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Get Ready for Summer Enrollment

06/04/2021

Summer Enrollment for Plan Year 2022 begins soon. Your agency or higher education institution is assigned a specific Summer Enrollment phase. If you are an active employee or retiree not eligible for Medicare, you can change current coverage for yourself and your eligible dependents during the two-week Summer Enrollment phase assigned to you. Benefit elections made during Summer Enrollment will be effective on September 1, 2021.

You can learn more about HealthSelectSM plan benefits and changes during Summer Enrollment. Whether you're new to HealthSelect or have had coverage previously, keep an eye out for summer enrollment resources coming soon.

Here’s what’s new for Plan Year 2022:

We welcome HMO participants to HealthSelect of Texas®

The Texas Employees Group Benefits Program (GBP) will no longer offer enrollment in a health maintenance organization (HMO) plan after September 1, 2021. Read why the Employees Retirement of System (ERS) made this change.

If you’re currently enrolled in an HMO and do not have Medicare as your primary insurer, you will be automatically enrolled in HealthSelect of Texas® beginning September 1. You also have the option to choose Consumer Directed HealthSelectSM or waive GBP health coverage during Summer Enrollment.

Change to Total In-Network Out-of-Pocket Maximum

Effective January 1, 2022, the total in-network annual out-of-pocket maximum will increase for all HealthSelect plans, including Consumer Directed HealthSelect. The out-of-pocket maximum will increase to $7,000 for employee-only coverage and $14,000 for family coverage. The out-of-pocket maximum includes expenses you pay toward medical and prescription drug copays, coinsurance and deductibles (primarily for those enrolled in Consumer Directed HealthSelect).

Remember: It pays to say in-network! There is no out-of-pocket maximum for out-of-network care.

$0 Copay on Mental Health Virtual Visits

Beginning July 1, 2021, mental health Virtual Visits through Doctor on Demand® and MDLIVE® will be covered at 100% if you are enrolled in HealthSelect of Texas, HealthSelectSM Out-of-State or HealthSelectSM Secondary. This means you will pay nothing for mental health Virtual Visits.

Note: Your coverage for medical Virtual Visits remains the same. See the Virtual Visits page for information.

If you are enrolled in Consumer Directed HealthSelect, you must meet your annual deductible before mental health Virtual Visits are covered. After you meet your deductible, you will pay 20% coinsurance.

Visit the Mental Health page for updates.

Hemoglobin A1C Lab Test

Effective September 1, 2021, Consumer Directed HealthSelect and HealthSelect Secondary plan participants will no longer need to meet their annual deductible before in-network diagnostic A1C testing for diabetes is covered. Coinsurance will still apply. Because there is no in-network deductible for HealthSelect of Texas and HealthSelect Out-of-State, there is no change to these plans. In-network preventive A1C testing will still be covered at no cost to you.

The 2021 Summer Enrollment Guide will be available starting June 21, 2021. Find this and other resources on the Summer Enrollment page on www.healthselectoftexas.com.

Summer Enrollment webinars

To help ensure the health and safety of all employees, retirees and third-party benefits administrators (TPAs) during the COVID-19 pandemic, ERS will continue hosting Summer Enrollment events online.

Beginning the first day of Summer Enrollment, ERS will host webinars throughout the Summer Enrollment period. You can attend the webinars from the convenience of your computer or other device.

The Summer Enrollment webinars will review important benefit updates for Plan Year 2022. You will also have the opportunity to ask questions directly to ERS and the TPAs — just as you would during an in-person Summer Enrollment Fair.

ERS will post the webinar schedule on the Summer Enrollment webpage and have details of each webinar on the online events calendar. Please check the ERS Summer Enrollment webpage and the calendar regularly for updates.

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