Who Pays for your IU Medical Care Coverage?
Not Anthem. You and Indiana University pay for it. Large employers, like IU, Monroe County School System, and Monroe County Government have self-insured plans and do not need an insurance company that shares risks among many plan participants. As a result, IU only uses Anthem to:
- gain access to negotiated discounts with medical providers such as Premier;
- process medical claims;
- pay medical providers and bill IU for these payments; and, then
- inform you of the portion that you are to pay.
Indiana University pays Anthem a fixed monthly fee for administrative services and reimburses Anthem for the amount it pays medical providers.
Who pays when physician fees increase?
Since you and Indiana University pay for medical costs, when physicians raise their fees, we pay for the increase; not Anthem. As a large, self-insured employer, these increases are passed on immediately to you and IU.
Who pays when Premier’s fees increase?
You and Indiana University pay the cost of medical services at Premier; therefore, we pay for increases in fees. When Premier raises its rates, we pay the cost of these fee increases, and Anthem continues to provide the services listed above for the same fixed monthly fee.
Indiana University continues to encourage Premier to renew its contract with Anthem, whose PPO fee schedule allows IU's employees to receive affordable medical services within the community. A decision by Premier not to do so will be harmful to Indiana University and its employees.
