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Open enrollment for participants of State Optional Retirement Program

December 31, 2015

The annual open enrollment period for all participants of the State Optional Retirement Program  (State ORP) is January 1 to March 1 of each year. During this period, State ORP participants may change their State ORP vendor or, if eligible, may irrevocably elect to participate in the South Carolina Retirement System (SCRS).

 

Details about the 2016 open enrollment period are available here.

 

Pharmacy benefits manager change effective January 1, 2016

November 25, 2015

The South Carolina Public Employee Benefit Authority (PEBA) contracts with a pharmacy benefits manager to administer the prescription drug program for the State Health Plan. PEBA is transitioning from Catamaran to Express Scripts as the pharmacy benefits manager. PEBA’s contract with Catamaran will end on December 31, 2015, and PEBA’s contract with Express Scripts will begin on January 1, 2016. Throughout this transition, members will maintain prescription drug coverage.

 

As a result of this vendor change, members may receive communication from Catamaran and Express Scripts. All members will receive welcome packets and new prescription drug ID cards from Express Scripts prior to January 1, 2016.

 

Members who are enrolled in the State Health Plan Medicare Prescription Drug Program will receive multiple letters from both Catamaran and Express Scripts. These letters are required communications by the Centers for Medicare and Medicaid Services, and members should not be alarmed. Medicare Prescription Drug Program members will automatically be unenrolled from the Catamaran program and enrolled in the Express Scripts program without losing coverage.

 

2016 Medicare costs released

November 19, 2015

The 2016 Medicare premiums, deductibles and coinsurance figures are now listed on the Medicare site, www.Medicare.gov. Here is a summary:

 

Part A

  • Premium: Most people do not pay a premium for Part A because they or their spouse paid Medicare taxes while they were working.
  • Deductibles:
    • Each benefit period: $1,288
    • Inpatient hospital stay:
      • $322 a day for days 61-90 for each benefit period
      • $644 a day for each “lifetime reserve day” after day 90 for  each benefit period
    • Skilled nursing facility stay: $161 a day for days 21-100 for each benefit period.

Part B

In 2016, the standard Part B premium will be $121.80 (or higher depending on your income. However, most people who get Social Security benefits will continue to pay a Part B premium of $104.90 a month. You will pay a different premium in 2016 if:

  • You enroll in Part B for the first time in 2016.
  • You don't get Social Security benefits.
  • You have Medicare and Medicaid, and Medicaid pays your premiums.
  • Your modified adjusted gross income, as reported on your federal tax return from two years ago, is above a certain amount. You can get more information about your Part B premium from Social Security.

 

Part B deductible is $166 a year.

 

More detailed information about Medicare's 2016 costs is available here.

 

Medicare & You 2016 is offered in several formats on the Medicare website. Please encourage retirees covered by Medicare and individuals who care for older relatives to read this book. It will help them use Medicare wisely and avoid costly mistakes.

 

EGWP pre-notification letters

November 17, 2015

Express Scripts, the State Health Plan pharmacy benefits manager for 2016, recently mailed a required EGWP pre-notification letter to Medicare-eligible retirees and Medicare-eligible dependents of retirees. Active employees and dependents of active employees who are eligible for Medicare and for whom the State Health Plan is the primary insurer may have received a letter in error.

 

Active employees and dependents of active employees will not be enrolled in the EGWP plan effective January 1, 2016, and should  disregard the letter. EGWP is a Medicare Part D prescription drug program for retirees and any Medicare-eligible dependents of retirees who are not active employees of a State Health Plan participating employer.

 

PEBA extends open enrollment period due to flooding

November 2, 2015

In response to the catastrophic flooding in many areas of our state, PEBA is extending the insurance benefits open enrollment period. Subscribers will have until Friday, November 6, 2015, to submit open enrollment changes, and benefits administrators will have until Friday, November 20, 2015, to approve open enrollment changes using the Employee Benefits Services (EBS) website and to submit open enrollment Notice of Election forms to PEBA.Remember, the most efficient way to process enrollment changes is through the MyBenefits website and the benefits administrator-based EBS website.

 

Employees also will be able to enroll in or change their MoneyPlus accounts until November 6.

 

While this extension is available to all subscribers and benefits administrators, PEBA is asking that those subscribers and employers who are able to please complete open enrollment selections and transactions by the original deadlines of October 31 and November 15, respectively. This will help ensure that all open enrollment changes are processed and updated to the carriers in a timely manner.

 

Please be mindful that delays in processing enrollment transactions impact the exchange of enrollment information to carriers that is necessary to issue benefits identification cards, process insurance claims, and bill for insurance premiums. Enrollment changes processed after the extended due dates can cause subscribers to experience delays in receiving new insurance cards and using new benefits.

 

BlueCross BlueShield of South Carolina awarded dental contract

October 28, 2015

BlueCross BlueShield of South Carolina will be the dental insurance provider effective January 1, 2016. State Dental Plan monthly premiums will not change. The 2016 monthly premiums for Dental Plus coverage will be:

  • Subscriber: $25.96
  • Subscriber/spouse: $52.46
  • Subscriber/children: $60.50
  • Full family: $78.60

 

Subscribers have until December 31, 2015, to drop State Dental Plan and/or Dental Plus coverage for themselves and any eligible family members for the 2016-2017 plan years.

 

Changes to prescription benefits effective January 1, 2016

October 16, 2015

The South Carolina Public Employee Benefit Authority (PEBA) and Express Scripts— the company awarded the contract to administer the State Health Plan prescription drug benefit effective January 1, 2016— are working hard to make sure you get the medications you need conveniently and at the lowest possible cost.

 

Physicians and pharmacists continually review and compare the medications on a pharmacy network’s formulary, which is the network’s list of preferred drugs, including new drugs and generics. As a result, some safe and effective drugs become “preferred” and others may become “non-preferred.”

 

What are “preferred” and “non-preferred” medications?

  • Preferred, or formulary, medications are effective medications that are similar to non-preferred medications. This list of drugs is determined based on the advice of pharmacists and a group of independent doctors. Preferred medications cost less than non-preferred medications. The formulary for the State Health Plan, effective January 1, 2016, is now available. Please note: Not all drugs on the list are covered by all prescription plans and the enclosed list might not show every covered drug.
  • Non-preferred, or non-formulary, medications are those medications not on the State Health Plan’s list of recommended drugs and therefore may cost you more.

 

If you currently are prescribed a drug that is not on the preferred list, we encourage you to talk with your doctor now about prescribing preferred drugs that are on the formulary list. Doing this can save you money, and using generic drugs may save you even more. If you have any questions, please call Express Scripts at 855.612.3128.

 

PEBA extends open enrollment period due to recent flooding

October 12, 2015

In response to the catastrophic flooding in many areas of our state, PEBA is extending the annual insurance benefits open enrollment period. Subscribers will have until Friday, November 6, 2015, to submit open enrollment changes. The easiest way to make changes to your insurance coverage is through MyBenefits. Go to www.eip.sc.gov and click MyBenefits for more information.

 

PEBA will be closed on October 6, 2015

October 5, 2015

PEBA will again be closed on Tuesday, October 6, 2015. Our thoughts and prayers are with all the families in South Carolina affected by this massive flooding. Please be safe!

 

PEBA's office closed on October 5, 2015

October 4, 2015

Due to the extensive flooding in our area, PEBA's office will be closed on Monday, October 5, 2015.

 

PEBA’s Step-tember wellness walk postponed until Monday, September 28

September 24, 2015

Based on Friday’s weather forecast, PEBA’s Step-tember wellness walk is postponed until Monday, September 28. The festivities will kick off at noon and end at 2 p.m. and will be held at Columbia’s Riverfront Park. Healthy refreshments, free goodies and door prizes will be featured. A registration table and vendors will welcome participants at the main entrance to the Riverfront Park. While there is a large parking lot, participants are encouraged to carpool to the event.

 

You will have a chance to win a kayak trip for two from River Runner Outdoor Center, a Fitbit from BlueCross BlueShield of South Carolina, a three-month membership to the YMCA, a free pair of sunglasses from EyeMed and more. Don't miss out on what promises to be a fun-filled fall day!

 

For more information, email wellness@peba.sc.gov or call 803.737.5713.

 

Data Breach at Excellus BlueCross BlueShield May Impact Some State Health Plan Members

September 10, 2015

On Wednesday, September 9, 2015, BlueCross BlueShield of South Carolina (BCBSSC) informed the South Carolina Public Employee Benefit Authority (PEBA) that some current and former State Health Plan members and former BlueChoice HealthPlan HMO members may be affected by a data breach that occurred at Excellus BlueCross BlueShield (Excellus). Excellus is an independent licensee of the Blue Cross Blue Shield Association serving the 31-county upstate New York area.

 

Please be assured that neither PEBA’s nor BCBSSC’s computer systems were breached. PEBA’s commitment to data security remains constant and is always at the forefront of the agency’s operations.

 

BCBSSC and Excellus are evaluating the extent of the breach and identifying the individuals who may have been impacted. Data that was breached includes information for members who received services as part of the BlueCard® program in the upstate New York area.

 

The BlueCard® program applies when members receive care outside of South Carolina. The out-of-state health care providers file claims with the BCBS affiliate in their respective state and the information is securely passed between the BCBSSC and other BCBS affiliate’s systems to process claims. PEBA encourages current or former State Health Plan member or former BlueChoice HealthPlan HMO members who know they received health care provider services in the upstate New York area and believe they may have been impacted to read the information on Excellus’ website at www.excellusfacts.com.

 

Federal law requires that affected members be notified by mail. Those letters will let affected members know about the breach and any free identity repair and credit monitoring services to be provided by Excellus.

 

PEBA is closely monitoring this situation and will provide updates as additional details become available. For now, more information about the breach may be found at www.excellusfacts.com.

 

PEBA is serious about protecting member information. Learn more about how PEBA is working to keep your personal information safe and secure.

 

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