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Insurance

Health Insurance

Annual Enrollment is the time of year when employees / retirees can make changes to their insurance plans. There are 3 different enrollment periods this year.  Plan changes are effective date of January 1, 2019.  The LSU First (Option 2) health plan is being eliminated. Enrolled plan members will automatically be defaulted to the LSU First (Option 1 - lower deductible) health plan with the option to move to an Office of Group Benefits Health plan.  Members enrolled in Flexible Spending (Diversified Benefits Services) or the Pelican HSA 775 plan must update their contributions for 2019.  

It is recommended that employees review their current coverage, make any changes (if necessary) and complete the open enrollment event  in Workday by the deadlines listed below.  Please reference the Workday Annual Enrollment Job Aid. Retirees should submit all change forms to the LSUS HR Department by the designated annual enrollment deadlines. Submitting information directly to OGB may delay processing and result in incorrect insurance deductions.

2019 ANNUAL ENROLLMENT PERIODS

Insurance Plans

Start Date

Deadline

Effective Date of change

LSU First Health Plan and LSU Voluntary Benefits (Dental, Vision, AD&D, LSU Life)

October 1, 2018

October 31, 2018

January 1, 2019

Flexible Spending 
Diversified Benefits Services

 October 1, 2018

November 15, 2018

 January 1, 2019

OGB Health Plans:  Magnolia Local, Magnolia Local Plus, Magnolia Open Access, Pelican HRA 1000, Vantage Medical Home

October 1, 2018

November 15, 2018

January 1, 2019

OGB Medicare Advantage Health Plans

October 15, 2018

December 7, 2018

January 1, 2019


The standard health plans available for the 2019 plan year are follows.

LSU Plan

Administrator

LSU First Health Plan (Option 1)  lower deductible

WebTPA (Claims administrator), AETNA and Verity Healthnet (provider networks)

OGB Plans

Administrator

Vantage Medical Home HMO

Vantage

Pelican HRA 1000

Blue Cross Blue Shield 

Magnolia Local

Community Blue and Blue Connect

Magnolia Local Plus

Blue Cross Blue Shield of LA

Magnolia Open Access

Blue Cross Blue Shield of LA


The Medicare Advantage health plans available for the 2019 plan year are follows:

OGB Medicare Advantage Plans

Vantage Medicare Advantage Premium HMO –POS

Vantage Medicare Advantage HMO Zero Premium

Vantage Medicare Advantage HMO-POS Plan

People’s Health HMO Medicare Advantage

One Exchange*

*Note: The One Exchange plan is a private Medicare exchange plan with HRA credits of $200 to $300 per month.  Plan members can visit: https://medicare.oneexchange.com/ogb or call 1-855-663.4228 to speak with a licensed Medicare representative to learn about different plan options.  Retirees must be careful to elect only OGB affiliated plans.

Health Insurance Plans Forms and Resources
Click here to view the Workday Open Enrollment Job Aid 
Click here to view Health Insurance Comparison Chart
Click here to view Health Insurance Premiums (actives)
Click here to view Health Insurance Premiums (retirees)
Click here to view a summary of annual enrollment changes
Click here to view the 2019 Annual Enrollment Guide 

Office of Group Benefit Health Plans
Office of Group Benefits Customer Service
: 1.800.392.4089
Websitewww.groupbenefits.org 
Office of Group Benefit Health Plans:  Magnolia Local, Magnolia Local Plus, Magnolia Open Access, Pelican HSA 775, Pelican HRA 1000, Vantage Medical Home and the Retiree Medicare Advantage plans.
Claims Administrator:  Blue Cross / Blue Shield of Louisiana, Vantage (Vantage Medical plan only)
Search for in-network providers: https://www.bcbsla.com/ogb

Learn about Office of Group Benefit Health Plans
1) Enrollment Guide: Please click here to review the enrollment guide.  This is a great resource!
2) Office of Group Benefits Website: http://annualenrollment.groupbenefits.org/
3) Regional Meetings: Actives and retirees with no Medicare meetings: November 6th at the Bossier Civic Center at 9:00 am and 2:00 pm. Retirees with Medicare meetings: November 7th at the Bossier Civil Center at 9:00 am and 2:00 pm.
4) Recorded Webinars are not available this year but copies of the Annual Enrollment presentations will be available on the http://annualenrollment.groupbenefits.org/ website. 
5) Call the Office of Group Benefits Customer Service at 1.800.272.8451.
6) View In-network providers:  Go to: http://annualenrollment.groupbenefits.org/, then select "Find a Provider."

2019 Office of Group Benefit Plan Changes
1) The Office of Group Benefits has announced no premium increases on OGB plans.
2) It is recommended to visit https://www.annualenrollment.groupbenefits.org/ for additional details.

LSU First Information
Customer Service: 1.855.346.5781
Website:  http://www.lsu.edu/lsufirst/
Member Portal: http://www.webtpa.com/
Claims Administrator: WebTPA
Pharmacy Benefit Manager: Citizens Rx
Search for In-Network Providers: http://www.lsu.edu/lsufirst/providers.php

Learn more about the LSU First Health Plans:
1) Visit the LSU First website at http://www.lsu.edu/lsufirst/
2) Click here to view the 2019 LSU First Benefits Snapshot. 
3) Click here to view the 2019 Health Insurance Comparison Chart
4) Click here to view the Speciality Drug List - Coming soon!
5) Click here to view the Prescription Drug Formulary (Exclusion list) - Coming soon!

LSU First Health Plan 2019 Changes
1) There will be a 3% premium increase.
2) Eliminating Option 2 (higher deductible plan). LSU First plan members will automatically default to LSU First Option 1 (lower deductible) with the option to change to an Office of Group Benefits Health Plan.
3) Emergency Room (ER) Co-pay of $150, waived if admitted.

Reminders on the LSU First Health Plan:
Citizens Rx will continue as the pharmacy benefit manager for 2019.
Generic drugs: the cost of generic drugs comes out of the HRA and rollover accounts first and then is covered by the plan at 100%.
Brand name drugs: The cost of brand name drugs will first be deducted from the HRA account. After the HRA is exhausted, plan members are responsible for 100% of the cost of the drug until the deductible is satisfied. After the deductible is satisfied, plan members are responsible for 20% co-insurance (maximum cost is $150 for a 30-day supply).
Specialty Medications: The cost of specialty medications will first be deducted from the HRA account. After the HRA is exhausted, plan members are responsible for 100% of the cost of the drug until the deductible is satisfied. After the deductible is satisfied, plan members are responsible for 20% co-insurance (maximum cost is $150 for a 30-day supply).
Preferred drug and drug exclusion lists are available at www.citizens.com/member/documents
Please make sure that services receive pre-authorization: MRI, PT/OT/ST, surgery, etc.
Routine eye exam: The plan will not pay for a vision exam for plan members who are enrolled in the vision plan. See page 57 of the Summary Plan Description. https://www.lsu.edu/hrm/pdfs/LSU_First_SPD.pdf

Premiums Only Plan 
The premiums for medical, dental, vision and OGB life insurance will automatically be deducted before taxes from your paycheck. There is no cost or tax liability. Due to the tax advantages under this program, you can only change or cancel these insurance plans during Annual Enrollment or if you experience a qualifying event (with proof of the event within a 30 day window).

Waiver of coverage requirement  / Affordable Care Act
Employees who do not elect health insurance are required to complete a waiver of coverage in Workday.  The Affordable Care Act has mandated a “penalty” or a fee for individuals that don’t have health insurance coverage.  If you don’t have coverage, you will pay a fee according to ACA rules. LSUS is required to issue Form 1095-C documents.  These documents will be issued to each employee when W-2’s are issued. This will be your “proof of health insurance coverage.”

 
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