Open Enrollment for UNM's medical, dental, vision, life, disability, accidental death and dismemberment (AD&D) insurance plans is scheduled for Wednesday, April 24, 2013 through Friday, May 17, 2013. Benefit changes made during Open Enrollment are effective July 1, 2013. You will not be able to make changes to your plans after Open Enrollment unless you experience a Qualifying Change of Family Status Event. It is very important to prepare yourself for Open Enrollment so you can make educated decisions about the options available to you.
Medical Insurance
Elections made during the Open Enrollment Period are effective July 1, 2013.
Enrollment changes must be completed online via
LoboWeb from
Wednesday April 24, 2013 through 11:59 pm on Friday, May 17, 2013.
If you have questions, contact the Benefits Office at (505) 277-MyHR (6947).
Proof Documentation for dependents enrolled during Open Enrollment must be submitted to the HR Service Center no later than 5:00 pm on May 31, 2013. Failure to submit proof documentation by 5:00 pm on May 31, 2013 will void enrollment for your dependent. For more information see the Dependent Proof Documentation Requirements.
UNM Medical Plan Rates 2013-2014
UNM Medical Plan Third Party Administrators (TPAs)
UNM offers medical provider options through two Third Party
Administrators (TPAs):
Preventative
Services require no co-pay under LoboCare, Lovelace or Presbyterian
Networks.
Networks of Coverage
Once you have enrolled with your chosen TPA, you will have an option
of three different networks of coverage each time you need medical care.
The network you choose at the time of service determines your
out-of-pocket costs for services received. Please review the Summary of
Benefits for your chosen TPA for details on out-of-pocket costs.
LoboCare Network:
- HSC/UNMH and First Choice Community Health Providers and
Facilities.
- Primary care locations throughout Albuquerque.
- LoboCare Clinic for same-day or next-day acute care appointments.
- Both Lovelace and Presbyterian participants have the same access to
the LoboCare Network.
- LoboCare
Network Flyer
- LoboCare
Clinic Frequently Asked Questions
In-Network: (Lovelace or Presbyterian contracted
providers)
Out-of-Network:
- Providers and facilities not contracted with your TPA (note: if you
use this option, notify your TPA first to receive the maximum available
benefit).
- Only usual and customary charges are covered.
Medical ID Cards
Upon enrollment your TPA will mail ID cards to your home address on
file. If you do not receive your ID card, please contact your TPA to
request a new one. UNM provides your TPA with your UNM Banner Id for
identification purposes. Please provide your UNM Banner Identification
number, and not your Social Security Number, when utilizing services at
your medical provider or when speaking to your TPA.
Third Party Administrator Contact Information
For additional information or questions, please contact:
LoboCare
Network
Lovelace
- (855) 259-5471
- TTY: (800) 659-8331
Presbyterian
- (505) 923-5232
- 1-866-574-9567 (Outside Albuquerque only)
Dental Insurance
Elections made during the Open Enrollment Period are effective July 1, 2013.
Enrollment changes must be completed online via
LoboWeb from
Wednesday April 24, 2013 through 11:59 pm on Friday, May 17, 2013.
Proof Documentation for dependents enrolled during Open Enrollment must be submitted to the HR Service Center no later than 5:00 pm on May 31, 2013. Failure to submit proof documentation by 5:00 pm on May 31, 2013 will void enrollment for your dependent. For more information see the Dependent Proof Documentation Requirements.
Dental Insurance Rates - Plan Year 2013-2014
UNM offers two dental plans through Delta Dental of New Mexico
- Delta PPO (low cost option)
- Delta Premier (high cost option)
Services Outside of New Mexico
Delta Dental is a nation-wide insurance company. You may utilize any
dental provider outside of NM that is contracted with Delta Dental under
the Premier or PPO preferred plans. When using a provider outside of NM,
the provider should contact the NM Delta Dental office to confirm your
coverage and the claims must be submitted by the provider to the NM
Delta Dental Office. Contact the Delta Dental office when accessing
services outside of NM to insure proper coordination and processing of
claims.
Dental Insurance ID Cards
Upon enrollment Delta Dental will mail you Insurance ID cards.
Dependents will not receive a card with their names. Everyone covered
will use the card with the primary member's name. If you do not receive
your ID card, please contact Delta Dental to have one sent to you or you
may log onto Delta Dental’s Web site and print out an ID card. UNM
provides Delta Dental with your UNM Banner Id for identification
purposes. Please provide your UNM Banner Id number, not your social
security number, when utilizing services at your Dental Provider or when
speaking to Delta Dental.
Delta Dental Contact Information
For additional information or questions you may review the Delta
Dental Benefit Booklet, Delta Dental website or contact Delta Dental's
Benefits Service Department. You will need to provide Delta Dental
and/or your Dental Provider with your UNM Banner ID, not your SSN, for
identification. The Delta Benefit’s Service Department is able to
provide coverage and pricing information and answer questions.
Contact Delta Dental's Benefits Service Department at:
Vision Insurance
Elections made during the Open Enrollment Period are effective July 1, 2013.
Enrollment changes must be completed online via
LoboWeb from
Wednesday April 24, 2013 through 11:59 pm on Friday, May 17, 2013.
Proof Documentation for dependents enrolled during Open Enrollment must be submitted to the HR Service Center no later than 5:00 pm on May 31, 2013.
Failure to submit proof documentation by 5:00 pm on May 31, 2013 will void enrollment for your dependent. For more information see the Dependent Proof Documentation Requirements.
Vision Insurance Rates - Plan Year 2013-2014
UNM offers one vision plan, the Vision
Service Plan and it is 100% employee paid.
Vision Rates
- In-Network, no claims to file.
- Both in-network and out-of-network benefits.
- Annual eye exams.
- Prescription eyewear coverage (contacts, lenses,
and frames).
Once enrolled in VSP, you will need to find a VSP
doctor. You can do so by:
- Visiting the VSP Doctor Directory at http://www.vsp.com
- Or by Calling the toll-free Member Services Support Line at (800)
877-7195. The toll-free T.D.D. number for the hearing impaired is (800)
428-4833.
After you have selected a Doctor, you can obtain
services by:
- Making an appointment with your chosen VSP doctor and
- Telling the office that you are a VSP member when making the
appointment.
After you make an appointment, your doctor and VSP will handle the
rest by verifying your benefits and eligibility for services. UNM
provides VSP with your UNM Banner Id for identification purposes. Note: VSP does not issue membership cards. Please
provide your UNM Banner Identification number, not your Social Security
Number, when using services at your vision provider or when speaking to
VSP.
Vision Service Plan Contact Information
For additional information or questions, please contact VSP at:
Life and AD&D
Elections made during the Open Enrollment Period are effective July 1, 2013.
Enrollment changes must be completed online via Standard's Enrollment/Member website from Wednesday April 24, 2013 through 11:59 pm on Friday, May 17, 2013.
Open Enrollment Options without Evidence of Insurability Requirements
Life:
- Enroll in Basic Life
- If not previously enrolled in Employee Additional Life, enroll in one times salary
- If previously enrolled in Employee Additional Life, increase by one times annual salary (maximum three times annual salary without Evidence of Insurability)
- If not previously enrolled in Spouse Domestic Partner Additional Life, enroll in $10,000 of coverage
- If previously enrolled in Spouse/Domestic Partner Additional Life, increase by one $10,000 increment of coverage (maximum of $50,000 without Evidence of Insurability)
- Review Standard’s Life Insurance Booklet for more information
- Visit the HR Life Insurance webpage for more information
Accidental Death and Dismemberment:
Enrollment - Only Online or by Telephone
Employee Access to View and Update Coverage
Offered online or telephonic (Must complete initial login process listed above under Enrollment or call Standard Customer Service line at 1-800-759-8702)
Employees may:
- View current enrollment and request enrollment changes to add, drop, increase, or decrease coverage levels
- View and update beneficiaries (Online option only, employees are responsible for updating beneficiary information)
- View Certificates of Coverage, other plan document information, and access cost calculation tools
Standard Insurance Company Contact Information
Disability
Elections made during the Open Enrollment Period are effective July 1, 2013.
Enrollment changes must be completed online via Standard's Enrollment/Member website from Wednesday April 24, 2013 through 11:59 pm on Friday, May 17, 2013.
Open Enrollment Options without Evidence of Insurability Requirements
Long-Term Disability:
Short-Term Disability:
Enrollment - Only Online or by Telephone
Employee Access to View and Update Coverage
Offered online or telephonic (Must complete initial login process listed above under Enrollment or call Standard Customer Service line at 1-800-759-8702)
Employees may:
- View current enrollment and request enrollment changes to add, drop, increase, or decrease coverage levels
- View and update beneficiaries (Online option only, employees are responsible for updating beneficiary information)
- View Certificates of Coverage, other plan document information, and access cost calculation tools
Standard Insurance Company Contact Information
Prescription Drug Plan
Elections made during the Open Enrollment Period are effective July 1, 2013.
Enrollment changes must be completed online via
LoboWeb from Wednesday April 24,
2013 through 11:59 pm on Friday, May 17, 2013.
Enrollment in the UNM Prescription Drug Plan is automatic once enrolled in either the Lovelace or Presbyterian UNM Medical Plan.
UNM contracts directly with a Prescription Benefits Manager (PBM), Express
Scripts, Inc., for the administration of prescription drug benefits. All
participants enrolled in medical coverage will automatically be enrolled in
Express Scripts, Inc. UNM's prescription drug plan is a four tier co-pay plan
and includes a home delivery program. For more details, please review
Express Scripts Benefit Booklet 2013-2014 Coming Soon or contact
Express Scripts Member Services.
UNM Prescription Drug Plan Changes FY 2014 Effective July 1, 2013
Changes to the UNM health plan include the following changes to copays for prescription drugs under the Express Scripts Prescription Drug Plan:
- Generic drug copay will be reduced from $10.00 to $5.00 for a 30-day supply
- Preferred Brand copay will be increased from $25.00 to $30.00 for a 30-day supply
- Non-Preferred Brand copay will be increased from $40.00 to $50.00 for a 30-day supply
- Retail purchases at a pharmacy will no longer be limited to a 30-day supply. You may now purchase a 90-day supply at three times the 30-day copay.*
- For example:
- Generic = $15.00 for a 90-day supply purchased at a pharmacy
- Preferred = $90.00 for a 90-day supply purchased at a pharmacy
- Non-Preferred = $150.00 for a 90-day supply purchased at a pharmacy
- Mail-order prescriptions will be a 90-day supply at two times the 30-day copay for Generic, Preferred, and Non-preferred.
- For example:
- Generic = $10.00 for a 90-day supply purchased via mail-order
- Preferred = $60.00 for a 90-day supply purchased via mail-order
- Non-Preferred = $100.00 for a 90-day supply purchased via mail-order
Express Scripts Member Services and Contact Information
For additional information or questions you may review the
Express Scripts Benefit Booklet 2013-2014 Coming Soon,
Express Scripts website or contact Express Scripts Member Services. You will
need to provide Express Scripts your UNM Banner ID, not your SSN, for
identification. The Member Services line is able to provide drug coverage and
pricing information and answer questions on mail ordering and other
prescription coverage information. Contact Express Scripts Members Services at:
CuraScript (Express Script's Specialty Pharmacy)
866-824-5662 (toll free)
www.curascript.com
A
basic summary of covered medications, not including the co-pay tier
level, is available for participant review. For more specific
information, participants can contact Express
Scripts Member Services to obtain specific co-pay information for
covered medications. Additionally, the Express
Scripts Website allows participants to enter a specific drug and
related regimen information to receive co-pay information for each drug
entered, including mail order prices.
Certain diabetic supplies are available for a $0 co-pay. Please
contact Express
Scripts Member Services for specific pricing. Non-preferred supplies
may be covered at a higher co-pay, so it is very important for to
contact Express Scripts for specific coverage and pricing information.
Express Scripts is contracted with over 50,000 pharmacies nationally
including
CVS, Walmart, and other contracted
pharmacies. See Express Scripts Benefit Booklet 2013-2014 Coming Soon for options to fill a prescription.
Participants may register on the Express Script's Web site, express-scripts.com,
to manage prescription requests, check pricing and coverage, locate a
participating retail pharmacy, and print claim forms.
Express Scripts offers influenza, tetanus, and Zoster vaccine
immunizations administered through your local retail pharmacy. Vaccines
administered at your retail pharmacy typically do not require an
appointment, and they are the same effective medications as your
physician's office. Contact your participating pharmacy in advance to
inquire about vaccine availability. See your medical provider for
immunizations not offered through Express Scripts.
Locate a participating Pharmacy:
- Visit express-scripts.com
and click the "Find a Pharmacy" link for a list of network chain
providers.
- Call the number on the back of your prescription benefit ID card to
find a participating pharmacy.
Prescription Drug ID cards will be sent directly from Express
Scripts. Dependents will not receive a card with their names. Everyone
covered will use the card with the primary member's name. If you did not
receive your ID card, please contact Express
Scripts to have one sent to you. You must remember to provide
your Express Scripts ID card to your pharmacist.
