Through your Connecticut healthcare benefits, you can now compare costs for medical services and earn cash rewards for being a “smart shopper.”
Register by visiting VitalsSmartShopper.com or call 1.844.328.1579. When your doctor recommends a medical procedure (i.e., colonoscopy, mammogram, surgery), visit the website or call to search for a high quality, lower cost option in your area. You can verify the amount of the cash reward and 4-6 weeks after the procedure, you will receive a check in the mail.
This program allows you to be informed about the costs of your procedures and you benefit from the savings if you make a more cost-effective choice.
ebenson September 20th, 2018
Posted In: Healthcare, SEBAC
As part of the 2017 SEBAC Agreement, some changes were made to healthcare to save money for the State while continuing to provide a high level of care for our members.
What were the changes?
- Tiered Provider Networks (Preferred Providers) waive the current $15 co-pay for primary care providers and specialists who have been found to provide high quality, cost-effective care.
- For the Smart Shopper Program, there are currently 9 medical procedures (Colonoscopy, Hip Replacement, Knee Surgery, Spinal Surgery (spinal fusion anterior/posterior), Shoulder Surgery (arthroscopy), Sigmoidoscopy,
Hysterectomy/Hysteroscopy, and Upper GI) for which rebates will be made available to members based on data showing these procedures are provided in a way that is cost-effective and reduces secondary risks like hospital readmission, hospital-acquired infection, etc.
- Site of Service is the name for the new network structure for outpatient laboratory services and diagnostic imaging (blood work, urine tests, stool tests, x-rays, MRIs, CT scans, etc.). Plan data has shown tremendous variation in the amount the Plan is charged for outpatient diagnostic tests such as blood tests, MRI, and CAT scans, even though the reading of those results is by the same doctors. To encourage the use of the reasonably priced labs, about 60% of labs and imaging centers will be designated preferred labs and will continue to be 100% covered by the Plan.
These changes are starting to be implemented, so below please find links to Preferred Providers, Site of Service, & Smart Shopper for your insurance:
(there is also a link to a provider lookup tool within this link as well as a listing of all tier 1 providers and preferred site of service facilities)
- United (Look for a “Preferred”/Tier 1 provider by clicking the Local (Tri-State) Network Provider Search link, and then click on “Find a Physician or Facility.” In your search results, look for 2 full blue hearts.)
- Site of Service
ebenson October 26th, 2017
Posted In: Healthcare, SEBAC
As part of the SEBAC Agreement, as of Oct. 1, 2017, some changes have been implemented to the state’s available health plans.
- Avoid costs for lab work and imaging services in Connecticut: Pay nothing when you see an in-network preferred provider for outpatient lab work, diagnostic x-rays and/or high-cost imaging services like MRIs, CT and PET scans. For tests performed at Non-Preferred in-network labs or imaging centers, you’ll pay 20% of the cost. If you are in the POS Plan, you’ll pay 40% of the cost for out-of-network tests. To find a Preferred provider, visit www.Athem.com/statect or www.welcometouhc.com/stateofct.
- Avoid costs for primary care physicians and certain specialists in Connecticut. Pay nothing when you see an in-network preferred primary care physician (PCP) or specialist for one or more of ten medical specialties (including OB/GYN, cardiology, gastroenterology). The current $15 copay will be waived when you see a State of Connecticut “preferred provider.” To find a Preferred Provider, visit www.Anthem.com/statect or www.oxhp.com/stateofct.
- The list of covered drugs – or “formulary” – for the prescription drug plan will change. If one or more of your current prescriptions will be affected by this change, you should have received a letter from CVS/Caremark in September with information on how to switch to a therapeutically equivalent drug.
- Prescription drug tiers for non-HEP drugs. The current generic drug copay will be split into two tiers: Preferred generic and Non-Preferred generic. New copays: Preferred generic: $5; Non-Preferred generic: $10; Preferred brand name: $25; Non-Preferred brand name: $40; no change to HEP copays.
- Emergency Room Copay for non-emergencies will cost $250. In certain circumstances, including actual emergencies or you’re admitted to the hospital, your copay will be waived. Find the ER Copay Waiver Form here.
ebenson October 12th, 2017
Posted In: Healthcare, SEBAC
Hello and welcome to the Spring Semester! I hope you were fortunate enough to have your class run. Last semester, one of my courses was canceled due to low enrollment. It looked like that would happen again this spring, but the night class filled at the last minute. Whew!
I teach computer graphics at Tunxis. I’ve been teaching since 2006. Back then, I was married and not as dependent on my teaching income. My graphic design business was thriving and my husband worked. Now that I’m divorced, it’s different. I am well aware what it’s like to have half your income disappear. It’s a sick feeling. Losing income as well as contributions to your retirement plan is scary. Especially when you’re over 60.
Add the burden of purchasing health insurance as an individual over 60. That is something many of our full time colleagues haven’t thought about. When married, I didn’t give it much thought either. My former husband worked for the State and I enjoyed exceptional health coverage with little thought to those who didn’t.
Since the divorce, I’ve been on COBRA paying $978 per month for BCBS through the state. Last semester, my take home pay for one course was $1100/month. Guess where my adjunct income went? Good thing I had savings, freelance work, and a weekly yoga class to teach.
Knowing COBRA ends March 1st, I looked for health coverage during open enrollment. And I learned the Affordable Care Act is not very affordable!Premiums for plans with $5000 – $10,000 deductibles (and 80/20 co-pays) were over $700 per month. What an eye opening experience! Looking at all the available plans made me wonder if purchasing insurance through Tunxis would be a better deal. So I contacted the college. Maria Drwiega in payroll was very helpful and provided info on plans and costs. The BCBS POE coverage I had on COBRA would cost about the same as the high deductible polices on the open market – but without the high deductibles! My monthly insurance cost will be about $730 per month. Premiums are not deducted from pay, but paid by the employee. I will have to go on COBRA between semesters at a slightly higher cost. But keeping the same insurance is worth it.
So fellow adjuncts – if you find yourself needing health insurance, do yourself a favor and contact your college. As adjuncts, we are entitled to purchase group health insurance through the state. And parents, you can also insure your dependents. When you compare what you get as a state employee to what an individual can purchase on the open market, it’s a no brainer! (In my opinion.)
For many, 2016 was a tough year. I’m not one for whining and complaining. I believe in taking action. I hope you will get involved this year and support your union. We need your input and action more than ever before.
Try to attend Higher Ed day
at the State Capitol this Thursday, January 26.
Many colleges are sponsoring buses. There will be a rally at noon with other events throughout the day. Click here for more info.
There’s no better time than now to make your choices heard! Make it a great semester and be the change you wish to see.
4Cs VP Part Timers
ebenson January 23rd, 2017
Posted In: Healthcare, Part-Timers