The open season that began on Nov. 21 allows retirees and beneficiaries to change plan coverage [moving from single to couple or family coverage], switch to low-option plan or combination of both.
In his memorandum to retirees and beneficiaries, Fund administrator Richard S. Villagomez said, “GHLI now offers members a choice between a High Option and a Low Option plan.”
According to Villagomez, only those who wish to switch to low-option plan must fill out and return an Enrollment/Waiver/Change Request form no later than Friday this week.
Otherwise, those who would fail to file this form and make the necessary changes to their subscription will be assessed the high option plan.
Under the high option plan, Aetna pays 80 percent while eligible subscriber pays 20 percent.
The low option plan makes Aetna pay 70 percent while subscriber pays 30 percent.
According to the rate sheet, if a subscriber opts to stay in the high option plan, the Fund pays $109.34 in premium for single plan; $224.14, couple not including domestic partner; $109.34, couple including domestic partner; $349.87, family but domestic partner not included; and $240.53, for family coverage including domestic partner.
The retiree’s share will be $109.34, single plan; $224.14, couple not including domestic partner; $338.94, couple with domestic partner; $349.87, family coverage with no domestic partner; $222.51, family with domestic partner.
Should the subscribers decide to take a low-option plan, the Fund pays $101.14 per pay period for single plan; $207.34, couple not including domestic partner; $101.14, couple including domestic partner; $323.65, family but domestic partner not included; and $222.51, for family coverage including domestic partner.
Under the low-option plan, retirees pay $101.14, $207.34, $313.54, $323.65, and $424.79 for the above-mentioned plan types.
Fund legal counsel Carolyn Kern reported to the trustees that the Fund spent $6.9 million on retirees’ premiums in the last fiscal year.
With the new contract taking effect on Jan. 1, Kern said the Fund expects to pay about $8 million.
Although the new contract carries with it an 18 percent price tag increase, the plan promises an extended coverage for both enrollee and beneficiary.
The contract touts a no annual maximum as opposed to the prevailing cap of $200,000.
It also removes the lifetime plan maximum ceiling of $1 million.
Dependents covered include those up to 26 years old regardless if he or she is a student, resides with enrollee or is married.
The new plan also covers 100 percent in preventive care services when previously it was only 80 percent.
These services include routine adult physical once a year, gynecological examinations (with one exam and pap smear per calendar year), hearing and eye exams (once in two years), mammography with unlimited visits per year, colorectal cancer screenings.
It also covers newborn testing and monitoring, routine well baby and child exams, immunizations.
For males over the age of 40, the plan covers PSA (Prostate Specific Antigen) / Digital Rectal Exam tests.
In his Dec. 7 memorandum, Villagomez wrote, “Enrollments and changes selected during Open Season shall take effect January 1, 2012, if the request is approved.”
He also said that deductions will begin on the benefit payment scheduled for Jan. 15.
For a copy of the form, please contract the Fund at 322-3863, log on to www.nmiretirement.com.
