Changes are coming to Rice medical benefits

Open enrollment will be April 7-25

During this year’s benefits open enrollment, which runs April 7-25, employees will have four medical plans to choose from. Two will be tried-and-true favorites — the Aetna HMO and the Aetna Choice POS II — and two will be new plans that modify the PPO and offer a lower-cost alternative to the HMO plan. The Catastrophic plan is being eliminated because it is not compliant with the Affordable Care Act, and it has very low enrollment.

“Rice has had the same set of health plans for the past 11 years, and those plans have served us well; however, with all the changes happening in health care both nationally and local, we decided to review our options to determine what will work for Rice for the next five to 10 years,” said Elaine Britt, assistant vice president and director of benefits and compensation in Human Resources.

Among the new offerings are another lower-cost health insurance plan and a new, increased level of customer service from Aetna via its concierge customer service. Rice will continue to pay for between 62 and 84 percent of the plan premiums, depending on the level of coverage you choose.

The health insurance options for the 2014-2015 plan year, which begins July 1, are:

Memorial Hermann Accountable Care Organization (ACO)

The ACO offers comprehensive HMO-style benefits with a lower premium than Rice’s HMO plan. The network is limited to the Memorial Hermann system in the Houston area and, outside of the Houston area, covers only emergencies. MD Anderson Cancer Center, St. Luke’s Episcopal Hospital, the Methodist Hospital and Baylor College of Medicine are not available through the ACO plan.

Aetna HMO

The HMO is the same plan as currently offered but with slight copay changes. The plan is expanding to a national service area, which means employees enrolled in this plan can elect the HMO anywhere in the U.S. where Aetna HMO doctors are. This plan is still a traditional HMO, where the employee selects a primary care physician (PCP) and referrals from the PCP are required to access a specialist physician or service.

Aetna Choice POS II (Open Access)

The POS is the same POS plan as currently offered but with a few adjustments to copayments and a new, broader network of service providers. This plan is built on the HMO model but does not require a primary care physician or referrals to see specialists — that is, it is “open access.”

High Deductible Health Plan (HDHP)

The HDHP is similar to the current PPO plan but with higher deductibles ($1,750 for individuals/$5,250 for families) and with coinsurance — rather than copayments — for physician services. The network of providers is the same as offered by the Aetna Choice POS II plan. With a HDHP, employees can also elect a health savings account, or HSA, to help fund the higher deductible. The increase in deductible and plan design changes allow the plan premiums to drop 21.1 percent below the current PPO premiums, making the plan much more affordable.

“The HSA feature is a real selling point for the HDHP,” Britt said. The HSA allows additional pre-tax deductions over the current medical spending account, and is not a “use it or lose it” plan. However, you cannot be enrolled in other medical coverage besides the HDHP to be eligible for the HSA, including Medicare.

The two new plans will be lower in cost than the plans they are replacing; however, as in past years, the premiums on the HMO and POS are increasing by 6.8 percent.

“Our own medical claims expenses drive the cost up — all of us pay for the health care that each individual uses,” Britt said. Spending on prescription drugs, frequency of doctor visits, high-tech treatments and use of the emergency room rather than an urgent care clinic affects the premium costs to all Rice employees who participate in our health plans, she said.

The co-payment for prescriptions will see a slight increase across all plans and coverage will still be through Envision Rx and Orchard Pharmaceutical for mail order.

One other change to employees will see will be to the dental plan, which will be through Aetna, rather than United Concordia. The plan design is the same, but rates will be slightly lower.

Employees can learn more about Rice benefits and open enrollment at Information sessions will be held over the next several weeks at locations across campus:

Kyle Morrow Room

March 25, 10-11 a.m.

March 26, noon-1 p.m.

March 27, noon-1 p.m.

FE&P Training Room

April 1, 9:30-10:30 a.m. (Spanish)

April 3, 3-4 p.m. (Spanish)

Housing & Dining West Servery

April 1, 2-3 p.m. (Spanish)

Housing & Dining Seibel Servery

April 9, 2-3 p.m. (Spanish)

McMurtry Auditorium in Duncan Hall

April 3, 9-10 a.m.

April 15, 2-3 p.m.

April 16, noon-1 p.m.

Police Department Training Room

April 9, noon-1 p.m.

BioScience Research Collaborative, Room 282

April 10, noon-1 p.m.

Rice Fest, the annual showcase of benefit providers during the open enrollment period and educate faculty and staff about benefits, will be from 11 a.m. to 3 p.m. April 8 in Rice Memorial Center’s Grand Hall.

Faculty and staff must complete their benefits enrollment online via Esther by 11:59 p.m. Friday, April 25. This is a hard and fast deadline, so there will be no extensions or grace periods.

This is a great opportunity for employees to really evaluate their own healthcare needs, the plans available, and make a choice that is appropriate for them.  Employees who miss the April 25 deadline for open enrollment will automatically be re-enrolled in their current plan (or will be mapped to a new plan if their plan is eliminated); however, renewing contributions to a flexible spending account is not automatic. Employees must re-enroll each year to set their medical spending and dependent-care spending account contribution, even if they are currently enrolled in the plan. The account is reset to zero each year unless employees actively re-enroll through Esther.

Human Resources representatives will be at RiceFest to answer questions about open enrollment. Employees can also contact benefits representatives at or 713-348-2363.

About Jennifer Evans

Jennifer Evans is a senior editor in the Rice's Office of Public Affairs.