New insurance plans being readied

he University has selected Aetna to administer the employee health insurance program on a self-insured basis, effective July 1. Aetna's national account customer segment, which services employers with 3,000 or more employees, has 10.2 million members, and 8.1 million of those are self-insured.

Aetna was chosen through a request-for-proposal process including local and out-of-town companies. "Aetna has a national perspective on how to help us design and administer the best programs we can offer to our employees," said Ronald J. Paprocki, senior vice president for administration and finance.

"Self-insurance" means that an institution like the University contracts with a third party administrator to process claims and provides additional services for the customer. The medical claims are funded by the University, and not by Aetna acting as an insurer. As before, the University contributes toward the medical plan for each employee; and, as before, most employees also pay a contribution toward that medical plan. The self-insured plans of the University are modeled after the existing plans and will function as those plans do.

The University will offer four health plans, including a traditional indemnity plan, for active faculty and staff (and retirees under age 65). Two plans will be offered to retirees 65 and over. The plans will not contain major benefit changes from the plans currently offered. Employees and retirees will receive detailed information and an enrollment form at their homes in early May.

While GRIPA, a ViaHealth-affiliated physician group, recently announced that it would not participate with Aetna as the third party administrator, about 80 percent of Monroe County's physicians have agreed to participate in Aetna's network, and a substantial majority of GRIPA's own members are already in the Aetna network or are in the credentialing process. "GRIPA's announcement does not mean that its member physicians are not participating," said Chuck Murphy, associate vice president for human resources.

"I urge any employees who see physicians that are affiliated with the ViaHealth or Unity Health systems to contact their doctors and encourage them to sign up," Murphy said. "It's our goal to offer the widest possible panel of participating physicians to our employees."

A list of participating physicians and hospitals will be included in enrollment packets which are being mailed to employees' homes in early May.

For further information about the University Medical Care Plans, visit the University benefits Web site at www.rochester.edu/working/employment/benefits.

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