Health Insurance (OGB & LSU First)

The Standard health plans available for the 2022 plan year are follows:

The Medicare Advantage health plans available for the 2022 plan year are follows:

*Note: Via Benefits 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.

2022 plan information
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 the 2022 BC/BS Annual Enrollment Guide
Click here to view the 2022 Benefits Booklet

Office of Group Benefit Health Plans
Office of Group Benefits Customer Service: 1.800.392.4089
Website:  www.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) Zoom meetings schedule: https://annualenrollment.groupbenefits.org/meetings.html.  
4) Call the Office of Group Benefits Customer Service at 1.800.272.8451.
5) View In-network providers:  Go to: http://annualenrollment.groupbenefits.org/, then select "Find a Provider."

Health Insurance Premiums
1) The Office of Group Benefits has announced a 5% premium increase on all Blue Cross / Blue Shield health plans and a 10% increase on Vantage. Retirees should review the retiree premium sheet as rates will increase January 1, 2022.
LSU First has announced a % premium increase that varies by level of coverage:
- 1.6% for employee only
- 3.3% for employee / spouse
- 9.3% for employee / children
- 5.9% for family

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/ (health plan) and www.medimpact.com (Pharmacy Benefit Manager)
Member Portal: http://www.webtpa.com/ (health plan) and https://www.medimpact.com/ (pharmacy)
Claims Administrator:WebTPA
Pharmacy Benefit Manager: MedImpact
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 2022 LSU First Benefits Snapshot
3) Click here to view the 2022 Health Insurance Comparison Chart
4) Click here to view the MedImpact Formulary Look Up Tool
5) Click here to view the MedImpact Mail Mail order flier (instructions)
6) Click here to view the MedImpact Direct Mail Order form

LSU First Health Plan 2022 Changes
LSU First will have a premium increase for the 2022 plan year. The percentage increase varies based on level of coverage ranging from a 1.6% increase to 9.3%. Medimpact will continue as the  Pharmacy Benefit Manager for the 2022 plan year.

Beginning January 1, 2022, LSU First will implement a penalty for certain services performed in a hospital setting (even if at a first choice provider). There wil be no penalty associate with these services if they are received outside of a hospital setting, such as a free-standing surgery or imaging center or at a doctor's office. 

The penalty is simiar to a co-pay but does not accrue toward a member's out-of-pocket maximum.
- $150 penalty for CT scan and/or MIR performed in a hospital setting
   No penalty if performed at a a free-standing imaging center
- $300 penalty for outpatient surgery performed in a hospital setting
   No penalty if performed at ambulatroy surgery center

Reminders on the LSU First Health Plan:
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 will be available soon.
Please make sure that services receive pre-authorization: MRI, PT/OT/ST, surgery, etc.

New Hires and Mid-Year Changes (30-day window), Workday changes and required documentation
New Hires must complete the enrollment in Workday within the first 30 days of employment. A GB-01 document must also be completed within the 30-day timeframe and must include dependent verification documents: birth certificate for children and a marriage certificate for a spouse. International documents must be translated and notarized. 

Mid-year changes are allowed for IRS "qualifying events" within 30 days of the event. Qualifying events are: change in family status (birth, marriage, divorce, legal separation, change in employment status of employee or spouse), changes required by judgment, FMLA qualified leaves of absence, significant cost or coverage changes. Proof of the qualifying event is required in order to make a mid-year change. Employees who have a mid-year change must complete the change in Workday within the 30 day window.  GB-01 document must also be completed within the 30-day timeframe and must include dependent verification documents: birth certificate for children and a marriage certificate for a spouse. International documents must be translated and notarized.  Please contact an HR representative with any questions. 

- Click here for a list of qualifying events
- Click here for a GB01 document
- Click here for a Workday "change benefits" job aid (this is for qualifying events)

Continuing Insurance into Retirement - Retiree participation Schedule (Vesting)
Retirees may continue medical coverage upon retirement if eligibility requirements for age and years of service under TRSL or LASERS is met. Members of TRSL’s Optional Retirement Plan must meet the eligibility requirements, as defined by the TRSL, to continue coverage. Please contract HRM with any questions concerning retirement eligibility. Employees enrolled in health insurance are required to complete the Health Insurance Continuation/Cancellation Forms. Health insurance (along with AD&D and OGB Life Insurance) premiums will be deducted from the monthly retirement check for TRSL and LASERS retirees. ORP retirees must complete the Authorization for Insurance Deductions Form to have the LSU Payroll draft monthly premiums from your bank account in retirement.

If participation in a health plan through the State of Louisiana began on or after January 1, 2002, the state subsidy of the premium after retirement will be based on the number of years participated in a Group Benefits program. Employees with continuous coverage from prior to 2002 through their retirement are grandfathered into the 75% premium category below.

If a spouse and/or dependent began participating in a health plan through the State of Louisiana on or after July 1, 2002, the state subsidy of their premium after retirement (upon retiree's death) will be based on the number of years they have participated in a Group Benefits program. Please direct any questions regarding your retiree insurance premiums to Payroll/Insurance section at insurancepayroll@lsu.edu.

The following schedule is used in determining the state's subsidy of a retiree's premium. 

Notice regarding Medicare: Retirees and their dependents who continue their LSU-sponsored medical coverage and who are eligible to enroll in Medicare are required to enroll and remain enrolled in Medicare Part A and Part B. Failure to do so could result in loss of LSU-sponsored 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.”