Group Health Insurance
2009-2010 Plan Benefit Information - Effective November 1, 2009
Below is a general comparison of the 2 options available under Washburn University's Group Health Insurance Plan. Both plans are provided through Blue Cross/Blue Shield and include Dental Insurance.
(See premiums for additional information)
Base PlanBlue Choice Comprehensive Major Medical |
Buy-Up PlanBlue Choice Comprehensive Major Medical |
|
| Deductible | $1000 Individual/$3000 three or more persons | $500 Individual/$1500 three or more persons |
| Coinsurance (Member portion for most services) | 20% of allowed amounts after deductible has been met; up to $1000 Emp/$3000 Emp & Dependents | 20% of allowed amounts after deductible has been met; up to $1000 Emp/$3000 Emp & Dependents |
| Annual Out-of-Pocket Maximum (includes deductible and coinsurance) Copays do not apply to the annual out-of-pocket amount. | $2000 Individual/$6000 three or more persons | $1500 Individual/$4500 three or more persons |
| Office Visit Copay | $25 Copay | $25 Copay |
| Routine Eye Exams | $25 Copay | $25 Copay |
| Out-Patient Lab & X-Ray | ||
| Mental Illness & Substance Abuse Disorders - Inpatient Services (Requires pre-admission certification from New Directions Behavioral Health at 1-800-952-5906) | ||
| Mental Illness & Substance Abuse Disorders - Outpatient Services | $25 office visit copay | |
| Unmarried Dependents | Covered to age 23 | Covered to age 23 |
| Lifetime Maximum | $5 Million for each covered person. | $5 Million for each covered person. |
| In-Hospital Pre-Admission Certification | Yes* | Yes* |
| Prescription Drugs - BlueRx Card - RETAIL | $5 Generic/$40 brand formulary/$70 brand non-formulary | $5 Generic/$35 brand formulary/$60 brand non-formulary |
| Prescription Drugs - BlueRx Mail (90 day supply) | 2 times retail copay. | 2 times retail copay. |
*Blue Cross/Blue Shield MUST be notified prior to any planned in-patient admissions.
