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2012 Open Enrollment

Open Enrollment

Health and Dental Insurance Plan Information

Monthly Insurance Rates:Health, Dental, and Post Retirement

Flexible Spending Accounts

Voluntary Short Term Disabiltiy (STD) Insurance

Voluntary Supplemental Term Life Insurance

Optional Vision Coverage

Human Resources Benefits Contacts

Open Enrolllment Forms and Documents

Open Enrollment

It is very important that you take time to review this information closely as you make your health care choices for 2012.

During the Open Enrollment period benefit eligible employees have the opportunity to evaluate your health insurance needs and make changes in your health plan coverage for the following plan year.

2012 Open Enrollment will be October 28, 2011, to November 10th, 2011.

  At this time you may: 

  • Apply for health insurance coverage
  • Change your current health insurance coverage.
  • Add or drop dependents to your health insurance coverage
  • Enroll in the flexible benefit plan. Note: You must enroll in this plan annually
  • Enroll in a health savings account (as long as you elect the CDHP/HSA health option) and make an election for 2012
  • Enroll in, drop or change coverage in the voluntary supplemental life insurance program
  • Enroll in, drop or change coverage in the optional vision plan.
  • Enroll in the voluntary short-term disability plan

In 2012, the University will offer four healthcare plans: Anthem Blue Access 300 Buy-Up Plan; Anthem Blue Access 500 Core Plan; Anthem Consumer-driven High Deductible Health plan (CDHP) with a Health Savings account (HSA) called Lumenos CDHP/HSA; and Welborn HMO. Each of these options includes prescription drug coverage through the medical provider and dental coverage through Health Resources, Inc. (HRI). A 2012 Insurance Comparison Overview sheet is available for you to compare the benefits of the different health plans.


If you are a current participant in one of the Anthem plans or the Welborn HMO, you may change your coverage without providing evidence of insurability. If you previously waived coverage for yourself and/or your dependents, Anthem requires submission of a Certificate of Health Coverage to waive the pre-existing condition waiting period. Enrollment forms will be available at the Open Enrollment Kick-Off and Benefits Informational Fair on October 28, 2011, or may be obtained from the Human Resources Department in the Wright Administration Building, Room FA 166.

Open Enrollment will be your only opportunity to elect or change your medical, dental, vision, or related Section 125 Flexible Benefit Plan coverage elections and/or enroll or drop dependents or your own coverage on these plans for the 2012 calendar year. You may only make changes outside of the open enrollment period if you have a qualified family status change and notify the Human Resources benefit staff of that change within 30 days of the change.

Enrollment forms must be completed by November 10, 2011, to ensure coverage effective January 1, 2012.

Your current health insurance coverage will be continued unless you complete a form to change your coverage.

IMPORTANT NOTE: Benefits under the USI benefit plan(s) are provided pursuant to insurance contracts between USI and the insurance companies. If the terms of this enrollment document conflict with the terms of the insurance contract, the terms of the insurance contract will control, unless superseded by applicable law.


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ANTHEM BLUE ACCESS 300 BUY-UP PLAN – No Plan Design Changes for 2012

  • In-network deductible – $300 individual and $600 family
  • Non-network deductible – $600 individual and $1,200 family
  • In–network out-of-pocket maximum – $1,500 individual and $3,000 family
  • Non–network out-of-pocket maximum – $3,000 individual and $6,000 family
  • In-network co-insurance - 80%/20% and non-network co-insurance     60%/40%
  • Prescription retail co-payments - $10/24/40/70 / mail order co-payments $20/48/80/140 (90 day supply)

ANTHEM BLUE ACCESS 500 CORE PLAN – No Plan Design Changes for 2012

  • In-network deductible – $500 individual and $1,000 family
  • Non-network deductible - $1,000 individual and $2,000 family  
  • In-network out-of-pocket maximum- $2500 individual and $5,000 family
  • Non-network out-of-pocket maximum – $5,000 individual and $10,000 family
  • In-network co-insurance – 80%/20%,                                                       and non-network co-insurance – 60%/40%
  • Prescription retail co-payments $10/40/60/80/ mail order co-payments $20/80/120/160 (90 day supply)


  • This plan offers 100% preventative care coverage and extra wellness benefits
  • Deductible – $1,500 for single coverage and $3,000 for any level of family coverage (employee plus child; employee-spouse or family) in-network and out-of-network combined for this non-embedded deductible
  • Out-of-pocket maximum – $3,000 for single coverage and $6,000 for any level of family coverage (employee plus child; employee-spouse, or family); $6,000 for single coverage and $12,000 for any level of family coverage out-of-network
  • Co-insurance – after deductible, 90%/10% co-insurance in-network or  70%/30% co-insurance non-network, until maximum out-of-pocket is reached
  • Prescription drugs – subject to deductible and co-insurance: in-network Rx retail and mail order co-insurance is 10% after deductible; non-network Rx retail & mail order co-insurance is 30% after deductible
  • Enhanced wellness incentives with rewards include: Health Risk Assessments, MyHealth Coach, Healthy Lifestyles, ComplexCare, and Comprehensive Medical Management
  • On-line consumer tools, including comparative prescription drug shopping
  • A Health Savings Account (HSA) that allows both employer and employee to make tax-free contributions for use toward qualified healthcare expenses in 2012 and beyond
  • University Contributions to your Health Savings Account (HSA) are as follows:
    • For single members, initial funding of $250 and a regular contribution of $450 paid over 12 months, for a total of $700 in annual funding in 2012
    • For all levels of family membership, initial funding of $450 and a regular contribution of $950 paid 12 months for a total of $1,400 in annual funding in 2012
    • Newly eligible participants entering after January 1 will receive initial funding plus pro-rated regular contributions for the period in the plan

Wellness Initiatives for the Anthem Plans

Wellness initiatives will continue with the Anthem Blue Access Plans as steps toward controlling claims expense. These programs include:

  • 24/7 NurseLine: Access to a 24/7 NurseLine in which experienced registered nurses provide information concerning general health questions and guidance with critical health issues.
  • Future Moms: Support from trained obstetrical nurses to provide maternity management to help expectant parents have a healthy pregnancy and delivery.
  • ConditionCare: Assistance from registered nurses for members to better manage and improve chronic health conditions.
  • MyHealthAdvantage: Utilizes integrated information systems and data analytics to enhance early detection of potential health issues for participants. MyHealth Advantage provides members and their doctors with information about evidence-based standards that can facilitate better health care choices.

WELBORN HMO PLAN – No Plan Design Changes for 2012

  • Must use Welborn Health Plan provider (Deaconess Only); no out-of-network benefits
  • Deductible – $250 individual and $500 family
  • Out-of-pocket maximum – $1,500 Individual and $3,000 Family
  • In-network co-insurance – 80%/20% and non-network co-insurance – 60%/40% Prescription retail co-payments $15/35/50 / mail order co-payments $30/70/100 (90 day supply)


  • Dependent child coverage has been extended to age 26. Children will be covered until the end of their birth month in which they turn age 26.
  • No pre-existing conditions for children under age 19 in the Anthem plans. Welborn already has no pre-existing condition exclusions for any members, including children
  • 100% preventative coverage for all conditions identified as nationally recommended preventative services.
  • No lifetime plan maximums or annual limits on essential benefits. No referrals required for OB/GYN services for the Welborn plan; Anthem already has a no-referral plan design.
  • Emergency services coverage will not require preauthorization, be limited to in-network providers or impose higher cost sharing for out-of-network services in the Welborn plan; Anthem already has this feature.
  • Both Anthem and Welborn will continue to conduct appeals processes for these insured plans; and the insurers will adapt those processes to conform to all requirements of health reform. USI health plans will not retroactively terminate coverage, except in limited situations, such as when the covered individual commits fraud against the plan or makes intentional misrepresentations. When rescission is permitted for other reasons, USI’s health plans will provide the required prior notice of 30 days.

HEALTH RESOURCES, INC. DENTAL PLAN – No Plan Design Changes for 2012

  • 100% for preventive and 50% for restorative services
  • Must use a Health Resources, Inc., provider
  • Dependent limiting age extended to age 26 to match medical plans


  • The University and its insured employees continue to contribute to a fund for future retiree health benefits (VEBA Trust)
  • Employees continue to pay 25% or $2.12 for single coverage and $5.50 for all other coverage levels.

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MONTHLY INSURANCE RATES: Health, Dental and Post-Retirement

Click on the Individual Health Plan Links below for Bi-weekly Rates


2012 Monthly Rates


Blue Access 300 Buy-Up


Blue Access 500 Core


Blue Access Lumenos CDHP/HSA


Welborn HMO






EE + Child(ren)





EE + Spouse










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Flexible Benefit Spending Accounts allow you to set aside pre tax dollars to pay for certain un-reimbursed medical and dental expenses, and dependent care expenses. The spending account limit for the un-reimbursed medical and dental expense reimbursement plan remains at $6,000 per year. The dependent care plan remains at the federal maximum allowance of $5,000 per year. Summary plan descriptions are available in the Human Resources Department.

The IRS ruled that over-the-counter (OTC) drugs are NO LONGER an allowable expense. Some OTC items can be claimed like vitamins and certain medication if you obtain a prescription from your doctor stating these are medically necessary. However, a few non-medical OTC items that remain reimbursable are contact lens solution, bandages, and other first aid items. Please keep this in mind when determining the annual election for 2012. Examples of reimbursable medical expenses include eyeglasses, contact lenses, co-payments for doctor’s visits, deductibles, and other costs (health, dental, or vision) not covered by co-insurance.

Employees may use 2011 funds remaining in their medical flexible spending accounts at the calendar year end for expenses through March 15, 2012. Any remaining 2011 balances not exhausted by March 15, 2012 will be lost. Additionally, employees may use 2012 funds remaining in their flexible spending accounts at the calendar year end for purchases through March 15, 2013. The grace period/carry-over of account balances will only apply to un-reimbursed medical and dental expenses. The dependent care flexible spending account must be exhausted within the particular calendar year for which those expenses were elected.

Please note that if you enroll in the Lumenos CDHP/HSA you are NOT eligible to participate in the Medical Flexible Spending Account. Instead, you may defer tax-free funds into your Health Savings Account.


Employees currently enrolled in flexible benefit spending accounts need to complete a new Section 125 Plan Enrollment Form, even if allocation amounts remain unchanged for calendar year 2012. These enrollment forms should be completed and returned to the Human Resources Department, FA166, by November 10, 2011.

Benefit elections for current participants in the Flexible Benefit Premium Only Plan for pre-tax premium contributions will continue, unless you choose to change your election.

Employees interested in establishing a Flexible Benefit Spending Account for 2012 will need to complete a Section 125 Plan Enrollment Form. The Health Care Cost Estimation Worksheet and Dependent Care Cost Estimation Worksheet allow you to estimate the amount of out-of-pocket health care expenses for 2012. Enrollment forms should be completed and returned to the Human Resources Department, Wright Administration Building, FA166, by November 10, 2011.

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Short Term Disability insurance helps provide a partial income replacement for temporarily disabled benefit eligible employees. From October 28, 2011, through November 10, 2011, you have the opportunity to enroll in this coverage at the employee meetings we are holding or you can enroll online at any time during the enrollment period. This benefit is a supplement to the University’s sick pay benefit that will be of special interest to those (like short-service faculty and staff) with limited sick banks. To take full advantage of this plan, you should enroll at this first eligibility opportunity since late enrollees have a reduced benefit during the first 12 months after enrollment. Additional information, including rates, will be available shortly on the Human Resources website.

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Voluntary Supplemental Term Life Insurance offers you the option to purchase additional term life insurance at group rates on a payroll deduction basis for yourself, your spouse, and/or dependent children. You may be eligible to purchase up to $500,000 or eight times annual earnings, whichever is less, for yourself and up to half that amount for your spouse. There are four levels of coverage for dependent children. The life insurance program is offered through Prudential Life Insurance Company. Please note that this insurance plan is strictly voluntary and is offered as a supplement to the University-provided life insurance. An Evidence of Insurability (EOI) form must be completed when applying at any other time than upon hire.

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This is a stand-alone vision plan that is separate from your medical coverage. There are no changes to the plan design, and the rates did not increase for 2012. Anthem’s Blue View vision plan offers increased network size with retail chain access to top four national chains, eliminates frame restrictions and contact lens formulary, and provides 40% discounts on complete pairs of eyeglasses after funded benefits are used. While the plan allows participant choice of facility/provider in or outside the network, and retail and private practices are both included, there are maximum limitations on reimbursement. The maximum benefit is received by going to a network facility/provider to ensure contracted discounts. You do not have to participate in the University medical insurance plan to enroll in the optional vision plan.


Click Here for Bi-weekly Rates



Employee + Child(ren)


Employee + Spouse




You can access the vision provider network at by selecting "Find a Doctor"; then "View National Vision Provider Directory"; and then selecting the plan "Blue View Vision".

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Employees should contact the benefit representatives in the Human Resources Department with any questions concerning the 2012 Open Enrollment. The Human Resources Department is in the Wright Administration Building, Room FA166.

Amy Miller 464-1781
Connie Schnarre 461-5466
Brandyn Smith 464-1988


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Open Enrollment Forms and Documents

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Open Enrollment Dates

TIAA-CREF Representative

Lori Matthews of TIAA-CREF will hold individual appointments in the HR Training Room on the below dates. To schedule an appointment, contact 800/732-8353. 

2015-2016 Dates

  • Dec 9
  • Dec 10
  • Jan 13 & 14
  • Feb 23
  • Mar 23 & 24
  • April 19
  • May 25 & 26
  • June 21
  • Jul 20 & 21
  • Aug 23
  • Sept 21 & 22
  • Oct 18
  • Nov 16 & 17
  • Dec 6