USA Select Health Insurance Plan

Due to increased claims expenses, the USA Fringe Benefits Committee (FBC) recommended, an employee premium increase of $3 per month for single coverage and $9 per month for family coverage.
 

USA Select Plan - Base Premiums

Single coverage premiums will be $103 per month ($153 per month without the non-tobacco wellness incentive) Family coverage premiums will be $339 per month ($389 per month without the non-tobacco wellness incentive)

 

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 USA 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 USA 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 update your status is Employee Navigator.  No action is required by employees that currently receive the wellness incentive.

The USA Select Plan is 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 USA Choice Plan along with other plan information is available in Human Resources on campus and at USA Health Human Resources.

 

University of South Alabama

USA Select Plan - Plan Benefits

Glossary of Health Coverage and Medical Terms

 

Human Resources office addresses 

The USA Select Plan is a narrow network plan designed with lower deductibles and copay amounts when you use a USA Health network provider. Other BCBS PPO providers are covered at 70%. By using a USA Health provider, this will ensure that you receive the very best benefit possible. The pharmacy benefit is paid at 100% after the applicable copay. This is the same benefit as offered in the USA Choice Plan. The dental benefit is also the same as offered in the USA Choice Plan.

The plan is administered by Blue Cross Blue Shield of Alabama. 

The USA Select Plan is not for everyone:

1. The employee and dependents should reside in the state of Alabama.
2. The employee needs to understand the narrow network design.
3. The employee should be satisfied with the medical providers offered by this Plan.
4. Employees who select this Plan during open enrollment will be required to remain in the Plan until the next benefit year.
5. Employees with base premiums that elect the USA Select Plan and later make a change back to the USA Choice plan will be required to have standard premiums. 

Access the USA Select Plan - Plan Benefits here.

The USA Select Plan is a narrow network design based on USA Health medical providers and providers from the BCBS PPO network. To supplement primary care, a Telehealth program is included, providing telephone and internet access to a physician for minor medical concerns, resulting in a lower cost for the employee, time saved, and convenience. 

	Single	Family
USA Select	$ 103	$ 339

Premiums above include the non-tobacco wellness incentive of $50

Narrow network health plans provide the best benefits to specific hospitals, physicians and other medical providers. A narrow network design offers value to consumers through a lower premium, enhanced benefits and access to select medical providers concentrating on improved medical outcomes and preventive health.

The USA Select Plan has a calendar year deductible. 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 the USA Select Plan must be fulfilled before the Plan’s 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 medical calendar year deductible will be in addition to the existing calendar year prescription drug deductible of $100 per individual (maximum of 3 per family).

Enrollment in the USA Select Plan is on a voluntary basis to all benefits-eligible employees. 

• Highest benefit level provided when using the USA Health network with other BCBS PPO providers covered at 70%.
• Enhanced benefit design with lower deductible or copays for hospital and physician services when using the USA Health network:
  • $15 copayment for Physician, Physical, Occupational and Speech Therapy visits 
  • $150 Outpatient Surgery copayment
  • $200 Emergency Room copayment/waived if admitted
• Select providers concentrating on better medical outcomes.
• Preventive health for early detection and treatment of illness and chronic conditions.
• Telehealth to improve access and convenience for treatment of minor medical conditions.
• A voluntary offering for those employees who elect to participate.

Amazon Pharmacy Home Delivery Services

The USA Select Plan pharmacy annual deductible is $100 per individual (maximum of 3 per family).

The USA Select Plan copay structure 6-tier plan6-tier plan:

• Generic (preferred) COPAY $10
• Generic (non-preferred) COPAY $10
• Preferred Brand Name COPAY $50
• Non-Preferred Brand Name COPAY $75
• Specialty (preferred) COPAY $150
• Specialty (non-preferred) 50% COINSURANCE

Teladoc

Employees are eligible for participation in the USA 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 “variable hours” 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 20 hours per week on a regular basis.

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.

The USA Select Plan premiums are deducted before any Federal, State or Social Security taxes are withheld. Your gross income is reduced by the amount of your premiums and therefore, you pay fewer taxes. New employees are automatically enrolled in Premium Conversion. However, Premium Conversion is optional for employees. Contact the Human Resources department for information regarding opting out of Premium Conversion.

The University of South Alabama encourages all employees to adopt healthy lifestyle choices. That effort will benefit you, your family and your fellow employees. The University’s 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 made in Employee Navigator.

Existing employees that do not currently participate in this wellness incentive may begin participation by updating their status in Employee Navigator. 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 election date. 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 of the election (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 visit pivot.co/bcbsal6 and use access code: bcbsal6. The Program is provided at no cost to employees and covered spouses who want to stop using tobacco products and offers a personalized choice of tools and support. 

For additional tobacco cessation resources you may also contact the Employee Assistance Program office at 251-461-1346.

Coverage with the selected Plan will begin on the first day of the month following the first day of employment, contingent upon timely enrollment in Employee Navigator. 

Yes, the dental benefits are administered by Blue Cross Blue Shield of Alabama. 

No, you may only switch back to the USA Choice Plan during the annual open enrollment month for coverage starting January 1st of the following benefit year. You may not switch coverage during the year unless you have a change in your residence and you reside outside the state of Alabama. 

All medical providers which are Blue Cross Blue Shield network providers are covered by USA Select. Providers affiliated with the University of South Alabama referred to as USA Health network of providers have the highest level of benefits.

 

No, out-of-network medical providers are not covered.

You should consider that only a narrow network of medical providers will qualify for lower deductibles and copays. Other BCBS PPO providers are covered at 70%. This may not be the best plan if you have a chronic illness and receiving medical care from a BCBS PPO provider at this time. 

This is due to the fact that the medical providers have agreed to accept a lower fee. It is also due to medical providers working to achieve better medical outcomes through quality of care thereby reducing the cost of complications. The USA Select Plan benefits are better for medical services and the pharmacy and dental benefits are the same as the USA Choice Plan benefit.

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You must complete enrollment in Employee Navigator.