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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, 2018.  If you wish to remain in the same health plan, you do not need to do anything.  Your current coverage will continue for the 2018 plan year (January 1, 2018 - December 31, 2018).  Members enrolled in Flexible Spending (Diversified Benefits Services) or the Pelican HSA 775 plan must updaet their contribution for 2018.  

2018 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, 2017

October 31, 2017

January 1, 2018

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

October 1, 2017

November 15, 2017

January 1, 2018

OGB Medicare Advantage Health Plans

October 15, 2017

December 7, 2017

January 1, 2018

Any changes submitted during the annual enrollment period will be effective January 1, 2018.  Employees will need to complete all changes in Workday by the deadlines listed above.  Retirees should submit all change forms to LSUS HR Department by the deadlines listed above.  Submitting information directly to OGB may delay processing and result in incorrect insurance deductions. If you have any questions regarding your current benefits or plan information, please contact the carrier or the LSUS HR department.

The standard health plans available for the 2018 plan year are follows.

LSU Plan

Administrator

LSU First Health Plan (Option 1)  lower deductible

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

LSU First Health Plan (Option 2)  higher 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 2018 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 2018 Annual Enrollment Guide

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.

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: October 31st at the Bossier Civic Center at 9:00 am and 2:00 pm. Retirees with Medicare meetings: November 1st at the Bossier Civil Center at 9:00 am and 2:00 pm.
4) Recorded Webinars are typically available each year and are available on the http://annualenrollment.groupbenefits.org/ website. Employees or retirees typically need to register in advance to participate in live webinars.
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."

2018 Office of Group Benefit Plan Changes
1) The Office of Group Benefits has announced no premium increases on OGB plans.
2) There is a $1,000 out-of-pocket maximum increase on the Magnolia Local Plus and Magnolia Open Access plans.
3) There is $50 ER co-pay increase on the Magnolia Local Plus plan.
4) Disabled dependents: Beginning January 1, 2018, Disabled dependents will not be able to continue on the health insurance once they turn 26 years of age. However, disabled dependents who currently are covered on the state health insurance will be allowed to continue their health insurance, subject to an annual review of their status. In some cases, grandchildren may be added to health insurance plans.
4) 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 for the LSU First Benefits Snapshot. 
3) Click here to view Health Insurance Comparison Chart
4) Click here to view the Speciality Drug List
5) Click here to view the Prescription Drug Formulary (Exclusion list)
5) Click here for a Summary of Benefits and Coverage (LSU First Option 1) - coming soon!
6) Click here for a Summary of Benefits and Coverage (LSU First Option 2) - coming soon!

LSU First Health Plan 2018 Changes
1) There will be a 6.8% premium increase.
2) In-Network co-insurance will change from 90/10 co-insurance to 80/20 co-insurance.
3) Brand Name medications will change from $40 co-pay (following satisfaction of the deductible) to 20% co-insurance (following satisfaction of the deductible) with a maximum of $150 for each 30-day fill.
4) Specialty medication will change from $150 co-pay (following the satisfaction of the deductible) to 20% co-insurance (following the satisfaction of the deductible) with a maximum of $150 for each 30-day fill. Click here for a list of speciality medications.

5) Generic Medications:  Rollover HRA will now be used to pay for generic medications and First Choice Providers.  After the HRA is exhausted and the Rollover HRA is exhausted, generic drugs will continue to be paid by the plan at 100%.

6) There is an updated Prescription Drug Formulary exclusion list. Click here to review. Impacted plan members will be notified directly from Citizens Rx.

7) Rollover HRA cap will reduce to 1X your current year HRA amount. For example:
    - Employee only coverage HRA rollover will cap at $1,000 (vs. $4,000).
    - Employee / children and Employee / Spouse levels of coverage will cap at $1,500 (vs. $6,000).
    - Family level of coverage will cap at $2,000 (vs. $8,000).

8) Rollover HRA money that exceeds the amounts listed above will reduce to the new maximum beginning January 1, 2018. For example: Jane has LSU First, Option 1, employee only level of coverage with a HRA Rollover balance of $4,000. That will be reduced to $1,000 beginning January 1, 2018. 

9) Rollover HRA will now apply to LSU First Choice Providers and Generic Drugs. After the HRA and HRA rollover balance are both exhausted, these claims will be paid by the plan at 100%.

10) Effective January 1, 2018, the LSU First contract wtih AmWell for Telemedicine services will expire. LSU First is currently reviewing other telemedicine vendors.

11) LSU First must follow the Office of Group Benefits eligibility and dependent eligibility guidelines. The Office of Group Benefits announced some changes to disabled dependent eligibility and grandchildren coverage. LSU First must also implement the same changes effective January 1, 2018.
Disabled dependents: currently enrolled disabled dependents (over age 26) may continue their health insurance coverage subject to an annual review of their impairment status. Beginning January 1, 2018, disabled dependents WILL NOT be able to continue on the health insurance plan once their turn 26 years of age. In some cases, grandchildren may be added as a dependent. Please review the following guide for additional details. https://www.annualenrollment.groupbenefits.org/docs/2018/2018%20GUIDE_FINAL_v2_8-29-2017.pdf.

Mandatory Dependent Verification Audit
As part of our commitment to provide the highest level of benefits possible and to control unnecessary spending, LSU First is taking steps to ensure that only eligible dependents are enrolled in our health care benefits.  LSU First has hired Hodges-Mace, LLC, to conduct a dependent audit in order to verify that all enrolled dependents meet the established plan requirements for eligibility. If you have a covered spouse or any other dependents, you will receive instructions in the mail directly from Hodges-Mace, LLC, on how to verify your dependents. Please note that failure to comply with the audit requirements may result in loss of dependent coverage.

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.”