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An employee publication of the Texas Department of Criminal Justice
May/June 2017

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Update: HealthSelect transitions to BlueCross/BlueShield September 1

Effective September 1, BlueCross and BlueShield of Texas (BCBSTX) will serve as the HealthSelect plan administrator for a term of six-years. HealthSelect insurance plans cover more than 400,000 participants, including employees and retirees of state of Texas agencies and certain higher education institutions, and their dependents.

Blue Cros Blue Shield health insurance logo.

Until BCBSTX becomes the new third-party administrator (TPA) on September 1, UnitedHealthcare will continue to serve as the HealthSelect and Consumer Directed HealthSelect TPA. Referrals and prior authorizations issued by UnitedHealthcare before September 1, 2017, will be transferred to BCBSTX. If the provider is still in the HealthSelect network, referrals and prior authorizations will be honored through the original expiration date. For specialists who will no longer be in the network, referrals and prior authorizations will be honored for 90 days after September 1 or until the exhaustion of the referral, whichever occurs first. After September 1, 2017, all new referrals and prior authorizations must be reissued by BCBSTX. Employees whose current doctors are not in the network will be notified by email and letter, and given instructions on how to nominate a provider for inclusion in the network, along with directions on how to find a new, in-network provider.

General information and answers to questions about the transition are available at either the new BCBSTX HealthSelect transition website (www.bcbstx.com/hs), or the BCBSTX call center where a Personal Health Assistant can answer questions and provide information, either by phone or live online chat. To speak with a Personal Health Assistant, call 800-252-8039 toll-free Monday through Friday from 7 a.m. to 7 p.m., or on Saturday from 7 a.m. to 3 p.m. Personal Health Assistants are also available to chat online Monday through Friday from 8 a.m. to 5 p.m.

BCBSTX Personal Health Assistants are trained to help you make the best use of your health insurance benefits by providing accurate, timely and useful information. Your Personal Health Assistant can tell you whether a particular doctor, hospital or other provider is in the HealthSelect network, provide an estimate of costs for health care services or procedures before going to the doctor, and tell you whether you need a referral or prior authorization to see a health care provider. They can also help you with the status of your referrals and prior authorizations, and can even make appointments for you.

If you've received a diagnosis or are managing a medical condition, your Personal Health Assistant can connect you with a nurse who can help you or provide information about programs and tools available under your health plan, including disease management, wellness, and weight loss programs.

With HealthSelect of Texas and Consumer Directed HealthSelect, you have access to the large network of health care providers in Texas. You can search for an in-network provider by name, location, or by type of procedure or condition, and you can also find network hospitals, urgent care providers, laboratories and other health care facilities.

If your current doctor, hospital, or other provider isn’t in the network, you can continue to see them as a non-network provider, but you will pay more. Also, going to a non-network provider means you will pay higher out-of-pocket costs, including an out-of-network deductible.

It's important to note that, even if your hospital is in the HealthSelect network, the doctors, anesthesiologists, radiologists and other providers who practice at the hospital may not be. You can use the Find a Provider feature on the BCBSTX transition website to view a list of hospitals, doctors and other health care providers currently in the HealthSelect network. Employees may also contact their personal provider to see if they are already members or are planning to participate in the network.

Other benefits associated with the HealthSelect health plan include a mental health program which can help with an emotional problem, provide counseling for an ongoing situation, or support you through a difficult health challenge, and holistic health management to help provide the right mix of tools, resources and programs to meet your every health and wellness need.

For more information, visit the HealthSelect transition webpage.

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ERS Summer Enrollment for TDCJ employees ends July 28

beach scene. Reminder! Summer enrollment ends July 28. 2017 Summer Enrollment. ERS, Employees Retirement System of Texas.

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ERS update: Health Plan premiums, Sunset Review

Health Plan premiums to rise slightly

At the May meeting, the Employees Retirement System Board of Trustees approved slight increases in Plan Year 2018 premiums for some Texas Employees Group Benefits Program plans. The State of Texas will continue to pay 100 percent of health insurance premiums for eligible full-time employees and retirees, and 50 percent for eligible dependents.

ERS, Employees Retirement System of Texas logo.

HealthSelect of Texas and Consumer Directed HealthSelect will see an increase in dependent premiums not to exceed 1 percent, and premium rates for the State of Texas Dental Choice PPO will see a slight increase.

All other premium rates will stay the same, to include those of health maintenance organizations, the dental DHMO and State of Texas Dental Discount Plan. The Texas Income Protection Plan (TIPP) long-term disability insurance, optional life insurance and voluntary accidental death and dismemberment insurance will also remain the same, but TIPP short-term disability insurance will be reduced from 30 to 26 cents per $100 of coverage.

The administrative fee holiday continues for TexFlex health care, dependent care and limited flexible spending accounts. Participants are not yet required to pay the $12 administrative fee and there is no additional cost for debit cards for the health care and limited spending accounts. The administrative fee for commuter spending accounts continues to be $3.

Also at the May meeting, contracts for Consumer Directed HealthSelect HSAs and TIPP were awarded to the current third-party administrators: Optum Bank for administration of health savings accounts, and ReedGroup for administration of TIPP long-term and short-term disability insurance.

ERS Sunset Review

Senate Bill 301 by Watson, the ERS Sunset bill, was signed by Governor Abbott on June 9 and will take effect on September 1, 2017. Also in June, the Texas Sunset Advisory Commission issued its Staff Report with Final Results regarding its ERS Sunset Review and the actions taken by the Legislature. Some examples of Commission recommendations enacted by the 85th Legislature include:

The ERS will be required to track and report profit shares received in connection with alternative investments, and the ERS Board of Trustees must approve any individual alternative investment that exceeds 0.6 percent of the total market value of the trust fund.

The ERS has been directed to expand its annual report on the Group Benefits Plan to include more comprehensive information to help the Legislature evaluate the program's overall effectiveness and plan for its sustainability, establish an advisory committee to obtain regular stakeholder and expert input on benefits, and develop a process and clear criteria for evaluating changes to the GBP.

ERS must also allow members to participate directly in the insurance appeal process, develop and maintain a precedent manual for the insurance appeal process and comprehensively track and analyze benefit application decision and appeals data.

ERS was directed to better educate members about choices and decisions that can lead to unexpected health insurance charges, and to ensure balanced representation on the Grievance Review Committee of customer service and other staff.

The next Sunset review of the ERS is set for 2029. As a constitutionally created agency, ERS is not subject to abolishment under the Sunset Act.

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Call toll-free to report waste, fraud and abuse of TDCJ resources

Waste, fraud and abuse of state resources cost all taxpayers millions of dollars each year

The Office of the Inspector General is dedicated to detecting, investigating and prosecuting reports of waste, fraud and abuse of state resources within all divisions of the Texas Department of Criminal Justice.

If you have any information regarding waste, fraud or abuse of state benefits, equipment, personnel or funds, please contact the Office of the Inspector General, Crime Stoppers or the State Auditor’s Office toll free.

Crime Stoppers 1-800-832-8477 Office of Inspector General 1-866-372-8329 State Auditor's Office 1-800-892-8348

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Update: HealthSelect transitions to BlueCross/BlueShield September 1

ERS Summer Enrollment for TDCJ employees ends July 28

ERS update: Health Plan premiums, Sunset Review

Call toll-free to report waste, fraud and abuse of TDCJ resources

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