2019 Open Enrollment will be held October 31-November 14, 2018.
2019 Open Enrollment information and plan rates will be mailed in mid-October. If you have moved, please contact Benefits at firstname.lastname@example.org or 617-496-4001 to update your address so that you receive materials promptly. Please note that there are separate Open Enrollment packages for eligible retirees and dependents under age 65 and those age 65 and older, so families with eligible members in both groups will receive two packages.
Beginning January 1, 2019, Express Scripts (Express Scripts Medicare® for retirees age 65 and over) will be Harvard's new pharmacy benefits administrator for the prescription benefit that is included with all Harvard-sponsored medical plans for retirees. You can learn more below.
Retirees age 65 and over: Preview of Upcoming Changes
There are no major plan design changes to the three Senior Medical Plans for retirees and eligible dependents age 65 and over for 2019. However, the prescription benefits administrator is changing beginning January 1, 2019. Rates are increasing for 2019 for the senior plans - view the 2019 Senior Plan rates.
Medicare Part D prescription drug coverage for all three senior medical plans is included as part of your retiree medical plan coverage, and the cost of the prescription plan is included in your monthly premium. Harvard has selected Express Scripts Medicare® as the new pharmacy benefits administrator for this coverage.
If you are enrolled in a Harvard retiree medical plan for 2019 you will receive a new member ID card for Express Scripts Medicare® (PDP) for Harvard University by January 1, 2019. It is very important to present this new pharmacy ID card when filing any prescriptions on or after January 1, 2019. You will also receive a Welcome Kit with more information. Additional information on the transition to Express Scripts Medicare will be available in the coming months.
Note that the copayment structure for prescriptions is not changing, although there may be routine changes to the tier and cost of a medication on the preferred drug list, also called a formulary. You will receive notification of any medications tier changes that affect you from Express Scripts Medicare.
Retirees under age 65: Preview of Upcoming Changes
There are several changes and new services for retirees and/or eligible dependents under age 65.
New Pharmacy Benefit Manager: Express Scripts
Beginning January 1, 2019, Express Scripts will become Harvard's new pharmacy benefits administrator for the prescription benefit that is included with all Harvard-sponsored medical plans for retirees under age 65. In mid-December, retirees and/or eligible dependents under age 65 who are enrolled in a Harvard-sponsored medical plan will receive an enrollment kit from Express Scripts, with a new pharmacy card, which should be used to fill prescriptions on or after January 1, 2019.
The prescription copayment structure is not changing, although similar to most years, individual medications may change category (e.g., preferred to nonpreferred). Additional information on the transition to Express Scripts will be available in the coming months.
Did you know that prices for the same quality medical services, such as MRI, mammogram, colonoscopy and more, can vary by hundreds to thousands of dollars? SmartShopper, available beginning January 1, 2019, is a new service that provides retirees under age 65 enrolled in Harvard-sponsored medical coverage with an easier way to shop for certain health care services, either online or by phone, and receive a financial incentive of up to $250 when you receive services at a preferred provider. (Note that the SmartShopper service is not available before January 1, 2019, so appointments that are made prior to this date may not qualify or may need to be rescheduled.) Look for more information in your Open Enrollment package.
The hearing aid benefit available through the Under Age 65 plans will no longer be limited to those under age 19 beginning in 2019.
Retired Members of Local 26 under age 65 retired on or after 9/4/2014
Retired members of Local 26 and/or their dependents who are under age 65 and eligible for coverage under a Harvard health plan will see several changes for 2019:
New Salary Tiers
For 2019, Harvard is changing the salary tiers that are used for medical plan premiums for retired Local 26 members and eligible dependents who are under age 65. Harvard will add a new salary tier for less than $55,000 and adjust other tiers upward.
Retirees and/or dependents in these groups who are under age 65 will be moved into one of the four medical plan premium tiers based on the retired employee’s FTE salary at retirement:
- Salary Tier 1: < $55,000
- Salary Tier 2: $55,000-$74,999
- Salary Tier 3: $75,000-$99,999
- Salary Tier 4: $100,000 and above
For 2019, there will be new copayments for certain hospital services, including ER visits, and high-tech imaging. Office visit and therapy copayments will increase to $25.
Note that these salary tiers and copayments are already in effect for retired faculty, nonunion staff, and members of other unions (with the exception of SEIU Arboretum) and their eligible dependents under age 65.
Health Plan Rates for Retirees and Dependents Under Age 65
Retirees and eligible dependents are enrolled in the active plans for an pay rates according to the employee group they were in at retirement. 2019 rates are below: