Open enrollment is the one time of year when you can change your health or dental plan, enroll in dental coverage if you don't already have it, or add dependents to your coverage without a qualifying event such as marriage or a new child. It's also when 2012 rates and plan benefits are announced.
If you don't want to make any changes to your plan, then you'll automatically be enrolled in the 2012 version of your current plan.
Dental benefits aren't changing at all in 2012. Health benefits aren't changing significantly in 2012, but there will be some updates to help you save on out-of-pocket costs.
If you want to get dental insurance, and haven't been enrolled in it in the last 12 months, this is the one time of the year that you can add it. If you enroll in dental coverage, your December invoice will include both your dental and health rates. See the 2012 dental plans and rates.
There will be rate increases for 2012 health and dental coverage. Despite wide increases in health care premiums in New York State and nationally, our health plans will increase by an average of only 6%. Our dental plans will have even smaller increases: 2.5% for PPO plans and no increase for MDG plans.
2012 health rates:
Prescription drugs can be a huge out-of-pocket cost. That's why FIC used the power of the group to negotiate discounts on 90-day prescriptions purchased from Walgreens and Duane Reade. Instead of using mail-order for your 90-day prescriptions, you can now get them from these pharmacies for less.
Certain classes of prescription drugs will also be covered differently. On PPO 1 and PPO 2 plans, you'll pay a percentage of the full cost for most brand-name drugs up to a maximum amount per prescription. Overall, there's a good chance you'll pay less for your prescriptions in 2012.
Drugs on the formulary list (the list of preferred drugs) change on a regular basis and will be changing for January 2012.
Some services now need to be pre-certified. Pre-certifying helps to ensure that you'll know how your service will be covered so you won't be hit with unexpected out-of-pocket costs, and it ensures that your treatment meets national standards of care. The process for pre-certification and a complete list of services that need to be pre-certified can be found in each plan's Benefits Booklet.
In 2012, the following services will be added to the pre-certification list:
To better represent the plans, HD 5,000 will be renamed Value 1, and HD 10,000 will be renamed Value 2.
To help simplify the benefits for the Value 1 plan (previously called HD 5,000), the deductible has changed. Formerly, the deductible was $5,000, plus coinsurance on prescription drugs, up to a $5,950 out-of-pocket maximum. Now, there is just a flat $6,000 deductible for both medical services and prescription drugs together. After you reach the deductible, you won't pay anything else for covered medical services and prescriptions.