What’s New for 2010?
IU PPO Blue Access Plan (formerly the Blue Preferred POS plan)
- Anthem is discontinuing support for the Blue Preferred Primary provider network and the POS (point-of-service) primary care gatekeeper model. The IU Blue Preferred POS plan will be restructured as the IU PPO Blue Access plan.
- Employees currently enrolled in the Blue Preferred POS plan who do not choose a different medical plan during Open Enrollment will automatically continue enrollment in the IU PPO Blue Access plan.
- Preferred providers are in Anthem’s networks in Indiana and across the U.S., the same as the PPO $900 Deductible plan. Members are not required to select a PCP.
- The copay structure will be similar to the POS plan (no deductible and fixed-dollar copays for office visits, inpatient stays, outpatient surgery, emergency room, and urgent care), but with percent copays on other outpatient services such as diagnostic testing (e.g., MRIs, C-scans, non-maternity ultrasound, labs), durable medical equipment, and home medical services.
- Lab services billed by an Anthem Independent Laboratory Network provider (sometimes called a reference laboratory) will have no copay.
IU PPO $900 Deductible Plan
- Mental health and substance abuse coverage will be covered as any other illness, using Anthem networks and subject to the same deductibles, copays, and maximums. This change is in compliance with federal Mental Health Parity regulations. (IUPM administration and network services will be discontinued.)
- Lab services billed by an Anthem Independent Lab Network provider will no longer be subject to member copays.
- Annual medical out-of-pocket maximums for a family will increase to $7,200. The $2,400 maximum for an individual remains the same.
- Prescription drug copays will be based on tiers, with the following copays: retail (up to a 30-day supply) Tier 1 $8, Tier 2 $25, and Tier 3 $45; mail order (up to a 90-day supply) Tier 1 $20, Tier 2 $62, and Tier 3 $112.
- The 4th quarter deductible rollover provision will be discontinued.
- In 2011, member copays will change to 15 percent after meeting the deductible for in-network services.
IU HDHP PPO & Medical Savings Plan
- Annual deductibles will increase to reflect the minimum IRS requirement for 2010: $1,200 for employee-only and $2,400 family (employee plus one or more family members). These amounts are double for out-of-network services.
- Preventive prescriptions will no longer be subject to the deductible, only the copay.
Medical Savings Component
- Annual University contributions will increase to $300 for employee-only coverage and $750 for family coverage. The amount will be contributed to the employee’s medical savings account in January.
- The employee minimum contribution will increase to $300.
- The maximum annual contribution (IU contribution plus employee contribution) for 2010 is $3,050 for employee-only and $6,150 for employee plus any dependents. The additional catch-up contribution for those age 55 or older remains the same at $1,000 per year.
Dental Plan
No plan changes.
Tobacco-free Wellness HRA
No plan coverage changes for 2010; however, University contributions for participants who sign an affidavit to complete the Quit for Life program by June 1 will begin receiving benefits only after notifying the University that they have completed the program. After verification, University contributions will be made retroactive to January 1 and continue monthly for the remainder of the year.
Personal Accident Insurance
No plan changes.
2010 Medical Premium Rates (Monthly)
6.4 Percent Average Increase in Premiums
Indiana University’s contribution policy for 2010 is to freeze employee contributions at the 2009 rates with the University absorbing a higher proportion of the total premium.
Total Monthly Premium |
% of Change(1) |
Employee Contribution(2) |
Difference 2009 to 2010(3) |
|
IU PPO $900 Deductible |
||||
Employee Only |
$ 396.27 |
3.99% |
$ 5.00 |
$0 |
Employee/Child(ren) |
$ 790.44 |
3.99% |
$10.00 |
$0 |
Employee/Spouse |
$ 966.31 |
3.99% |
$10.00 |
$0 |
Family |
$1,097.39 |
3.99% |
$39.74 |
$0 |
PPO Blue Access (formerly Blue Preferred Primary POS) |
||||
Employee Only |
$ 429.41 |
8.33% |
$ 5.00 |
$0 |
Employee/Child(ren) |
$ 850.60 |
8.33% |
$10.00 |
$0 |
Employee/Spouse |
$1,041.81 |
8.33% |
$17.04 |
$0 |
Family |
$1,182.92 |
8.33% |
$76.42 |
$0 |
IU HDHP PPO & Medical Savings Plan |
||||
Employee Only |
$320.12 |
-6.66% |
$ 5.00 |
$0 |
Employee/Child(ren) |
$638.54 |
-6.66% |
$10.00 |
$0 |
Employee/Spouse |
$780.60 |
-6.66% |
$10.00 |
$0 |
Family |
$886.50 |
-6.66% |
$10.00 |
$0 |
|
||||
More details of employee contribution amounts, including dental coverage and additional IU subsidy for lower salaries, will be included with Open Enrollment materials.
