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Benefits

Due to Welborn's decision to leave the healthcare market, employees in Welborn plans will need to choose an Anthem plan for 2013.

Welborn HMO

Introduction - Coverage - 2012 Rates - 2011 Rates - Forms/Documents

The Welborn HMO Plan is available to regular full-time employees working on at least a 75 percent academic or fiscal year appointment. Contact Human Resources for information on those benefits applicable to temporary, part-time, or other employee groups.

Coverage

Welborn HMO Plan Highlights

* 100% Preventive Care Coverage only Plan Design Change for 2011

  • Beginning 1/1/2011, 100% Preventive Care Coverage
  • Must use WHP 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
  • Co-Insurance
    • Network - 80%/20%
    • Non-network co-insurance - 60%/40%
  • Prescription Co-Payments:
    • Retail Pharmacies (30-day supply) - $15 generic; $35 brand formulary; $50 non-formulary
    • Mail Order (90-day supply) - $30 generic; $70 brand formulary; $100 non-formulary

Beginning January 1, 2011, Welborn will waive the annual deductible for the purchase of Diabetic Testing Supplies.  View the full announcement.

Welborn HMO 2012 Summary of Benefits

Welborn HMO 2011 Summary of Benefits

Welborn HMO 2011 Plan Certificate

(top of page)


Welborn Rates for Plan Year 2012

Welborn HMO Plan - The premium is inclusive of medical, prescription drug, and dental insurance coverage.

2012 Rates Employee's Bi-weekly Premium Employee's Monthly Premium
Single Plan $80.42 $160.84
Employee + Child(ren) $157.61 $315.22
Employee + Spouse $172.70 $345.40
Family Plan $243.26 $486.52

For Retiree and COBRA Rates, contact Brandy Smith

(top of page)

Welborn Rates for Plan Year 2011

Welborn HMO Plan - The premium is inclusive of medical, prescription drug, and dental insurance coverage.

2011 Rates Employee's Bi-weekly Premium Employee's Monthly Premium
Single Plan $62.30 $124.60
Employee + Child(ren) $122.60 $245.20
Employee + Spouse $133.86 $267.72
Family Plan $188.75 $377.50

For Retiree and COBRA Rates, contact Brandy Smith

(top of page)

Forms and Documents

2012 Welborn Enrollment and Change Form

(top of page)



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. 

2014/2015 Dates

  • Tuesday, Dec 9
  • Thursday, Dec 11
  • Tuesday, Jan 27
  • Wednesday, Feb 25
  • Thursday, Feb 26
  • Tuesday, Mar 24
  • Wednesday, Apr 22
  • Thursday, Apr 23
  • Tuesday, May 19
  • Wednesday, June 24
  • Thursday, June 25
  • Tuesday, July 21
  • Wednesday, Aug 19
  • Thursday, Aug 20
  • Tuesday, Sep 8
  • Wednesday, Oct 21
  • Thursday, Oct 22
  • Tuesday, Nov 17
  • Wednesday, Dec 9
  • Thursday, Dec 10