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Now that we’re firmly planted into the new 2016-2017 plan year and New Year’s Day is behind us, the books have been closed on last plan year (2015-2016) and the numbers are in. With 2016 in hindsight, let’s take a look at how the core benefits of the self-funded UT SELECT plans faired in terms of enrollment numbers, how we used the plans in terms of healthcare utilization and claims dollars, and how our insurance vendor partners helped us when we had a question and needed customer service.
UT SELECT Medical with Prescription Benefit Coverage
The self-funded UT SELECT Medical plan with prescription benefit coverage is the center-piece of the UT Benefits program. Full-time benefits eligible employees and retirees are eligible to enroll in the UT SELECT Medical plan at no cost with 100% of the premium paid by their UT institution and the state of Texas. Claims payments for services received are paid from the collection of premiums and from the plan participant in the form of deductibles, copayments and coinsurance. This arrangement of claims payments classifies the UT SELECT Medical plan as self-funded.
Here is how the UT SELECT Medical plan with prescription benefits looked by enrollment, utilization, and customer service in the last plan year, 2015-2016 (with the prior year’s numbers included for comparison):
UT SELECT MedicalAdministered by Blue Cross and Blue Shield of Texas and Express Scripts, Inc. |
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2015-2016 |
2014-2015 |
Difference |
|
Enrollment |
Monthly average |
Monthly average |
+7,639 |
Medical |
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Total Billed Amount |
$3,796,424,074 |
$3,290,406,727 |
+$506,017,347 |
Total Paid Amount |
$818,248,211 |
$747,225,954 |
+$71,022,257 |
Prescription |
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Total Prescriptions Dispensed |
2,834,188 |
2,668,684 |
+165,504 |
Total Paid Amount |
$328,125,490 |
$293,373,016 |
+$34,752,474 |
Customer Service Calls |
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Blue Cross and Blue Shield |
128,551 |
118,131 |
+10,420 |
Express Scripts, Inc. |
127,230 |
130,537 |
-3,307 |
UT SELECT Dental and Dental Plus
Just like the medical plan, the UT SELECT Dental and UT SELECT Dental Plus plans are 100% self-insured and premiums are paid 100% by the participant. There is no premium sharing provided by the institution or by the state of Texas. Even though the plan is supported 100% by participant premiums, enrollment in the Dental plans remains very high, and members continue to utilize the program for the benefit of themselves and their family members. Here are the claim details:
UT SELECT Dental and UT SELECT Dental PlusAdministered by Delta Dental |
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|
2015-2016 |
2014-2015 |
Difference |
Enrollment – UT SELECT Dental |
Monthly average |
Monthly average |
|
Enrollment – UT SELECT Dental Plus |
Monthly average |
Monthly average |
|
UT SELECT Dental Claims |
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Total Paid Amount |
$24,187,221 |
$23,727,845 |
+$459,376 |
U T SELECT Dental Plus Claims |
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Total Paid Amount |
$44,695,648 |
$35,396,812 |
+$9,298,836 |
If you have a question about your UT SELECT Medical or UT SELECT Dental benefits, you can contact Customer Service at:
Blue Cross and Blue Shield of Texas: (866) 882-2034
Express Scripts: (800) 818-0155
Delta Dental: (800) 893-3582