LSU Health Sciences Center Human Resource Management
 

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 for adults 19 and over - 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.

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 be retroactive to the date of birth/adoption.

Please click on the links below for more information.

 

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)/Blue Cross/Blue Shield Nationwide

Phone:
1-800-392-4089
Website:
www.groupbenefits.org
www.bcbsla.com/ogb
Pharmacy Provider:
Catamaran Rx:
1-866-358-9530
Mental Health & Substance Abuse:
Magellan Behavioral Health
1-800-523-6435
www.magellanhealth.com/member
 
  • Indemnity Plan featuring a network of contracted providers and facilities. 

  • Annual deductibles of $500/person and coinsurance apply.

  • Freedom to select from network physicians; no referrals required.

  • 50/50 pharmacy benefit; employee pays 50% of cost up to $50/prescription.

  • FDA approved generic usage mandatory

  • Unlimited benefits.

 

HMO by Blue Cross/Blue Shield of LA

Phone:
1-800-392-4089
Website:
www.bcbsla.com/ogb
Pharmacy Provider:
Catamaran Rx
1-866-358-9530
Mental Health & Substance Abuse:
Magellan Behavioral Health
1-800-523-6435
www.magellanhealth.com/member
  • Nationwide network

  • No deductibles, fixed co-payments for services.

  • Out of network services available only for emergency care.

  • $90 one time co-pay for maternity care physician visits.

  • Discounts for dental, vision, hearing, massage therapy, and cosmetic surgery available at no additional cost.

  • 50/50 pharmacy benefits: employee pays 50% of cost up to $50/prescription.

  • FDA approved generic drug usage mandatory.

  • Unlimited benefits.

Plan documents including provider directory posted at www.groupbenefits.org (Quick links - Health Plans)

LSU First Health Plan

Phone:
1-866-929-5781
Website:
www.mycigna.com
www.lsufirst.org
  • 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.
  • $25,000 term life insurance  and 25,000 AD&D policy is included.
  • Unlimited lifetime maximum.

Consumer Driven High Deductible Plan - Administered by Blue Cross/Blue Shield

Phone: 1-800-392-4089

www.bcbsla.com/ogb

Restricted Enrollment Eligibility:

CANNOT participate in the HSA if you have:

  • You or Spouse are enrolled in Health Care Flexible Spending Account

  • Medical coverage under a non-Consumer Driven health plan

  • TRICARE or TRICARE for Life

  • Used any VA benefits within the last 3 months

  • Medicare Part A and/or Part B

  • Maintenance drugs and wellness exams/immunizations are not subject to deductible.

Deductibles Out of Pocket Maximum
Employee Only - $1,250 $2,000 + deductible
Employee plus 1 - $2,500 $4,000 + deductible
Family of 3 - $3,000 $6,000 + deductible
Family of 4 - $3,000 $8,000 + deductible
Family of 5- $3,000 $8,900 + deductible

Employee plus one and/or family unit must satisfy the total deductible before co-insurance applies.

After deductible is met, plan members pays

  • 20% co-insurance for network providers
  • 30% co-insurance for non-network providers

Health Care Spending Account (HSA) Option

Voluntary enrollment, however only employees enrolled in the Consumer Driven High Deductible Health Plan may elect to contribute to the HSA.

  • You can use your HSA to pay eligible expenses.

  • Reimbursement limited to current account balance.

  • Funds can roll from one plan year to the next.

Contribution Limits

  • $3,250 (individual coverage)

  • $6,450 (family coverage)

  • Can add an additional $1,000 if you are age 55 or over

For a chart of the comparisons between plans, please click here.