Health Insurance Plans
Employees working 30 hours (75% effort) or
more per week are eligible to participate in one of the health
plans. Coverage is effective the first day of the month
following one full calendar month of employment. Newly hired or
newly eligible employees have 30 days to enroll on the earliest
possible date. Employees may enroll or add a dependent as a
"late applicant" at any time during the year. The effective
date of the coverage depends upon what time of the month the
paperwork was submitted. The deadline to be effective the first
of the following month is no later than the 14th of each month.
All medical plans have a 12 month
pre-existing condition clause - conditions treated during the 6
months prior to the effective date of LSU coverage, are excluded
until coverage has been in effect for one full year.
Pre-existing conditions are waived when proof of prior coverage
is submitted. Premiums for Health Insurance are paid one month
in advance and are deducted through payroll deductions. members
have a choice of paying premiums on a before-tax or after-tax
basis. Those wishing to have deductions taken on a before-tax
basis must sign up for the Premium Only Cafeteria Plan. Please
note that deductions of premiums from your paycheck is NOT an
indication that coverage has been entered into the providers
system. The providers issue ID cards to new enrollees. Please
contact the Benefits section at (504) 568-7780 for assistance,
if you need to utilize services but have not received an ID
card.
The Annual Enrollment period is April of each
year to become effective the following July 1st.
To add or delete a dependent from a health
plan, employee must complete an Enrollment/Change Form (GB01)
available through the Benefits section or on-line. If you work
at a remote site, please contact our office at (504) 568-7378
for assistance; most sites have a Business Office which can
provide you with these forms. For newborns/adoptions, coverage
is not automatic even if you have family coverage. There is a
30 day window to add the new dependent in order for coverage to
re retroactive to the date of birth/adoption.
Please click
here for a summary of the
health plans. For the list of premiums, please click
here.
Medical Plans
Please read the plan brochure to familiarize
yourself with the pre-certification procedures of your plan.
Failure to follow required pre-certification procedures will
result in a loss of benefits. Each health plan includes mental
health/substance abuse coverage and prescription drug benefits.
Preferred Provider Organization (PPO)
| Phone: |
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1-800-272-8451 |
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1-225-925-6500 |
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Website: |
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www.groupbenefits.org |
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Pharmacy Provider: |
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1-877-362-3933 |
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Mental Health/ Substance Abuse |
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1-866-492-7143 |
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Indemnity
Plan featuring a network of contracted providers and
facilities.
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Annual
deductibles of $500/person and coinsurance apply.
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Various
levels of reimbursement based on utilization of PPO/Non-PPO
provider in the Region where services are received.
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Freedom to
select from network physicians; no referrals required.
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50/50 pharmacy benefit;
employee pays 50% of cost up to $50/prescription.
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$5 million/person
lifetime maximum including prescription drugs.
Useful Links
|
Humana HMO
| Phone: |
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1-800-564-9159 |
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Website: |
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www.humana.com |
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Pharmacy Provider: |
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Catalyst Rx |
| 1-866-358-9530 |
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| Mental Health/ Substance
Abuse |
| 1-866-492-7143 |
|
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Each
insured member selects a "family doctor" known as the
Primary Care Physician who coordinates referral to
specialists, hospitalizations and outpatient procedures.
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No deductibles, fixed
co-payments for services.
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Out of network services
available only for emergency care.
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$90 one time co-pay for
maternity care physician visits.
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Discounts for dental,
vision, hearing, massage therapy, and cosmetic surgery
available at no additional cost.
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50/50 pharmacy benefits:
employee pays 50% of cost up to $50/prescription - limited
to prescriptions written by OHP physician.
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$5 million/person lifetime maximum
including prescription drugs.
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LSU First Health Plan
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- Nationwide network of providers to select from
utilizing CIGNA provides nationwide, the First Choice
providers and Verity Health’s Louisiana network.
- LSU deposits money into a Health Reimbursement
Account (HRA). The money in this account applies toward
your deductible.
- No out of pocket expenses until HRA is exhausted.
- If expenses exceed your HRA, then you are
responsible for a deductible based on the level of
coverage (employee only, employee + spouse, employee +
child or family).
- Once the deductible has been met, plan pays 90% in
network providers or 70% to out of network providers.
- Any unused HRA balance on July 1st rolls over and
can be used in future years. The more money in the HRA,
the lower the deductible; it's possible to eliminate the
deductible entirely.
- Each member receives a personalized web site with
health resources and tools to help maximize your
healthcare needs.
- No co-pay at the pharmacy for prescription drugs.
Generic drugs are available at no cost after HRA is
exhausted.
- Preventive Care Covered 100% with in-network
providers.
- First Choice Providers offering 100% coverage after
HRA is exhausted.
- Employee has $5,000 Critical Illness policy;
$500/child (spouse not included).
- Extensive Employee Assistance services available at
no cost.
- $10,000 term life insurance policy is included.
- $5 million/person lifetime maximum.
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United Health Care
- EPO
|
Phone: |
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1-866-336-9374 |
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Website: |
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www.myuhc.com |
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Pharmacy Provider: |
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1-866-358-9530 |
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Mental Health/ Substance Abuse |
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1-866-492-7143 |
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Nationwide network of United Health
Care providers.
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Co-pays for most
services.
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$300/person deductible for services
without a deductible.
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$90 one time co-payment
for maternity care physician visits.
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50/50 pharmacy benefit;
employee pays 50% of cost up to $50/prescription.
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$5 million/person
lifetime maximum including prescription drugs.
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For a chart of the
comparisons between plans, please click
here.
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