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Medical Benefits


Health Insurance Plan Options

The State of Texas provides benefits-eligible employees with health coverage that includes medical care and prescription drug benefits. For full-time employees, coverage begins on the first day of the month after your 60th day on the job. 

During your first 60 days of employment, you can sign up your dependents for health insurance with no questions asked and without evidence of insurability. Even if you or a family member has a chronic medical condition, coverage is guaranteed.

Employees are automatically enrolled in HealthSelect of Texas. If you choose to waive health coverage for yourself, you need to notify the Office of Human Resources.

Employees are considered full-time for health insurance purposes if they are scheduled to work 30 or more hours a week.

If you and your dependents are enrolled in the health insurance plans, you are required to certify whether you and your dependents use tobacco. The monthly premium is $30 per person, up to $90 per household. If you do not certify, you will be subject to the monthly Tobacco User Premium. For more information, view the tobacco policy on the ERS website.

The prescription drug deductible starts over every January 1—you and each of your covered dependents must pay separate $50 deductibles before the plan begins to cover drug costs.

For the latest information about health insurance plans and rates, visit the ERS website.


Health Maintenance Organization (HMO)

Although benefits-eligible employees are automatically enrolled in HealthSelect of Texas, you may switch to a health maintenance organization (HMO) through Scott & White Health Plan. An advantage of the HMO option is that no PCP is required. Following this option, you must use doctors and hospitals in the network for services to be covered. Out-of-network providers can only be used in cases of emergency.

To receive information specifically about the Scott & White Health Plan available to ASU employees, access these Scott & White pages via the ERS website.

These are the monthly rates established for Sept. 1, 2016–Aug. 31, 2017:

Scott & White Health Plan Coverage
  Members Pay
Member only
$0.00
Member and spouse
$349.58
Member and children
$234.06
Family
$583.64

HMO Prescription Drug Plan

The Scott & White Health Plan includes prescription drug coverage that is administered by Scott & White Health Plan and Scott & White Prescription Services.

For more information and a complete list of participating pharmacies, visit the Scott & White pages of the ERS website.


HealthSelect

UnitedHealthcare administers the HealthSelect of Texas plan. On the UnitedHealthcare website, you can send e-mails about your policy, participate in live web chats, look up a physician, designate a primary care provider (PCP) and use other tools. To register online, you will need your group number and policy number. Following this plan, you choose a HealthSelect PCP and that doctor refers you to specialists and other providers within the network. When you stay in the network, you reduce your costs.

These are the monthly rates established for Sept. 1, 2016–Aug. 31, 2017:

HealthSelect Health Plan Coverage
  Members Pay
Member only
$0.00
Member and spouse
$353.68
Member and children
$236.80
Family
$590.48

For more details about this plan, visit these HealthSelect pages of the ERS website.

HealthSelect Prescription Drug Plan

The Employees Retirement System of Texas (ERS) Board of Trustees awarded the third-party administrator contract for the HealthSelect Prescription Drug Program to OptumRx, an affiliate of UnitedHealthcare, Inc., starting January 1, 2017.  You may visit www.HealthSelectRx.com  for program information or any questions regarding the transition.  Employees may contact customer care representatives toll-free at (866) 336-9371, TTY 711.

Contact Caremark for current coverage and claims information through December 31, 2016 toll-free at (888) 886-8490. Employees can view their claims online with Caremark through December 31, 2019 at www.Caremark.com/ers.


Consumer Directed Health Select

Consumer Directed HealthSelect is a high-deductible health plan, which means you could pay much more in out-of-pocket costs for health services and prescriptions. The member is responsible for paying an annual in-network deductible of $2,100 for an individual or $4,200 for a family (member plus at least one family member) for covered health services and/or prescriptions before the plan begins to pay for anything except for preventive services. Preventive services, like annual check-ups or vaccinations, are covered at 100%. The member would have to pay the full cost of other services and prescriptions until the deductible is met, and it’s important to understand what the full costs are, especially for prescriptions. After the deductible is met, the health plan pays 80% of covered, in-network services and prescriptions.

One of the advantages of joining Consumer Directed HealthSelect is that you can contribute to an HSA. An HSA is a personal bank account to help you save and pay for health care while giving you real tax savings.

These are the monthly rates established for Sept. 1, 2016–Aug. 31, 2017:

Consumer Directed HealthSelect Health Plan Coverage
  Members Pay
Member only
$0.00
Member and spouse
$318.32
Member and children
$213.12
Family
$531.44

For more details about this plan, visit these Consumer Directed HealthSelect pages of the ERS website.

Consumer Directed HealthSelect Prescription Drug Plan

Beginning January 1, 2017, United HealthCare Services, Inc. will become the third-party administrator of the prescription drug program for Consumer Directed HealthSelect. Caremark will continue to administer the program through December 31, 2016.

To see what level of coverage your prescription medications fall under, visit the Caremark website. For more information, call Caremark at 1-888-886-8490.


Compare Health Plans

Please use this comparison chart to view your out-of-pocket expenses for both the HealthSelect and HMO plans. For more information, call UnitedHealthcare at 1-866-336-9371 or Scott & White at 1-800-321-7947.

Medical Contact Information

HealthSelect – Visit the UnitedHealthcare website or call 1-866-336-9371.

  • Pharmacy Benefits: Visit the Caremark website or call 1-888-886-8490.

HMO (Scott & White Health Plan) – Visit the Scott & White pages of the ERS website or call the San Angelo administrative office at 325-659-7591 or 1-800-782-5068.

  • Pharmacy Benefits: Visit the ERS website or call 1-800-728-7947.