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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

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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

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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

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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