What’s New for 2019

For 2019, there will be several important benefits changes and new Identity Theft Protection option available to all Harvard faculty and staff. In addition, there will be several health plan changes for Local 26 union members based on their most recent union contract.

Plan Changes and New Options for all Faculty and Staff Members

New Pharmacy Benefits Administrator: 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 (replacing current administrator Optum Rx). Express Scripts offers a user-friendly, online portal and 24/7 support as well as mail order pharmacy.

In mid-December, all faculty and staff who are enrolled in a Harvard-sponsored medical plan will receive a Welcome Kit from Express Scripts. It will contain a new pharmacy card, which should be used to fill prescriptions on or after January 1, 2019, along with important information about mail order prescription services and transitions.

The prescription copayment structure is not changing, although similar to most years, individual medications may change category (e.g., preferred to nonpreferred). Harvard faculty and staff can contact Express Scripts Customer Service at 877-787-8684 with any questions or visit them online at express-scripts.com/HarvardUniversity, where you may also access the Express Scripts formulary; these resources are available beginning October 31, 2018. You may review a list of the most commonly prescribed drugs covered for 2019 (this is an abbreviated, not comprehensive list). Note that the HUHS Pharmacy will be part of the Express Scripts network, so employees may continue to use this option.

Transition information: It is recommended that you have on hand at least a three-week supply of regular medications during the transition in January.

You will receive communications from Express Scripts in November if your prescription:

  • Will change to a higher cost tier in the formulary – If so, you may visit the ESI website or call ESI’s customer service team for help finding lower tier alternatives, if available, that you may discuss with your doctor.
  • Is not on the formulary – If so, you will be provided with information on alternatives to discuss with your doctor. Your doctor can prescribe another effective medicine that's on the formulary.
  • Is filled through a specialty pharmacy – If so, you will receive information about your transition to Express Scripts specialty pharmacy, Accredo.

New Option: Identity Theft Protection

Beginning January 1, 2019, Harvard will offer identity theft protection with the PrivacyArmor Plus® plan from InfoArmor. This program provides full identity monitoring, credit monitoring, proactive alerts, and full-service restoration and insurance coverage of up to $1M if your identity is stolen. You can learn more on the InfoArmor flyer, FAQs, and also by visiting www.MyPrivacyArmor.com or call 800-789-2720 with questions.

Coverage is available at two levels – Individual (employee only) or Family (employee and all household members).

If you want this coverage for 2019, you must enroll during Open Enrollment and select coverage the coverage level you want (Individual or Family). Open Enrollment will be your only opportunity to enroll for 2019. Costs are paid via payroll deduction. This coverage may be continued directly through InfoArmor if you leave or retire from Harvard (costs may vary).

If you enroll, you will receive a welcome letter in early January with information about registering for full monitoring, which will require you and your covered family members to provide Social Security numbers at that time.

Monthly cost

$9.95 Individual coverage

$17.95 Family coverage

Special Opportunity to Increase Supplemental Life Insurance Coverage and Plan Enhancements

Supplemental Life Insurance will add a new coverage level of 6x salary, up to new maximum coverage of $2.5 million. If you are capped at the current $1.25 million coverage maximum, you will receive information from Harvard about your new coverage amount and cost for 2019 under the new limit.

Special enrollment opportunity for 2019: If you are currently enrolled in Supplemental Life Insurance, you may increase your coverage by one level during this year's two-week Open Enrollment period without completing a Statement of Health – for example, from 2x salary to 3x salary (does not apply to Dependent Life insurance). You may increase your coverage by more than one level, but increase amounts above one level will require a Statement of Health (español) that must be approved by MetLife (the one level increase will be automatic and in effect as of January 1, 2019, with the levels above one being subject to review of Statement of Health).

Plan Change for Faculty and Nonunion Staff

Health Savings Account (HSA) Enrollment Change

For those currently enrolled in an HSA, beginning in 2019, your HSA elections will continue from year to year, so you do not need to re-enroll, and you will automatically receive the Harvard tax-free contribution to this account - $500 for individual coverage, $1,000 for family coverage. The HSA is only available to faculty and staff enrolled in Harvard’s high deductible health plan (HDHP).

If you want to open an HSA or if you want to change your contribution amount, you can do that during Open Enrollment or anytime during the year.

Plan Changes for members of Local 26

Members of Local 26 will see health and dental plan changes under their most recent contract, including:

  • Addition of a lower tier for medical premiums across all plans for those earning less than $55,000 (FTE) and adjustment of existing salary tiers. Tiers for 2019 will be:
    • Salary tier 1: less than $55,000
    • Salary tier 2: $55,000-$74,999
    • Salary tier 3: $75,000-$99,999
    • Salary tier 4: $100,000 and above
  • New copayments of $100 for hospital inpatient and outpatient services and $50 for high-tech imaging, and increased copayments of $25 for non-preventive office visit and therapy and $100 for emergency room visits.
  • Adoption of the enhanced dental plan design that provides a second level of coverage when a covered participant reaches the Level 1 annual maximum of $3,000, providing financial protection for very high dental costs. (This is the dental plan that is currently available to faculty, nonunion staff and most other union members – see details here.)
  • Copayment Reimbursement Plan that reflects new copayment costs. You must be enrolled in a Harvard-sponsored medical plan. In-network, out-of-pocket medical expenses, including copayments for office visits, prescriptions, testing, hospital visits and emergency room may apply to the thresholds:
    If your FTE salary is... You can be reimbursed for copayments for... Above
    Individual Family
    < $75,000 Office visits $225 $550
    Hospital, high-tech imaging and ER copayments $300 $450
    Prescriptions $500 $1,000
    $75,000+ Office visits $450 $1,100
    Hospital, high-tech imaging and ER copayments $600 $900
    Prescriptions $1,000 $2,000
  • Elimination of the PPO option. Current participants, who do not make any changes, will be defaulted into Harvard Pilgrim Health Care (HPHC) POS as of January 1, 2019. You may also choose to enroll in one of Harvard’s other available health plan options during Open Enrollment.
  • Those who enroll or continue in a Harvard-sponsored HMO or POS plan for 2019, will receive a $275 contribution to a Health Care FSA to help pay for eligible out-of-pocket medical, dental, and vision care expenses for you and your eligible dependent(s)
  • A new Supplemental Health Care fund will also be available to help cover 2019 copayments for emergency room, hospital and high-tech imaging services. You must apply for reimbursement for 2019 copayments by December 31, 2019 by submitting a reimbursement form to Benefit Strategies, the administrator of this fund for Harvard. There is no salary threshold nor minimum copayments required to use this fund. However, you cannot submit for the same expenses to both the Copayment Reimbursement Plan and the Supplemental Health Care Fund – and cannot submit expenses that have been already been paid using your Health Flexible Spending Account (FSA).

New: SmartShopper!

Beginning January 1, 2019, all faculty and staff who are enrolled in a Harvard-sponsored medical plan will have access to a new optional service – SmartShopper, which lets you compare costs for certain medical procedures and receive a financial incentive of up to $250 for using a preferred provider.

Prices for the same quality medical services, such as MRI, mammogram, colonoscopy, can vary by hundreds to thousands of dollars. SmartShopper is an easier way to shop for certain health care services. When your doctor recommends a procedure or test, visit the SmartShopper portal or call the Personal Assistant Team to shop inpatient and outpatient health care services in your area.

By using SmartShopper, you can determine whether the procedure is offered at different convenient providers, at a lower price and when you select a more cost-effective location for certain procedures or tests, you will receive a financial incentive of up to $250, depending on the service. Payments are taxable and you will receive a 1099 tax form for reporting purposes from SmartShopper if you receive $600 or more over the year. Harvard employees and their dependents enrolled in a Harvard-sponsored medical plan are eligible for this new program (provided they are not also enrolled in Medicare or Medicaid).

Sample incentives:

Health Care Service

Financial incentives paid to participants (amount depends on provider selection)

Bone Density Scan

$25-$50

Bunionectomy

$50-$150

Cataract Removal

$50-$125

Colonoscopy

$50-$250

CT Scan

$50-$75

Knee or Shoulder Arthroscopy

$50-$250

Mammogram

$25-$50

MRI

$50-$100

Ultrasound (non-maternity)

$50-$150

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.