? This includes both your share of the monthly premium and your out-of-pocket expenses when you receive medical care, such as co-pays.
3. Are the hospitals, doctors and specialists you want included in the network of the plan?
What is meant by 75/25, 80/20, and 90/10 PPO (Preferred Provider Organization) and HMO Plans?
For PPOs, the first number, very generally, is the percentage of eligible charges covered by the medical provider and the second number is the percentage covered by the patient (up to specified maximums and with caveats). Plans where the service provider pays a larger percentage will generally be priced at a higher premium rate.
For HMOs, members must utilize the providers and facilities associated with the medical provider. There are also generally no deductibles or claim forms and the patient pays a standardized co-pay.
The EUTF Health Benefits Reference Guide contains a more comprehensive explanation of all the different plan types starting on page 23 https://eutf.hawaii.gov/wp-content/uploads/2017/03/EUTFActiveReferenceGuide-s.pdf
Why are the rates for the EUTF HMSA PPO 75/25 plan cheaper next year?
Over the years, there have been more employee and dependent premiums collected than claim reimbursement dispersals being made to providers (those who pay for the plan don’t use their plan resulting in low utilization rates). Should utilization rates increase for this plan, premiums will likely increase for the following coverage year.
What plan(s) am I currently on?
What do I need to do if I want to make a change?
Complete an EC-1 form for EUTF plan subscribers or an EC-1H form for HSTA VB plan subscribers and mail it to the EUTF. The 04/2017 revision of the forms as fillable pdfs have not yet been loaded onto the EUTF website, but are available at the end of the Health Benefits Reference Guide via the link below and should be available in hardcopy format from your worksite soon.
Who can I contact if I have questions?
Informational sessions throughout the state and webinars are being held beginning March 30 and throughout the month of April. A DOE memo will usually go out on the first day of open enrollment stating that the superintendent has approved “Department of Education (DOE) employees’ use of up to two hours of work time, including travel time to attend, or one and one-half hours to view a webinar, as long as it does not disrupt normal school/office operations and is approved by the supervisor. Informational sessions are approximately one and one-half hours long.”
Where can I find more information?