Two new health insurance choices will be available to faculty, staff and retirees during this year’s Open Enrollment period, October 18 - 29.  The addition of the new plans is a result of the recommendation last year by the Committee on Health Insurance Premium Design (CHIPD) to investigate additional options for portable, comprehensive plans.

Two preferred provider organizations (PPOs) are being added to the mix of U-M medical plans.  M-CARE PPO PLUS and the Blue Cross Blue Shield of Michigan’s Community Blue PPO will be offered, with coverage effective on January 1, 2005.

PPOs generally are known for their flexibility, allowing plan members to seek care from both in- and out-of-network physicians without referrals.  Both M-CARE PPO PLUS and Community Blue PPO offer access to nationwide networks of providers at in-network coverage levels, which translate to lower out-of-pocket expense.  Members determine which type of doctor to visit – general practitioner or specialist – and pay the copay for services each time they seek care. Emergency care is covered worldwide, as it is with all U-M medical insurance plans.

“The Benefits Office has actively pursued new plan options since CHIPD issued its recommendations in late 2003,” says Marty Eichstadt, director of benefits.  “Recommendations about the specific plans offered by the University were not part of the committee’s work, but an important concern about the portability of plans for those who leave the area or live beyond the limits of HMO service areas was raised by the U-M community during the process of announcing the committee’s recommendations.”

Although the University already offers a completely portable, comprehensive plan – the Blue Cross Blue Shield of Michigan/United of Omaha traditional fee-for-service plan – its cost is significant to both the employee and the organization, particularly for dependent coverage, she says.  “The University’s executive officers asked that Human Resources & Affirmative Action investigate new portable medical insurance options. Since that time, we have been researching and negotiating new plan designs to meet the need,” explains Eichstadt.  “These new plans are the result of that process, and they offer access to two different provider networks at a cost to employees that is significantly less than the Blue Cross Blue Shield of Michigan traditional plan.”

Laurita Thomas, associate vice president and chief human resource officer, notes that the University community has expressed a desire for greater choice of plans that offer nationwide provider networks, and both of these new PPOs offer such access. She also emphasizes that the University ultimately will have to make some choices about which plans best meet the needs of faculty, staff and retirees while being cost-effective for both the university and for employees.

“With these additions, active employees will choose their 2005 coverage from among eight comprehensive medical insurance plans, with the GradCare plan also available for eligible graduate students. We will be following closely the enrollment patterns during the coming year, in order to help us make decisions about the number and types of plans that make the best long-term mix for our community going forward,” says Thomas.