Highmark Questions & Answers
Who does this new partnership affect?
Starting January 1, 2008, Highmark Blue Shield will be the health administrator for all benefits-eligible Penn State employees, retirees, and their dependents. Employees and retirees of the Pennsylvania College of Technology are not affected by this announcement.
Why did Penn State select Highmark Blue Shield?
After careful consideration, Penn State determined that Highmark Blue Shield was the best partner for this long-term, strategic initiative. Highmark Blue Shield is one of the few companies that can offer a comprehensive benefits plan across Penn State’s geographically dispersed population.
Why did Penn State enter such a long-term agreement?
Penn State’s 2006-2009 Strategic Plan calls for the University to “emphasize health, wellness, preventive care, and disease management, along with greater responsibility and incentives for good health practices among the University’s insured population.” Penn State’s 10-year partnership with Highmark Blue Shield supports this long-term, strategic investment in employee wellness. This new partnership also will help to bring consistency among the University’s health plans.
What kind of wellness programs will be offered through this new partnership?
Penn State and Highmark Blue Shield will provide employees the tools they need to take charge of their health. This starts by voluntarily completing Succeed, an online personal health assessment. This assessment provides a comprehensive health analysis along with recommendations for healthier approaches to life. Tools, programs and information to encourage good nutrition, exercise, and reduction of stress will be provided to help Penn State employees make more informed health care decisions.
After completing the Succeed personal health assessment, employees will have access to Highmark Blue Shield’s team of nurses, registered dietitians, exercise physiologists, and health coaches, who can design tailored programs that meet employees' unique health needs. Additional outreach initiatives will target those at risk of developing chronic conditions by helping them identify programs and services that reverse, stop or slow their chances of those diseases.
Will I need to change doctors?
No. Highmark Blue Shield’s statewide network includes more than 41,900 medical providers — that’s 61% more doctors than the current HealthAmerica HMO and Penn State Choice plans. And nationwide, nine out of 10 doctors are members of the Blue Cross Blue Shield network. In the very rare case that a doctor does not participate in the Blue Cross Blue Shield network, Penn State’s new medical plan will allow you to keep your doctor through an “out-of-network” coverage option.
How can I learn if my doctor participates in the Highmark Blue Shield network?
You can check Highmark Blue Shield’s current provider list online at http://www.highmarkblueshield.com/. Starting January 1, 2008, Penn State employees also will be able to check select quality measures of doctors who participate in the Highmark Blue Shield network.
Does the Penn State Milton S. Hershey Medical Center participate in the Highmark Blue Shield network?
Yes. Hershey Medical Center and all of its doctors participate in the Highmark Blue Shield network.
Do Geisinger doctors participate in the Blue Cross Blue Shield network?
Yes, currently almost all Geisinger doctors participate in the Blue Cross Blue Shield network. In the rare case that a Geisinger doctor does not participate in the Blue Cross Blue Shield network, Penn State’s health plan will allow for “out-of-network” coverage, similar to the current Penn State Choice coverage. You can check Highmark Blue Shield’s current provider list online at http://www.highmarkblueshield.com/.
How does this partnership affect Mount Nittany Medical Center?
Mount Nittany Medical Center is a member of the Highmark Blue Shield network and will continue to serve as a provider of choice for Penn State employees. The University’s unique relationship with Mount Nittany Medical Center will continue to support quality, affordable, and accessible healthcare for the Centre County community.
Will my medical premiums increase?
Penn State remains committed to paying a major share of employee health care costs, including 80% of premiums for individual plans and 74% of premiums for family plans. And although health care costs continue to increase nationwide, the wellness component of Penn State’s new partnership is designed to help minimize any cost increases for the University community.
How will my healthcare coverage change?
Penn State and Highmark Blue Shield are developing an exciting, new medical plan that will meet the health and wellness needs of the University community. Specific plan details will be announced this fall during the annual “Time To Choose” open enrollment period.
Why doesn’t Penn State offer plans from more insurance companies? Wouldn’t increased competition lead to lower premiums?
Just like many other services, there are benefits in economies of scale. Medical premiums are based on the concept of risk pools. Currently, Penn State employees are divided among several risk pools. However, by consolidating all employees under one healthcare administrator, the risk pool becomes stronger and premium increases can be minimized.
What does it mean when I hear that Penn State is “self insured”?
Penn State does not purchase healthcare insurance for its employees. Instead, the University is self insured, meaning that the University takes on 100% of the risk and pays for all expenses except employee contributions and copayments. Penn State will pay Highmark Blue Shield an administrative fee to determine benefits, process claims, provide customer service, and provide a network of physicians.
How will my pharmacy benefits be affected?
Penn State will continue to provide both retail and mail-order pharmacy options. Specific pharmacy details will be announced this fall during “Time To Choose”.
Does this announcement affect my dental or vision benefits?
No. Penn State will maintain its current partnerships with United Concordia and National Vision Administrators (NVA).
Will I have the same health coverage as employees at Hershey Medical Center?
No, your health coverage will be designed by Penn State to meet the health and wellness needs of the University community. Hershey Medical Center will continue to provide a plan that meets the customized needs of its stakeholders. Although the plans will differ in design, cost, and coverage, both will be serviced by Highmark Blue Shield.
I just went through HealthAmerica’s transition to United Behavioral Health for mental health services. Who does Highmark Blue Shield use for its mental health network?
Unlike other insurance providers, Highmark Blue Shield does not outsource its behavioral health services. This means care is closely coordinated by one source and Highmark Blue Shield also has a medical director specifically dedicated to mental health services. Highmark maintains an extensive network of mental health providers. Highmark Blue Shield’s current provider list can be found online at http://www.highmarkblueshield.com/.