健康保险

Administrators, 教师, AFSCME 3200 and FOP

View the links below to view deductibles, 共同保险, 计划年度最高限额, office visit co-pays and coverage for a variety of categories. AFSCME 3200 and FOP members: the Collective Bargaining Agreement will supersede the following information in case of discrepancies.

AFSCME 1699 Bargaining Unit

的 Collective Bargaining Agreement will supersede the following information in case of discrepancies.

国歌 Blue Cross/Blue Shield

bet8九州登录入口's PPO medical plan is administered by 国歌 Blue Cross/ Blue Shield. Employees may contact 国歌 directly with questions regarding their coverage. 国歌还提供 门户网站 where members can log in and manage their accounts. 的 Sydney Health mobile app [PDF] allows users to access their digital member ID card, search for 网络供应商 and view deductibles, 共同支付和成本分担.

的 PPO plan is a "preferred provider organization." A PPO is a program in which a network of doctors, hospitals and other health care providers agree to provide medical services to plan enrollees at special, 达成率. Each health care provider in the network must meet and maintain strict quality requirements.

当你使用 网络供应商 for your health care, you will have to pay a co-payment at the time of your service. Most services are covered at 80% after the deductible has been met. You will still receive coverage when you see health care providers outside of the network, although you will receive a lower benefit level.

Transparency in Coverage (TIC) regulations require health insurers and group health plans to create machine readable files (MRFs) that contain the 达成率 for in-网络供应商 and allowed amounts derived from historical claims for out-of-网络供应商. 的se files will be available on July 1, 2022 on 国歌's website (http://www.Anthem.com/machine-readable-file/search) . bet8九州登录入口's tax ID number, 31-6402113, is needed to access information.

Opt-out/ Waive Insurance Coverage

Employees with medical coverage outside of the university may choose to waive bet8九州登录入口 health insurance.

预先存在的条件

的re are no pre-existing condition limitations for bet8九州登录入口's medical plans. You can change plans during open enrollment without concern that your present medical conditions would not be immediately covered.

Pre-certification Requirement

bet8九州登录入口 follows 国歌's standard predetermination and pre-certification requirements for both inpatient and outpatient procedures. Some procedures may require authorization prior to services being rendered. 呼叫。 1-866-776-4793 or check with your provider to determine whether your procedure requires prior authorization. All inpatient hospital admissions require pre-certification.

Notice of Privacy Practices

• This notice describes how medical information about you may be used and disclosed and how you can get access to this information [PDF]

的 平价医疗法案 (or health care reform law) requires that all members receive a Summary of 好处 Coverage (SBC). 这个文档, provided by 国歌 Blue Cross/ Blue Shield, may be downloaded below or a hard copy requested by emailing benefits@俄亥俄州.edu.

• Summary of 好处 Coverage (SBC)- Administrators, 教师 and AFSCME 3200 [PDF]
• Summary of 好处 Coverage (SBC)- AFSCME 1699 [PDF]

bet8九州登录入口 is legally obligated to provide the following document which details what the plan provides and how it operates.

• Summary Plan Description (SPD)- Administrators, 教师 and AFSCME 3200 [PDF]
• Summary Plan Description (SPD)- AFSCME 1699 [PDF]