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UT Dallas - Human Resources Management

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Annual Enrollment 2009

There are a number of plan changes for the 2009-2010 plan year. Please take a minute to review the changes below:

UT Select Medical for Full-Time Employees (Blue Cross and Blue Shield of Texas)
Coverage Level New Monthly Out-of-Pocket Premiums
Employee/Retiree Only $0.00 (No Change)
Employee/Retiree & Spouse $169.23 ($10.37 increase)
Employee/Retiree & Children $177.00 ($10.85 increase)
Employee/Retiree & Family $333.28 ($20.43 increase)
Other Plan Changes
Family Care Physician Office Visit Copayment $30 ($5 increase)
Specialist Office Visit Copayment $35 ($5 increase)

UT Select Medical for Part-Time Employees (Blue Cross and Blue Shield of Texas)
Coverage Level New Monthly Out-of-Pocket Premiums
Employee Only $196.54 ($11.98 increase)
Employee & Spouse $468.80 ($28.67 increase)
Employee & Children $439.45 ($26.87 increase)
Employee & Family $699.37 ($42.80 increase)
Other Plan Changes
Family Care Physician Office Visit Copayment $30 ($5 increase)
Specialist Office Visit Copayment $35 ($5 increase)

UT Select Prescription Drug (Medco Health Solutions)

Annual Deductible $100/person/plan year ($50 increase)
Retail Prescription Copayments

Generic: $10 (No Change)
Preferred: $35 ($5 increase)
Non-Preferred: $50 ($5 increase)

Mail Order Prescription Copayments Generic: $20 (No Change)
Preferred: $87.50 ($12.50 increase)
Non-Preferred: $125 ($12.50 increase)
Other Plan Changes
Medications are being added to the Medco Step Therapy Program as well as to the list of medications requiring authorization prior to initial prescription, medications requiring authorization to obtain additional supplies, and medications requiring authorization based on patient drug history. See the online UT Benefits Handbook or contact Medco for details.

UT Select Dental (Delta Dental)

Coverage Level New Monthly Out-of-Pocket Premiums
Employee/Retiree Only $29.96 ($1.70 increase)
Employee/Retiree & Spouse $56.87 ($3.22 increase)
Employee/Retiree & Children $62.69 (3.55 increase)
Employee/Retiree & Family $89.14 ($5.05 increase)

Vision (Superior Vision)

Coverage Level New Monthly Out-of-Pocket Premiums
Employee/Retiree Only $6.80 ($0.56 decrease)
Employee/Retiree & Spouse $10.76 ($0.72 decrease)
Employee/Retiree & Children $10.96 ($0.78 decrease)
Employee/Retiree & Family $17.40 ($1.50 decrease)
Other Plan Changes
A Contact Lens Fitting Exam is now covered in-network for a separate $35 copayment

Short-Term Disability (Fort Dearborn Life) - New Carrier!

Coverage Level New Monthly Out-of-Pocket Premium
Employee Only

$0.267 per $100 of monthly earnings
(47% decrease)

Other Plan Changes
Elimination period now 14 days (Formerly 30 days)
The new plan administrator is Fort Dearborn Life. Evidence of Insurability(EOI) will not be required for employees to enroll in STD coverage during this 2009 Annual Enrollment or following any qualified Change in Status event during the plan year.

Long-Term Disability (Fort Dearborn Life) - New Carrier!

Coverage Level New Monthly Out-of-Pocket Premium
Employee Only

$0.397 per $100 of monthly earnings
(3% decrease)

Other Plan Changes
The new plan administrator is Fort Dearborn Life. Evidence of Insurability(EOI) will not be required for employees to enroll in LTD coverage during this 2009 Annual Enrollment or following any qualified Change in Status event during the plan year.

Long-Term Care (CNA)

Note: This 2009 Annual Enrollment period, CNA is offering a "buy-up" opportunity. If you are currently enrolled in the Guaranteed Benefit Increase Option, you will be receiving a notice from CNA explaining that you have an opportunity to "buy-up" to a higher level of coverage and informing you whether or EOI is required. Your premium for any additional benefit elected will be based on your age as of September 1, 2009. Please contact CNA if you have any questions.