June> Special ANNUAL ENROLLMENT Edition for UT System Retirees >2012-2013 AE Benefits Overview

2012-2013 Annual Enrollment Benefits Overview

The 2012-2013 Annual Enrollment Benefits Overview table allows you to quickly view your insurance plan options and to easily see if there are changes to the premium rates and learn what is new within each of the plans. Additional information is included in the last column to highlight details such as evidence of insurability requirements and a brief description of the tobacco premium program.

Insurance Plan Premium Rates Plan Changes Additional Information
UT SELECT Medical (BCBSTX) and Prescription Drug Plan (Medco) Slight increase for dependent coverage No changes to copayments, deductibles, or out-of-pocket maximums No EOI required
New! Medical Tobacco Premium Program New monthly cost billed with UT SELECT Medical premium Applies to tobacco user(s) enrolled in the UT SELECT Medical plan New cost based on three categories: Member $30 per month, Spouse $30 per month, and Child(ren) $30 per month. Maximum of $90 per family per month for three or more tobacco users.
UT SELECT Dental
(Delta Dental)		 No changes New benefit for night guard Ideal for standard dental care needs
New! UT SELECT Dental Plus
(Delta Dental)		 New rates Higher annual benefit maximum than UT SELECT Dental standard plan Coordinates with UT SELECT Dental
Delta Dental HMO
(Delta Dental)		 Reduced rates Expanded coverage area, new provider network, simplified fee schedule New Dental HMO vendor
Vision
(Superior Vision)		 No changes No changes Ideal for standard vision care needs
New! Vision Plus
(Superior Vision)		 New rates Expanded benefits for lens options Higher allowances than standard vision plan for frames, contacts, and progressive lenses
Long Term Care (CNA) No changes

No changes

EOI required, must be submitted directly through CNA
Voluntary Group Term Life (Dearborn National) No changes No changes EOI required