新澳门六合彩开奖记录 Health and Dental Plan
Transparency in Coverage Rule
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新澳门六合彩开奖记录 Choice Plan
新澳门六合彩开奖记录
63-0477348
Frequently Asked Questions
Due to increased claims expenses, the 新澳门六合彩开奖记录 Fringe Benefits Committee (FBC) recommended, an employee premium increase of $10 per month for single coverage and $30 per month for family coverage. In addition to the premium increases, it is necessary to make benefit design changes for the 新澳门六合彩开奖记录 Choice and 新澳门六合彩开奖记录 Select Plans.
Below are the approved benefit design changes for the 新澳门六合彩开奖记录 Choice and 新澳门六合彩开奖记录 Select Plans, effective January 1, 2024:
The 新澳门六合彩开奖记录 Choice Plan will implement a new calendar year deductible structure for 2024. For single coverage, the calendar year deductible will be $125 and family coverage will have a calendar year deductible of $250. This will replace the existing $400 per person major medical deductible which
currently applies only to specific services such as ambulance services, cardiac rehab, physical therapy, etc.
The 新澳门六合彩开奖记录 Select Plan will also have a new calendar year deductible implemented. For single coverage, the calendar year deductible will be $125 and family coverage will have a calendar year deductible of $250.
The calendar year deductible on both the 新澳门六合彩开奖记录 Choice and 新澳门六合彩开奖记录 Select Plan must be fulfilled before the Plan鈥檚 benefits take effect. This means that you will be responsible for satisfying the applicable calendar year deductible before benefits are paid by the Plan.
The new calendar year deductible will be in addition to the existing calendar year prescription drug deductible of $100 per individual (maximum of 3 per family).- Urgent Care copay increase to $50 per visit on both the 新澳门六合彩开奖记录 Choice and 新澳门六合彩开奖记录 Select Plan; and will apply to the 新澳门六合彩开奖记录 Health Network (currently $15) and BCBS PPO Network (currently $40).
| 新澳门六合彩开奖记录 Choice Plan - Base Premiums (employee hired before 1/1/2013) | |
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| 新澳门六合彩开奖记录 Choice Plan - Standard Premiums (employees hired on or after 1/1/2013) | |
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Premiums for health and dental coverage are paid one month in advance and the employee
contribution for bi-weekly paid employees is split equally between the first two paydays
of the month. The employee contribution is exempt from federal, state and FICA taxes
with participation in the Premium Conversion Plan (automatic enrollment).
Wellness Incentive
The 新澳门六合彩开奖记录 Choice Plan and the 新澳门六合彩开奖记录 Select Plan implemented a Tobacco Cessation Program
to help participants stop the use of tobacco. The program includes a wellness incentive
that reduces the employee premium cost sharing by $50 per month, if both the employee
and covered spouse do not use tobacco products. As a current 新澳门六合彩开奖记录 health insurance member,
if you are not receiving the wellness incentive and both you and your covered spouse do not use tobacco products (and have not for at
least six months), you must complete the Tobacco Declaration Form. No action is required by employees that currently receive the wellness incentive.
The 新澳门六合彩开奖记录 Choice Plan and the 新澳门六合彩开奖记录 Select Plan are committed to helping you achieve your
best health. Rewards for participating in the Wellness Incentive Program are available
to all employees. If you think you may be unable to meet the standard for the reward
under this program, you may qualify for an opportunity to earn the same reward by
different means. Contact the Human Resources Department for additional information.
The 新澳门六合彩开奖记录 Choice Plan and the Select Plan along with other plan information is available in Human Resources on campus and at
新澳门六合彩开奖记录 Health Human Resources.
| 新澳门六合彩开奖记录 |
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| 新澳门六合彩开奖记录 Choice Plan - Plan Benefits |
| 新澳门六合彩开奖记录 Select Plan - Plan Benefits |
The 新澳门六合彩开奖记录 Choice Plan and the 新澳门六合彩开奖记录 Select Plan pharmacy annual deductible is $100 per individual (maximum of 3 per family).
The 新澳门六合彩开奖记录 Choice Plan and the 新澳门六合彩开奖记录 Select Plan copay structure 6-tier plan6-tier plan:
鈥� Generic (preferred) COPAY $10
鈥� Generic (non-preferred) COPAY $10
鈥� Preferred Brand Name COPAY $50
鈥� Non-Preferred Brand Name COPAY $75
鈥� Specialty (preferred) COPAY $150
鈥� Specialty (non-preferred) 50% COINSURANCE
Employees are eligible for participation in the 新澳门六合彩开奖记录 Choice Plan or the 新澳门六合彩开奖记录 Select Plan based solely on hours of service. The Affordable Care Act requires an offer of coverage to employees credited with 30 hours of service per week or 130 hours of service per month on average. The Plans may defer the offer of coverage if the employee is determined as having 鈥渧ariable hours鈥� in which case benefits-eligible status will be determined using a 12-month measurement period with a corresponding 12-month coverage period in compliance with the Affordable Care Act.
Eligible Employees include:
- An employee with a specific appointment with no termination date, occupying a permanently budgeted position, and working a minimum of 30 hours per week on a regular basis.
- An employee with an employment start date on or after January 1, 2013, who is credited with 30 hours of service per week or 130 hours of service per month on average.
Eligible Employees may also enroll their legal spouse, as recognized by the state of Alabama, and children under age 26. Coverage with the selected Plan will begin on the first day of the month following the first day of employment, contingent upon timely application to the Human Resources department and payment of any required employee contribution.
- Spouse 鈥� As recognized by the state of Alabama.
- Dependent child 鈥�
- Your natural-born child under the age of 26.
- Your stepchild under the age of 26.
- Your legally adopted child, including a legally adopted child living with you as the adopting parent, during a period of probation.
- A child under age 26 over whom you have legal guardian status by court appointment.
- A child under age 26 for whom you are legally required to provide health insurance coverage pursuant to a Qualified Medical Child Support Order (QMCSO).
- Your disabled child of any age provided the disability commenced prior to age 19. Coverage under the Plan continues without interruption for the duration of the disability as long as the employee maintains dependent coverage.
You may enroll in a selected plan, enroll your eligible dependents or terminate coverage for yourself or a dependent when certain events cause a Change-In-Status. To make an enrollment change due to a Change-in-Status event, you must make application and provide documented proof of the Change-In-Status event to the Human Resources department within 30 days of the event. The effective date of the election would be the date of the qualifying event. If you fail to notify Human Resources within 30 days of the qualifying event, you must wait until the Open Enrollment Period.
Some examples of qualifying events include, but are not limited to:
- Marriage / Divorce
- Birth of Child
- Adoption or placement for adoption
- Death
- Change in your spouse鈥檚 employment status
There is a one-month Open Enrollment Period, usually the month of November, during which an employee may enroll in the 新澳门六合彩开奖记录 Choice Plan, or the 新澳门六合彩开奖记录 Select Plan, and/or add eligible dependents. During this period, you may file an application with the Human Resources department and coverage will begin on the first day of the following calendar year. During this time, employees can also re-enroll in SouthFlex Flexible Spending Accounts if they wish to participate the following calendar year.
All new employees must complete New Employee Orientation. During orientation, you will have the opportunity to complete enrollment forms. You will be notified as to the date/time of your scheduled orientation.
| 新澳门六合彩开奖记录 Choice Plan - Base Premiums (employees hired prior to 1/1/13) | Single | Family |
|---|---|---|
| Non-Tobacco | $124 | $415 |
| Tobacco | $174 | $465 |
| 新澳门六合彩开奖记录 Choice - Standard Premiums (employees hired on or after 1/1/13) | Single | Family |
|---|---|---|
| Non-Tobacco | $144 | $479 |
| Tobacco | $194 | $529 |
Note: Premiums for health & dental insurance are pre-tax dollars and are paid one month in advance so the initial deduction may reflect a retroactive adjustment.
The 新澳门六合彩开奖记录 encourages all employees to adopt healthy lifestyle choices. That effort will benefit you, your family and your fellow employees. The University鈥檚 Fringe Benefits Committee recommended, and the University adopted, a tobacco cessation program which is intended to help employees stop using tobacco products. Tobacco use and especially smoking will increase your risk of heart disease, stroke, respiratory diseases such as emphysema and bronchitis, as well as cancer including: lung, throat, mouth, esophagus, pancreas, bladder, and leukemia. The benefits from stopping the use of tobacco are almost immediate regardless of how long you have been smoking or using tobacco.
For new employees the Tobacco Declaration information/election is provided within the 新澳门六合彩开奖记录 Health & Dental insurance enrollment form.
Existing employees that do not currently participate in this wellness incentive may begin participation by completing the Tobacco Declaration form. On this form employees will declare that they and their covered spouse do not use tobacco products; and have not used tobacco products within six months prior to the date on the form. This will qualify for a wellness incentive of $50 per month (one per family). The wellness incentive will be applied to the monthly insurance premium effective the pay period following the date on the Tobacco Declaration form (payroll deadlines can affect when this discount will be applied).
For employees enrolled in any of the University sponsored health plans seeking assistance with tobacco cessation please call 866) 784-8454 or visit to obtain information about the Blue Cross Blue Shield - Quit for Life Program. The Program is provided at no cost to employees and covered spouses who want to stop using tobacco products and offers a 24-hour support hotline, customized phone counseling sessions and nicotine replacement patches, gum or lozenges.
For additional tobacco cessation resources you may also contact the Employee Assistance Program office at 461-1346.
Premiums for health & dental insurance are paid one month in advance. Your cancellation date will be based on your last day of employment. Example: If your last day of employment is December 14, your last paycheck will be December 30. Premiums paid in December through payroll deduction have paid for coverage for January. Your insurance will cancel effective January 31.
Note: The above information applies only to employees in a paid status. For employees on a leave of absence in an unpaid status, please contact Human Resources for an effective date of cancellation.
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