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November 13, 2015

Welcome to this edition of  HR & Benefit News. Always feel free to send us your  comments and questions.


IMPORTANT!
UT Benefits Billing for COBRA Coverage

On September 1, 2015 COBRA billing was transitioned away from our third party administrators to be managed internally by the UT Benefits Billing for COBRA Coverage team here at OEB. Important COBRA enrollment resources for this plan year can be found on the Systemwide HR Central SharePoint site in the following folder: Document Libraries / Insurance / COBRA.   

QUICK TIPS

  • The only valid enrollment form is the current 2015-16 COBRA Enrollment Form (available through the link listed above). Older forms are invalid and the outdated information causes confusion and significant delays in enrollment. Please delete, discard, or otherwise dispose of any prior COBRA enrollment forms that you have kept in either electronic or hard copy. Use only the 2015-2016 COBRA Enrollment Form for the remainder of this plan year. 

  • Subscriber information and other key details, including the coverage termination and COBRA effective dates, should be completed before providing any COBRA Enrollment Form to an individual experiencing a qualifying event. Providing blank forms or forms with incorrect information, such as listing the employee name and/or BID for a dependent who is aging out, causes confusion and can delay enrollment.

  • Under COBRA rules, and because continuation only makes sense in certain limited circumstances, there are specific criteria that must be met to continue participation in the Health Care Reimbursement Account (HCRA) upon leaving employment. You must confirm that an employee’s account balance meets the eligibility criteria before offering a COBRA enrollment form for UT FLEX.

  • For eligible participants, all COBRA Enrollment forms as well as initial premium payments and UT FLEX contributions must be submitted prior to the applicable deadlines to maintain access to the benefits

Stay tuned for a training session that will offer a few helpful tips about how to use SGELIG to gather details necessary for the completion of the COBRA Enrollment Form.

For additional information regarding COBRA requirements and other details, please review OEB Administrative Policy 250 .

Contact Information for UT Benefits Billing for COBRA Team: Email: utcobra@utsystem.edu Phone:  (844) 579-8683 Fax: (512) 852-3204 Mail:  Office of Employee Benefits UT Benefits Billing for COBRA Coverage 210 W. 6 th Street Suite B. 140E Austin, TX 78701 Online Payment Website: http://www.texas.gov/UTCOBRA 

 


 

DON’T FORGET! UT FLEX Deadlines for FY 2015 Accounts

UT FLEX Account Type
Deadline to Incur Expenses
Deadline to Submit Claims

Health Care Reimbursement Account (HCRA)

November 15, 2015

November 30, 2015

Dependent Day Care Reimbursement Account (DCRA)

August 31, 2015

November 30, 2015


Good to Know

REMINDER  UT Select Medical Appeals

Employees, dependents, and retirees have the right to appeal a determination, including claims and preauthorizations, made by BCBSTX regarding their UT SELECT Medical benefits. The formal appeal process is structured to provide the opportunity for a fair and comprehensive review of a UT SELECT participant’s specific situation.

An appeal may be filed by the participant or by a person authorized to act on their behalf. If the participant wishes to designate a representative for purposes of an appeal, completion of the Standard Authorization Form to Use or Disclose Protected Health Information (PHI) will be required. Important Note: Healthcare providers are exempt from the completion of the Standard Authorization PHI form. 

Below is a high-level overview of the appeal process.

Medical appeals process

Any time a claim or preauthorization is denied, the participant will receive notice of their appeal rights and the filing deadlines. For guidance and tips on submitting the first level appeal, participants should work directly with BCBSTX customer service. 

Should your office receive questions about step 2 in the appeal process, we’ve compiled a few tips that you may want to pass along to the participant about submitting appeals to OEB. As a reminder, due to privacy issues you should avoid sending appeal correspondence on behalf of your employees, retirees, and their dependents. The individual participant should initiate all appeal requests and correspondence with the appropriate office. Following the tips below will help participants avoid unnecessary delay in the appeal review process.

Tips for Submitting Second-level UT SELECT Medical Appeals to OEB:

  • Gather all required documents for the appeal process with OEB, including:
    • An appeal letter explaining the situation and what action you are requesting (e.g. an exception to allow benefits, a network exception, additional or higher level of benefits, etc.);
    • The Appeal Determination Letter from BCBSTX;
    • Related Explanation(s) of Benefits (EOBs);
    • Documentation from your healthcare provider(s) including any information relevant to the appeal; and
    • Any additional documents you want considered in support of the appeal request.
  • Clearly state your desired outcome in the Appeal Letter.
  • Since appeal documentation can be lengthy and complex, it is highly recommended that you send all information in a single package to avoid unnecessary delays or confusion.
  • You may submit your appeal package to OEB via mail, fax, or email: 
    • Mail:    Office of Employee Benefits               The University of Texas System               210 W. 6th Street, Suite B.140E               Austin, TX 78701
    • Fax: (512) 499-4620
    • Email:   benefits@utsystem.edu

For additional information regarding the appeals process please review the 2015-2016 UT SELECT Medical Guide or contact the OEB Benefits Team.

 


 

UPDATE  2015-2016 Retired Employee Associations by Institution

Below you will find contact information for the Retired Employee Associations by institution. The list is comprised of information available to our office at this time.  To add your institution’s Retiree organization to this list please share your information with Laura Garlock at lgarlock@utsystem.edu . All available information will be included in the upcoming Insurance Enrollment Guide for New Retirees.

UT Arlington
UT MD Anderson Cancer Center

RETIREES CLUB

Frank Gault, President gaultfs@sbcglobal.net

Roseanne Minyard, Secretary Minyard@uta.edu http://www.uta.edu/hr/retireesclub/

MD ANDERSON RETIREES ASSOCIATION

retirees@mdanderson.org http://www.mdanderson.org/about-us/for-employees/ employee-resources/retirees-association/index.html

UT Austin
UT Medical Branch at Galveston

RETIRED FACULTY-STAFF ASSOCIATION

Nancy Payne, RFSA President (512) 345-2010 nancypayne3805@gmail.com Carol Barrett, RFSA Coordinator (512) 471-8081 barrett@alumni.utexas.edu http://sites.utexas.edu/rfsa/

UTMB  RETIREE ASSOCIATION

(409)763-5615

jrprice@UTMB.EDU http://hr.utmb.edu/retirees/

UT Dallas
UT San Antonio

RETIREE ASSOCIATION

https://www.utdallas.edu/ra/ https://www.utdallas.edu/ra/contact.htm

RETIRED FACULTY ASSOCIATION

retiredfacultyassociation@utsa.edu http://provost.utsa.edu/rfa/

UT El Paso
UT Tyler

UTEP ALUMNI ASSOCIATION

Peter & Margaret de Wetter Center  (915) 747-8600 alumni@utep.edu http://alumni.utep.edu/page.aspx?pid=1249

RETIREES’ ASSOCIATION

https://www.uttyler.edu/ohr/retireesassociation.php

UT Health Science Center Houston
UT Health Science Center San Antonio

UT HOUSTON RETIREE ORGANIZATION http://www.uthro.org/

Cindi Adcock AdcockC@uthscsa.edu

 


NEW  Annual HIPAA Privacy Policy Review

Barbara Holthaus, Assistant General Counsel, System Administration Privacy Officer, and Systemwide Privacy Coordinator, facilitated the annual HIPAA Privacy Policy and Employee Responsibilities session for UT System on October 5, 2015. Thank you to those of you that joined in via the Zoom meeting. 

A video of the training is available on our Systemwide OEB SharePoint site. This an internal training session specific to HR & Benefits staff which will not be displayed publicly on our OEB YouTube channel.   We encourage you to share the SharePoint location with any new and existing staff within your office who handle personal health information (PHI) or may do so in the future. To access the HIPAA video please visit our Systemwide OEB SharePoint site in the following folder: Videos / HIPAA / HIPAA_2015.

For access to the UT System Administration HIPAA Privacy Policy Manual (INT 166), please click here.

If you have any additional questions, please contact a member of the OEB Benefits Team.

 


 

NEW 2015-2016 Enrollment Guide for New Employees

The 2015-2016 Enrollment Guide for New Employees is available on our OEB YouTube webpage. This video provides an overview of the insurance, retirement, and wellness benefits offered by UT System OEB.  Access the video >


forms + pubs

REVISED OEB Policy Updates

The following policies in the OEB Administrative Manual were recently revised: 

Revision Date
Policy No.
Policy Title 
Summary of  Revisions 
September 2015 130 Office of Employee Benefits Terms and Definitions Revised definition of “dependent” to cite applicable state and federal law. Updated definitions of full-time and part-time employees to address ACA requirements.
September 2015 140 Funding for Group Insurance Coverage Clarified information about benefits-eligibility for employees who have previously retired under TRS. Added language to address ACA requirements.
September 2015 142 Premium Sharing for Part-Time Employees and Graduate Student Employees Revised to indicate enrollment in a UT institution’s Student Health Insurance Plan may be considered as enrollment in comparable coverage for purposes of waiving UT SELECT Medical coverage. Added language to address ACA requirements.
September 2015 210 Employee Eligibility and Enrollment Clarified information about benefits-eligibility for employees who have previously retired under TRS. Added language to address ACA requirements.
July 2015 230 Dependent Eligibility and Enrollment Updated eligibility requirements based on federal Supreme Court ruling requiring recognition of same-sex marriages. Replaced inline documentation chart with link to external chart to avoid duplication. 
July 2015 230 Chart Dependent Eligibility and Enrollment Updated documentation requirements for spouses following changes in eligibility described in Policy 230.

The current OEB Administrative Manual is available on the OEB website on the Forms and Publications page. 

For specific policy revisions, please review the internal versions on the OEB SharePoint site : Document Libraries / OEB Administrative Policy Manual.

If you have any additional questions, please contact a member of the OEB Benefits Team .


SUMMARY UT FLEX Participant Enrollment Report for Plan Year 2015-2016  

The UT FLEX Activity Report for Plan Year 2015-2016 is now available. The report displays a snapshot of contributions and participation by institution. 

Did you know…Plan Year 2016 has a 4.5% participation increase (in comparison to Plan Year 2015) with contributions over $40 million, yielding a system-wide FICA tax savings of $3.1 million. To learn more about the activity report visit the link below.

UT FLEX Report

> UT FLEX Activity 2016 [PDF]