INDIANAPOLIS – In response to the Affordable Care Act and in an effort to keep costs under control, HealthFlex will be making changes to the Indiana Conference Health Plan (PPO) for Active Clergy and employees for 2013. A review of these changes follows.
Flexible Spending Accounts
As a result of the Affordable Care Act the maximum amount that can be elected for a Flexible Spending Account for 2013 is $2,500. Participants will elect this amount with his or her church or employer on the Clergy Compensation Worksheet and again online during HealthFlex Open Enrollment in November.
Medical Plan Changes (PPO)
The co-pay for emergency room for 2013 will be raised from $100 to $200. The co-pay for office visits will go from $15 to $30 and from $40 to $50 for specialist visits. The maximum out-of-pocket for the PPO Medical Plan will go from $2,500 to $3,000 for individuals and from $5,000 to $6,000 for families.
Consumer Driven Health Plan (CDHP)
There are no changes to the CDHP plan for 2013. Rates will go up slightly. The CDHP continues to be the low cost plan for participants. Information on this plan with a rate chart are available online at www.inumc.org/benefits. Click on 2013 Health Premium Rates.
Pharmacy Plan Changes (PPO)
The biggest change is with the co-pays for the conference pharmacy plan. Both retail and mailorder pharmacy co-pays will change in 2013 for the PPO plan. All co-pays for the CDHP program will remain the same as 2012.
For a 30-day supply, the active PPO retail pharmacy co-pay for generics will go to $12; preferred brand drugs (Tier 1) co-pay will go to 20 percent of actual cost with a $15 minimum and a $45 maximum; and non-preferred brand drugs (Tier 2) co-pay will go to 25 percent of actual cost with a $30 minimum and a $90 maximum.
For a 90-day supply, the active PPO mailorder pharmacy co-pay for generics will go to $20; preferred brand drugs (Tier 1) co-pay will go to 20 percent of actual cost with a $40 minimum and a $120 maximum; and non-preferred brand drugs (Tier 2) co-pay will go to 25 percent of actual cost with a $75 minimum and a $225 maximum.
In addition, the annual out-of-pocket maximum that a participant will pay for pharmacy will be raised by $1,000 to $2,000 per person and from $2,000 to $4,000 per family.
Information on Rx Benefits Rates are available online at www.inumc.org/benefits. Click on 2013 Rx Rates.
The rates for 2013 will increase by two percent and also are available on the Indiana Conference website at www.inumc.org/benefits. Indiana Conference Benefits office also has a voice-over slide show on the Indiana Conference website (www.inumc.org) on the Administration/Benefits page, which walks through these changes.