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United Healthcare to be Lab's new health care provider in 2004

United Healthcare will administer the Health Maintenance Organization (HMO) and Preferred Provider Organization medical plans, as well as a new Consumer-Driven Health Plan for Laboratory employees, retirees and their covered family members.

The new health care-provider plan is effective Jan. 1, 2004. The Lab's current health-care provider, Blue Cross Blue Shield New Mexico, will continue to provide health care coverage through Dec. 31.

United Healthcare was selected through a competitive bid process that was initiated jointly by the University of California Office of the President and the Laboratory. Four health care companies bid on the HMO and PPO options while a fifth company bid only on the Consumer Driven Health Plan. One company bid only on disease management and demand management nurse line. United Healthcare was the only company that was able to offer the whole range of services and plans that Lab employees wanted.

The bid process began last February with a Request for Proposal for a HMO/Exclusive Provider Organization, PPO and Consumer Model Medical and Prescription Drug overage. The RFP closed April 7. Along with a panel of health care experts and administrators from UCOP and Los Alamos, Deloitte and Touche served as UC and the Lab's consultant partners and participated in the review of proposals and evaluation of finalists. Site visits were conducted by a cross section of these panel members including the Laboratory's benefits manager. The final selection was made this week.

"United Healthcare has an excellent national reputation and wide network coverage both in New Mexico and throughout the nation," said Michele French, executive director of UC Human Resources and Benefits Policy and Program Design. "We believe United will provide the excellent service that the Laboratory community expects, and they are working hard with local providers to have final contracts in place by January 2004."

One of the advantages of contracting with United Healthcare is its ability to provide seamless national network coverage and centers of excellence, which gives Lab employees and retirees access to specialty care when it is needed, said Mark Esteban of UC's Health and Welfare Policy and Program Design. Other advantages include a high quality member services office in Albuquerque, which will allow regular on-site presence by a United Healthcare-member advocate, and a high level of automation and Web presence in their operations, which will improve member access and speed of services, he added

In response to requests from the Laboratory community, United Healthcare also will be providing a new Consumer-Driven Health Plan as part of its suite of services.

"Last year, Laboratory employees and the Community Healthcare Roundtable sent us a clear message that they wanted a Consumer-Driven Health Plan as an option, and the CDHP gives them that choice", said Esteban.

While consumer models generally have higher deductibles than HMO and preferred-provider plans, they feature an employer-funded spending account that members can apply to some of the deductible costs. They also give members more advanced information and tools to enable them to be effective consumers of health care.

In addition to the new health care carrier, the University of California will be announcing new strategies for cost savings in the health care arena.

"Health care costs across the country continue to increase and this year is no exception. We anticipate having to manage a 15 percent increase in medical costs and this will need to be done through strategies such as the co-insurance plan design which was implemented last year," said Sandy Haire, benefits manager in Benefits and Employment Services (HR-B).

Next week, Judy Boyette, associate vice president for UC's Human Resources and Benefits, French and Esteban, of UC, will be at the Laboratory to answer questions about the bid process and the selection of United Health Care. They also will give Lab employees an update on California's state budget and its implications for UC. Check the Laboratory's main Web page for information about scheduled meetings.

For information about United Healthcare, go to www.unitedhealthcare.com online.

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