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What are Some of the Timelines Involved with Identifying the Need for and Establishing an IEP? What is the Difference Between Homebound Instruction and Instruction Conducted in the Home in the State of Michigan?
A special needs trust is set up for a person with special needs to supplement any benefits the person with special needs may receive from government programs.
We treat all sort of nail problems, such as ingrown toenails, fungal toenails, thickened, blackened, bruised nails. If you don't have insurance coverage, we offer the most competitive rates in the local area. Please be advised that under the Affordable Care Act, contraceptive prescription drugs are covered at 100%, effective September 1, for all Texas Employees Group Benefits Program health plans.
The new year will bring a new, convenient option for members submitting evidence of insurability (EOI) for Optional Term Life and Dependent Term Life insurance.
ERS wants to hear from you about Great-West Retirement Services® (Great-West), the third party that provides record keeping, web services, on-site education, and communication for the Texa$aver Program. The contribution maximums for each of the Texa$aver 401(k) and 457 Plans have increased by $500 to $17,500 for the 2013 calendar year. On September 4, 2012, ERS submitted to the Texas Legislature two comprehensive studies on state employee health and retirement benefits.
If you are a new employee coming to the end of your health coverage waiting period, you will receive your medical ID card seven to 10 business days after health coverage begins.
Make sure you stay within the maximum contribution limits allowed for the Texa$aver 401(k) and 457 Program. Remind your employees of the November 15 deadline to spend TexFlex account money from Plan Year 2012. Remember, if you have health insurance through the Employee’s Retirement System of Texas (ERS) Program, your annual prescription deductible starts on September 1, 2012. If you enrolled in a new health plan during Annual Enrollment, you will re¬ceive a new ID card soon. Under certain circumstances, referrals to specialists and hospital pre-authorizations will transfer from Blue Cross and Blue Shield of Texas to UnitedHealthcare. If you are a new employee to the University of Houston still within your first 31 days of hire, you can enroll in some benefits without proof of good health, called evidence of insurability (EOI). Due to system limitations during Annual Enrollment, newly eligible dependents added in August won’t be reported to carriers until September 1. You may have heard that, starting September 1, 2012, the ERS TexFlex program will lower the health care maximum annual contribution to $2,500. Day care accounts also have a maximum annual contribution of $5,000 a year.In Plan Year 2013, there will also be no change to the administrative fee or the optional TexFlex debit card fee. Remember that on April 28, you won’t be able to sign in to ERS OnLine if you are using Internet Explorer 6 (IE6).
If you received Short-term or Long-term Disability Insurance payments in 2011, you should have received a W-2 in January from Fort Dearborn Life Insurance Company (FDL). Texa$aver education counselors travel the state to demonstrate how Texa$aver can help you save for a brighter future. On February 21, 2012, the ERS Board of Trustees agreed to enter into contract negotiations with United HealthCare Services, Inc.
Wind about 18 inches of floss around your middle finger; wind the rest around the opposite middle finger.
Holding the floss tightly between your thumbs and forefingers, gently insert it between your teeth. HealthSelect coinsurance maximums and non-network deductibles started over January 1, 2012. Remember that HealthSelectSM of Texas coinsurance maximums and non-network deductibles are based on the calendar year, January 1 to December 31.
The Dental Maximum Benefit is the amount of benefits the State of Texas Dental Choice PlanSM will pay in a calendar year. For State of Texas Dental Choice PlanSM participants, any covered dental expenses that applied to their deductible during the last three months of 2011 will apply to their 2012 deductible. The "accumulations toward deductibles," which starts in October of the prior year, means participants don’t have to satisfy a deductible at the end of one year and a deductible at the start of another year. In February 2010, a Request for Proposal was issued to solicit bids from qualified auditing firms for a 100% dependent eligibility audit of ERS participants.
As of November 1, 2011, roughly 11,530, or 5.3% of dependents covered previously, are no longer part of the program.
Our group Long-Term Care Insurance provider John Hancock Life Insurance Company recently informed ERS that enrollment for this coverage will be discontinued effective January 1, 2012. Closing enrollment to new enrollees does not in any way affect employees or dependents who already have Long-Term Care Insurance coverage through John Hancock.
ERS will issue a Request for Proposal for a new Long-Term Care Insurance provider later in the year.
The contribution maximums for each of the Texa$aver 401(k) and 457 Plans* have increased $500 to $17,000 for the 2012 calendar year. The Over Age 50 Catch-up Provision, offered by both the 401(k) and 457 Plans, won’t increase in 2012.
The 457 Plan (but not the 401(k) Plan) lets employees who are getting close to retirement increase their contributions through a three-year Catch-up Provision.
Dearborn NationalTM will continue as the carrier for Short-term and Long-term Disability Insurance. Employees enrolled in our ERS medical insurance health plan who use tobacco or have a covered member who uses tobacco are responsible for certifying their tobacco use.
For HealthSelectSM of Texas participants, your Explanation of Benefits (EOB) statements are available anytime, anyplace. Each year, "Quit Smoking" and "Lose Weight" are among the top New Year’s resolutions. Encourage employees to use such materials as the expanded food diary and weekly activity log. An employee may ask you to send a physician’s statement or affidavit to ERS that states the employee (or dependent) cannot stop using tobacco products so that the employee will not have to pay higher health insurance premiums. Don't forget that HealthSelectSM of Texas coinsurance maximum and deductible for non-network services are based on the calendar year, January 1 to December 31. All employees enrolled in one of these products will get an announcement from Minnesota Life and ERS to inform them of the carrier change. Under state law, tobacco users will pay higher premiums for their health insurance coverage starting January 1, 2012.
The ERS website includes more information, such as the definition of a tobacco user and a list of products that will be considered tobacco.
Employees and retirees can get help to quit tobacco so they don't have to pay more for health insurance.
Under state law, tobacco users in the GBP will pay higher premiums for their health insurance coverage starting January 1, 2012.
Employees and retirees can get help to quit tobacco so they don’t have to pay more for health insurance. The ERS Board of Trustees approved a new secondary statewide health insurance plan for retirees and their spouses who are covered by Medicare.
ERS chose Minnesota Life Insurance Company to provide term life insurance to its participants beginning January 1, 2012. Employees can save on out-of-pocket prescription expenses for maintenance medications (medications taken regularly for chronic conditions or long-term therapy) by filling them in 90-day supplies through the Mail Service Pharmacy.


If employees do not use Mail Service or EDS HealthSelect pharmacies, their maintenance medication is not covered in 90-day supplies. Example: Once a HealthSelect member meets his $50 annual prescription deductible, he can fill his Tier 3 maintenance medication at a non-EDS retail pharmacy and pay a $60 co-pay (for a 30-day supply) plus a $15 retail maintenance fee for a total of $75. If the HealthSelect member purchases the same medication in a 90-day supply at Mail Service or through an EDS pharmacy, he will pay only $180 with no retail maintenance fee.
HealthSelectSM of Texas members do not have to go to a CVS pharmacy for their short-term medication (taken for a short period of time) or their maintenance medication (taken regularly for chronic conditions or long-term therapy).
Also, some pharmacies have special programs offering generic medications at discounted rates.
If you have coverage under more than one health plan, including Medicare or Medicaid, remember to show the ID cards from both plans when you get medical care.
Remember that from September 1 to August 31, you and each of your covered dependents must pay separate $50 deductibles before the plan begins to cover drug costs.
One of the best ways to save money on your health care is to make sure you take generic drugs whenever you can. ERS announced that preventive health care services as a result of the Affordable Care Act (ACA) will not go into effect until September 1, 2012, for Texas Employees Group Benefits Program (GBP). Either letter can be used to drop children from the Employees Retirement System of Texas (ERS). Please note that the Welcome letter is not a confirmation of enrollment in CHIP, but only a notification that the employee’s dependent(s) are approved. These insurance rates are set by the Employees Retirement System (ERS) of Texas, Group Benefit Plan (GBP). Humana Dental DHMO: There will be no change in the contribution rates currently in place for this plan. Preventative Care: The Affordable Care Act mandates that preventive care be paid at 100% by health care carriers.
Based on pending legislation, we expect the State Kids Insurance Program (SKIP) to end August 31, 2011. Health and Day Care Accounts: you will be automatically re-enrolled in your TexFlex account at the same contribution amount unless you make a change during the Annual Enrollment period.
During annual enrollment only, no Evidence of Insurability (EOI) will be required to add self or qualified dependents to the medical insurance.
When Aon Hewitt contacts you about your dependents covered under the Texas Employees Group Benefits Program (GBP), you must send copies of the requested documents proving that your dependents are eligible. As a result of this exposure, you can get one year of free credit monitoring and internet surveillance from CSIdentity.
On September 1, 2011, the Affordable Care Act raises the age for children’s eligibility in the Texas Employees Group Benefits Program (GBP) to 26, regardless of marital status.
During Annual Enrollment, employees can enroll children who turned 25 before September 1, 2011, or children under age 26 who are married. Evidence of insurability (proof of good health) is not required to enroll these children in the GBP during Annual Enrollment.
Based on pending legislation, we anticipate that the State Kids Insurance Program (SKIP) will end on August 31, 2011. Readers should not act upon the information contained in this website without professional counsel. Isaac Tabari offers complete care for any age and cutting-edge techniques to treat foot and ankle diseases, injuries and other disorders that may be slowing your child down. At the start of each calendar year, you are responsible for any applicable deductible or coinsurance amounts. Some restrictions apply, such as that drugs must be prescribed by a physician and be FDA approved, and that 100% coverage will not apply to brand-name drugs with a generic equivalent.
Both reports are the result of a year-long research process designed to be transparent and to include all stakeholders with an interest in the future of state employee benefits. Quest Diagnostics (a lab provider) is not a HealthSelect network provider as of September 1, 2012. You'll find information on UnitedHealthcare, coverage, costs, providers, referrals, wellness resources, and other topics. If you are concerned about exceeding IRS limits, you should reduce your payroll deductions before your last payroll contributions for 2012.
You and your covered dependents each have a $50 deductible for prescription drugs for the plan year, which is from September 1 to August 31.
However, ERS recently received notice from the Internal Revenue Service that the $5,000 TexFlex health care maximum annual contribution may continue through Plan Year 2013.On September 1 of each year, you are automatically re-enrolled in TexFlex at the same annual contribution amount as the previous year, unless you make a change during Annual Enrollment. To see when they will be in your area, see the Texa$aver Events Calendar or sign up for Texa$aver event updates. At the start of each calendar year, participants are responsible for any applicable deductible or coinsurance amounts. Participants can see the Carryover Credit deductible on the Explanation of Benefits (EOB) they receive after obtaining services. Once your family reaches these limits, the deductible for your entire family will be satisfied for the calendar year. ERS launched the Dependent Eligibility Audit in four phases between March 16 and June 24, 2011. They were either voluntarily or involuntarily removed from the health plan because they did not meet the eligibility requirements.
If you have questions about this decision or your Long-Term Care Insurance coverage, please call John Hancock at (800) 400-9396.
The provision allows employees to contribute an additional $5,500 above the allowed maximum to each plan. In 2012, this provision allows employees to use unused contributions (years in which they have not contributed to the plan) to save up to a limit of $34,000. Employees can apply for Disability Insurance during Annual Enrollment or within 31 days of a qualifying life event during the plan year.
Employees who contact ERS for insurance-related transactions will be asked to verbally certify as a tobacco user, or non-tobacco user.
If you have an email address on file in ERS OnLine, the notification will be sent to the email address. Employees can also call PayFlex (the company that administers the TexFlex program) at (866) 353-9839. We all could use a little help remembering things—especially when it comes to managing diabetes.
While you must continue to pay for Medicare Part B premiums, the Humana Medicare Advantage Plan replaces both traditional Medicare and HealthSelect as your primary and secondary coverage. Paul, Minnesota, also insures state employees in Arkansas, Colorado, Delaware, Florida, and other states.
HealthSelectSM of Texas members can also fill 90-day supplies at participating Extended Days Supply (EDS) retail pharmacies.
However, they can purchase maintenance medication in 30-day supplies at retail for their co-pay plus a retail maintenance fee. In this example, buying maintenance medication in 90-day supplies at Mail Service or through an EDS pharmacy saves $45 every 90 days, or $180 on just that one prescription for the year. They can purchase short-term medication and maintenance medication at ANY licensed pharmacy. By using one of these programs, employees may be able to get their medications for less than the regular co-pay amount. If employees opt-out of the health plan, they are also giving up the prescription coverage.


In the interim, managers that identify a need for mandatory counseling should contact their HR Generalist.Employees that need non-mandatory counseling services have two options.
The new mobile site provides access to interactive online tools through the HealthSelect website –designed for viewing and navigating on your smartphone. Representatives will assist you directly or make sure you are directed to the right person. For example, if you have two dependents, you would have a total family deductible of $150 per plan year for prescription medications if all of you fill at least $50 worth of prescriptions. If the member wants to wait until receiving confirmation that his or her child(ren) are enrolled in CHIP before dropping them from ERS, then the employee will need to wait until he or she receives the CHIP Enrollment Confirmation Notice before dropping the children. The University of Houston System and all UH components are participating employers in the ERS GBP that is the provider of state insurance benefits to our eligible employees and retirees. Starting September 1, 2011, employees will no longer pay 20% co-insurance for preventive care services. Recent federal legislation will allow state employees to apply for CHIP or Children’s Medicaid. EOI will still be required through Fort Dearborn Life for all other optional benefits (optional term life, dependent term life, short and long-term disability). All GBP participants with dependents covered under health insurance will receive these requests. In addition, a state employee reported that someone falsely claiming to be an ERS employee called to ask for a Social Security number.
In addition, the Comptroller’s office will provide identity restoration services if your personal information was misused as a result of the data posting, paid for by Comptroller Susan Combs' campaign fund.
The legislative charge was to present a range of options for the Legislature’s consideration.
Another 79 million Americans have prediabetes and are at risk for developing type 2 diabetes.
If you have questions about your HealthSelect medical ID card, call UnitedHealthcare toll-free at (866) 336-9371.
If you enrolled in dental insurance or changed to a different dental plan during Annual Enrollment, you should receive your dental ID card by the middle of September.
The optional debit card fee is $15, even if you have both health care and day care accounts.See more information on TexFlex. Neither Blue Cross and Blue Shield of Texas, nor United HealthCare, determines plan benefits.
Employees can participate in this catch-up provision in the three years before they reach retirement age. The HR Service Center can assist you in certifying your tobacco use in room 325 McElhinney.
If there is no email address in ERS OnLine, the announcement will be sent through regular mail. The new option lowers out-of-pocket premium contribution costs when compared to HealthSelect and offers additional benefits, such as gym memberships and discounted health and wellness services. Minnesota Life has provided group life coverage for more than 90 years and, with more than $682 billion of group life in force, is among the largest group life insurers in the country. However, to save money they should use one of the 54,000 retail pharmacies in the HealthSelect pharmacy network for short-term medication and use Mail Service or an Extended Days Supply (EDS) retail pharmacy to purchase maintenance medication.
By waiving coverage, employee would no longer have the Basic Term Life coverage that is part of the health benefit. The mobile site includes Blue Access for MembersSM and other features that HealthSelect participants use most often. If a child is dropped from the ERS using the Welcome Letter and does not end up becoming enrolled in CHIP, then the child would have neither CHIP or GBP coverage.
On June 1, Fort Dearborn Life Insurance Company (also known as Dearborn National™) began accepting Evidence of Insurability (EOI) applications for Plan Year 2012 coverage.
If anyone representing ERS calls you and asks for your social security number, please hang-up and call ERS at 1-877-275-4377 or (512) 867-7711, in the Austin area. Participants did not have to cover their children through the GBP previously to enroll them during this summer’s Annual Enrollment.
See the HumanaDental and American Dental Association websites for more information on good dental health.
ERS designs the plan, including such things as co pays, coinsurance, and eligibility rules. This means that as of January 1, 2012, participants had access to another $1,500 for dental expenses through December 31, 2012. Because there is no paper certification form required by ERS, you can print the tobacco certification screen for verification and for your records. The prescription drug benefit for the Medicare Advantage Plan will be provided by Caremark with the same formulary, coverage deductible and co-pays as HealthSelect. Most retirees who are Medicare eligible will be automatically enrolled in the Medicare Advantage Plan effective January 1, 2012. Minnesota Life, a subsidiary of Securian Financial Group, Inc., is highly rated by the major independent agencies that analyze the financial soundness and claims-paying ability of insurance companies.
It’s important to know when generics become available, because they generally cost less, and they have the lowest copay. During this annual enrollment only, no evidence of insurability (EOI) will be required to add self or qualified dependents to the medical insurance. A tobacco user is defined as a person who uses any form of tobacco, including cigarette, pipe, cigar, or smokeless tobacco. The role of the TPA is to administer the plan according to the plan design and policy given to them by ERS. Employees can find participating pharmacies, inquire about Mail Service, or find EDS retail pharmacies by going to the Caremark website or by calling (888) 886-8490 or (800) 231-4403 for TDD (telecommunications device for the deaf) users. Plus, if a generic is available and you buy the brand-name drug instead, you will pay the generic copay plus the difference between the cost of the brand-name and the generic drug.
Employees can keep their CHIP-approved children enrolled in ERS dental and dependent life coverage.
You may receive higher benefits if using a dentist through the preferred provider network in the Dental Choice Plan.
You can add these dependents back on your coverage during annual enrollment and they will remain covered until age 26 regardless of their marital status. To make it easier for employees to confirm if their doctor is in the network, ERS is working with United to launch a provider search feature on March 7 that does not require the employee to select a network. Because ERS controls the plan design, a change in administrator does not mean that the benefits will change.
The HealthSelect administrator is contracted to pay claims, provide customer service, offer health and wellness programs, and manage the HealthSelect provider network.The new contract is expected to save $41 million. ERS projects that about 2% of HealthSelect members might want to choose a new primary care physician (PCP) if their current PCP decides not to join. They will automatically receive a new HealthSelect ID card before the next plan year starts on September 1, 2012.We will post monthly updates on the ERS website throughout the transition period, with full details provided during Annual Enrollment. We also posted some frequently asked questions and answers on the ERS website with more information.



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