ISI accounting clerk Keith Johnson discusses his options with Benefits Office receptionist Helen Cakus. Benefits-eligible employees have until Dec. 4 to make up their minds about health and dental plans for the next year.

Photo by Irene Fertik

The month-long, open-enrollment period began Friday, Nov. 3, and continues through Monday, Dec. 4. This is the only time during the year that certain changes - such as switching health or dental plans or adding a dependent - can take place, according to Lisa Macchia, director of health plans. Changes made now are effective Jan. 1, 1996. (Changes in retirement plans or other insurance coverage can be made throughout the year.)

Macchia advises employees to pay close attention to their health and dental coverage. Although there are fewer changes this year than last, there are changes.

The biggest is the addition of a new HMO - California-Care - to the list of the university's health-plan options.

"CaliforniaCare is Blue Cross' HMO," said Macchia. "Many employees may find that their doctors are providers for both PacifiCare and CaliforniaCare."

Employee contributions for the CaliforniaCare Plan are lower than for the other two HMOs offered by the university, according to a comparison matrix.

Most plans' costs have changed by only a few dollars, with some going up slightly, while others have dropped slightly, said Macchia.

For instance, in 1996 a single employee on the USC Network Plan will pay $27.53 - about $2 more a month than last year. Employees with one dependent will pay $55.17, an increase of about $3.50.

In the case of Kaiser, rates are going down. A single employee will pay $18.70 per month, compared to $25.01 last year. Employees with one dependent will pay just $37.64, compared to $46.40 in 1995.

As in past years, USC contributes about 85 percent of the cost of health-care benefits.

Prescription co-payments, however, are going up under all plans. In 1995, Kaiser charged a flat $4 for prescriptions. In 1996, the co-payment rises to $7 per prescription for a maximum 100-day supply. At PacifiCare, generic drug co-payments remain at the 1995 rate of $5, but brand-name drugs will now cost $10. Members of the USC Network plans - who used to pay $3 or 10 percent of the prescription's cost (whichever was higher) - will now pay $5 or 10 percent when the prescription is written by a Network physician and filled by an RxNet pharmacy.

There are also changes in office-visit payments under some plans.

Office visit co-payments will be the same for all HMOs. This means, in the case of Kaiser, office visits will more than double - from $2 to $5. PacifiCare and CaliforniaCare also charge $5 per visit.

The USC Network Medical Plan still covers 100 percent of office-visit charges when the patient sees a USC faculty physician, and 90 percent when the patient sees regular Network physicians. (With regular Network physicians, the patient must meet the deductible before office visits are covered.)

Enrollment in the Network Plan continues to grow. In 1994, there were 2,625 participants in this plan: 56 percent of all faculty and 24 percent of all staff. Currently, there are 3,221 participants - 60 percent of faculty and 30 percent of staff. The Network Plan II - the closest thing USC has to an indemnity plan - has dropped to 169, with 38 fewer participants than last year.

Kaiser enrollees increased slightly - to 3,178 from last year's 3,050. PacifiCare currently has 890 faculty and staff enrolled, 119 fewer than in 1994. CIGNA (which has been purchased by Caremark International) now has only 55 participants. Its enrollment remains frozen.

There are no changes for 1996 in the Delta Dental Plan or the Safeguard Dental Plan, according to Macchia. Monthly fees for Safeguard have risen by less than $1 a month. Employees are eligible to enroll in dental plans after one year of service.

The university will continue to pay the entire cost of health plan coverage for a small number of staff who earn minimum pay, according to Macchia.

The university continues to support a wellness benefit that began last year in the form of noontime seminars and an exercise program.

Last year, "walking trains" traversed the campus at the lunch hour twice a week. This year, Macchia said, participants in the walking program will meet Mondays and Wednesdays at noon at Cromwell Field and will walk around the track at a pace that suits each individual. On the Health Sciences Campus, walkers will meet in front of the Norris Medical Library on a similar schedule.

The Wellness Speakers Series kicks off with instructor Joy Yakura from the Department of Biokinesiology and Physical Therapy. Yakura's "Exercising at Your Worksite" program will show participants on both campuses how to enhance flexibility and prevent work-related injuries. The HSC session will be held in the Doheny Eye Institute's conference room, from noon to 1 p.m., on Thursday, Nov. 16. The program repeats at UPC on Tuesday, Nov. 28, at the Town and Gown patio. In December, a stress-management program takes place on both campuses.

Macchia recommends that during the next few weeks employees carefully look over the materials they will receive and compare the different plans.

To let employees gather more information and talk to plan representatives, the university is also holding benefits fairs on both campuses. The fairs are slated for Nov. 15 and 28 on the University Park Campus, and Nov. 16 at the Health Sciences Campus (see box for specific locations and times).

In an effort to introduce University Park employees to Health Sciences Campus' facilities, Macchia said, the Health Plans Office is sponsoring a health tour on Wednesday, Nov. 29. The two-hour tram tour - which includes lunch - will leave from JEP House at 10:30 a.m. Space on the tour is limited, according to Macchia. Those interested should call the Health Plans Office at 740-0035 to reserve a space. Brochures with comparisons of all medical plans, changes to the plans, options available and other USC benefits including dental and pre-tax payment account programs were distributed to departments

Nov. 2. Employees who have not received their package by Nov. 6 should contact their home department coordinator.