- May 2010 > Insurance Insights
As posted in the March 2010 “A Matter of Health” newsletter, the Fully-Insured Life and Accidental Death and Dismemberment (AD&D) Insurance Plan and the UTFLEX Flexible Spending Accounts for Medical and Dependent Day Care Plans were submitted for competitive bid to the Texas Marketplace. By state law, UT System’s Office of Employee Benefits is required to request competitive proposals for each insurance plan offered at least once every six years. This process ensures that vendors contracting with UT System offer plans and services that are competitive with the current marketplace and that UT System plan participants continue to receive the best possible benefits at the lowest possible overall cost.
A total of seven (7) companies submitted bids in response to the Request for Proposals for the Fully-Insured Life and AD&D Plan. Following an extensive review process, Dearborn National (formerly Fort Dearborn Life Insurance) has been selected to continue providing Life and AD&D insurance for UT System employees, retirees, and dependents. This means that the existing benefits and excellent service which members are already familiar with will continue seamlessly through the next several plan years. In addition, through the competitive bid process, the Office of Employee Benefits was able to lower the premium an average of 11.2% over the current rates, resulting in significant savings directly to participants.
For the UT FLEX Flexible Spending Account Request for Proposals, PayFlex Systems USA, Inc. has been selected to continue administering the Flexible Spending Accounts for Medical and Dependent Day Care. The selection of PayFlex ensures no disruption to members currently enrolled in the UT FLEX program from one plan year to another, including the 10 weeks grace period from September 1, 2010 through November 15, 2010.
Overall, the Office of Employee Benefits is extremely pleased with the results of the competitive bid process and very glad to be able to offer value and savings to all participants enrolled in Life and AD&D and UT FLEX. Look for more details on these two plans during the upcoming Annual Enrollment period!
Subrogation: What it is and how it applies to you
A subrogation letter includes a questionnaire that Blue Cross and Blue Shield of Texas (BCBSTX), a Division of Health Care Service Corporation (HCSC), sometimes sends to members because of a recent claim.
BCBSTX’s Corporate Reimbursement/Subrogation department regularly checks UT SELECT claims to find out if another health plan might be primarily responsible for part of the claim. If diagnostic or treatment codes, or dates from a claim suggest another plan might be liable, then BCBSTX will send a questionnaire to learn more. Your answers on the questionnaire help BCBSTX decide whether to investigate further. If it is determined that another party is responsible for full or partial payment of the claim, BCBSTX will try to recover the money. This process, where BCBSTX recovers the money from other responsible parties on your behalf, is called subrogation.
The claims review process – and the information provided in the questionnaires – saved the UT System $1.5 million for the 2008–2009 fiscal year. These savings help to keep your health benefits costs down. So if you get one of these letters, please fill it out and send it back in the envelope provided.
Frequently asked questions
Q: Why would I receive a subrogation letter?
A: BCBSTX’s Corporate Reimbursement/Subrogation department reviews claims every day. If a diagnostic code, treatment code or date suggests that a claim might need more investigation, the department flags the claim. If the claim is for $500 or more, or if several similar claims together add up to $500 or more, BCBSTX will send you a letter asking for more information.
Q: What happens if I don’t fill out and return the questionnaire?
A: If you complete the questionnaire and send it back, you should not receive any more letters for that claim. If you don’t send it in, you will receive more letters. Remember that the recovery process helps save the UT System money, which helps keep your health benefits costs down.
Q: When would another party be liable for my claim?
A: There are a number of different situations when another party is liable for payment. Some of the most common examples are when:
Introducing a new Debit Card Activity feature available for PayFlex CardTM users! Now you can view your card status, outstanding card transactions and provide your debit card receipts all in one place. With this new feature, you can keep your card active simply by uploading documentation online!
Here’s how it works:
After successfully logging into www.UTFLEX.com, you will see your Debit Card Activity on your Accounts screen. One of the following three messages will be displayed:
Scenario #1: Active PayFlex Card with no transactions requiring documentation.
Action Required: NONE
Scenario #2: Active PayFlex Card with transactions requiring documentation.
Action Required: You must provide documentation for all outstanding card transactions listed in order to keep your card active.
What to do next:
Scenario #3: Inactive PayFlex Card with transactions requiring documentation.
Action Required: You must take one of the actions displayed, in order to activate your card.
What to do next:
All fax coversheets and uploaded documentation will be archived under the Documents link of the participant website.
If you have a Benefits question, submit your question by replying to the “newsletter email” or by sending an email to firstname.lastname@example.org.
UT System Employee Benefits Web site: www.utsystem.edu/benefits/
UT System Retirement Programs Web site: www.utretirement.utsystem.edu
Your Local Benefits Office: http://www.utsystem.edu/benefits/contacts#1