Medical banner-01

Benefits Enrollment Has Ended

The period for enrolling in 2019 benefits has ended. If you did not make changes to your benefits, you will automatically be enrolled in the same plans as the previous year. You may view your benefits by using EMPLOYEE SELF-SERVICE.

Medical Insurance

Each employee's needs are different. OUHSC offers two options for medical plans through Blue Cross and Blue Shield to meet those needs and provide flexibility to you and your family.

Key Changes in 2019: 

  • Deductible amounts for the Preferred Provider Organization (PPO) plan have changed for all coverage levels. While it is an increase, Blue Cross and Blue Shield of Oklahoma reports that most employees do not reach their deductible by the end of the plan year.

  • The coinsurance for the Blue Preferred network will remain at 90%. Coinsurance for the Blue Choice network will change from 80% to 70%. However, approximately 97% of Blue Choice providers are also Blue Preferred providers. The Blue Preferred network provides the deepest provider discounts and includes the OU Medicine branded providers.

  • The Premium Contribution Share is the percentage of the total premium that is paid by employees. Premium Contribution Share for Employee and Children, Employee and Spouse, and Employee and Family coverage will remain the same for 2019. The Premium Contribution Share for Employee-Only coverage will see an increase of 3 percentage points across all salary tiers.

News: Unpacking the HDHP

Growing in popularity, a High Deductible Health Plan (HDHP) can serve as a great benefit option for some employees. An HDHP plan does not include copays, which means that an employee is responsible for the total cost of prescriptions, doctor visits and medical events up to the deductible (except for preventative exams and care, which are 100% covered under both plans). However, HDHPs are designed to offset the total out-of-pock costs in several ways. Learn More

News: Make Your Annual FSA or HSA Elections!

Both FSAs and HSAs are pre-tax accounts to which employees contribute part of their income, and elections for both must be made every year during benefits enrollment! They can be used for a variety of expenses not covered by insurance. The major distinctions between the two are that an FSA can be used by those enrolled in the PPO plan, while an HSA is established for employees with the High Deductible Health Plan. They cannot be used together. Read More

PREMIUM RATES

View 2019 Monthly Benefits Rates


Premium Rates for Part-Time Employees

You can also view your monthly medical insurance deduction by your full-time-equivalent (FTE) rate. If you do not know your FTE, check with your supervisor. Note: to calculate your bi-weekly deduction, divide each rate by two. 

CONTACT BLUE CROSS

Visit: BCBSOK.com

Call: 855-649-9614
Monday-Friday
8:00 a.m. - 6:00 p.m.

PRESCRIPTION INFORMATION

Verify that your pharmacy is in a BCBSOK network and view a list of prescriptions at BCBSOK for Members

Overview of Plans

PLAN 1: BLUE OPTIONS

  • Blue Options is a preferred provider organization (PPO) plan, which gives you the flexibility to choose your provider and network at the time of service
  • You do not need to select a primary care physician. Your choice of health care providers can affect the level of health care benefits (including copayment and deductible amounts) – based on the network your provider is in.
  • With the Blue Options plan, you can choose from two different networks each time you need health care. Or, you may choose to see providers that are not in a network (out-of-network).
  • Most preventive care services for in-network providers are fully covered under the BlueOptions plan, which means you will pay no copayment or coinsurance for services such as well child and adult immunizations, routine exams, gynecological exams, mammograms and prostate specific antigen (PSA) tests.
  • BlueOptions members have nationwide access to contracting providers through the BlueCard Program when you or your covered family members live, work, or travel anywhere in the country.
  • View the Blue Options Summary of Benefits and Coverage

Plan Example 

BCBS PPO Plan (Fred; Married; One child)
When comparing the medical plans offered by the university, Fred and his spouse look for the plan that provides the less out-of-pocket costs at time of service because Fred’s spouse often needs the care of specialists. Having copays for these visits helps their financial stability. In addition, Fred’s son has allergies and also sees specialists. They would also benefit from BCBS PPO Plan’s 100% coverage for preventive care provision. Fred’s and his spouse’s salaries are adequate to cover the family deductible and they are also able to afford the monthly medical premiums.
After comparing the plans, Fred decides the PPO plan is the best option for his family.

PLAN 2: BLUE EDGE HDHP

  • The Blue Edge HDHP plan is a high-deductible plan that uses the Blue Choice network.
  • With an HDHP plan, a specific amount of money is deposited each benefit year in a health savings account (HSA). When you need any covered medical care, the first out-of-pocket costs you have can be paid from available funds in this account. The money paid from your health account is applied toward meeting your annual plan deductible or other copayment or coinsurance amounts you may be responsible for.
  • The BlueEdge HDHP has a notably higher deductible to satisfy each year. To help offset the higher deductible, money is put into a health savings account (HSA) each year on your behalf, which can be applied to your deductible or other eligible out-of-pocket medical expenses.
  • Note: If you have dependents on your plan, the entire family deductible of $6,000 for in-network coverage OR $8,000 for out-of-network coverage must be met before the plan assumes payments.
  • View the Blue Edge Summary of Benefits and Coverage

Plan Example

BCBS HDHP (Lee; Single; No children)
Lee is in good health and rarely has to go to the doctor. Lee reviews his medical expenses from past years and notes he has not exceeded $500 in the past. While studying the medical plans offered by the university, Lee sees the Blue Edge HDHP Plan option, which provides a $500 fund to a Health Savings Account for medical expenses. Although he realizes he would have to pay the next $2,500 in expenses should he exhaust the fund, he does not expect to pay more than he has in past years. He also can take advantage of the tax savings he receives by contributing pre-tax earnings to his Health Savings Account to save for potential future medical expenses. He would also benefit from Blue Edge HDHP’s 100% coverage for preventive care provision. Lee weighs all of his options and decides the Blue Edge HDHP provides the best benefit for his needs.

Networks

Plan Networks

BLUE PREFERRED 

The Blue Preferred PPO network provides the biggest discount and pays your benefits at the highest level, which means you will have the lowest out-of-pocket costs when you use providers in the Blue Preferred PPO network. (note: OU Physicians are in the Blue Preferred Network)
  • Coinsurance: 90% / 10%
  • Individual Deductible: $1,000
  • Family Deductible; $2,000

BLUE CHOICE

The Blue Choice PPO network will pay your benefits at the second highest level, although some aspects of coverage are the same with the Blue Preferred PPO and Blue Choice PPO networks.
  • Coinsurance: 70% / 30%
  • Individual Deductible: $2,000
  • Family Deductible; $4,000 

OUT-OF-NETWORK

If you see out-of-network providers, you will receive no discounts and your benefits will be paid at the lowest allowed amount.
  • Coinsurance: 50% / 50%

Choosing a Plan

You should choose the plan best suited for you and your family. There are important differences between the plans that should be considered. Details and benefits of each plan are listed on the following pages for easy comparison. Here are some additional factors to keep in mind:

Benefit Design

Each plan promotes wellness, offers preventive care and has unlimited lifetime maximums. However, there are notable differences among the plans, which impact the coverage and out-of-pocket costs you’ll have when you utilize your benefits.

BlueOptions has a calendar year deductible to satisfy before coverage begins. Many services are covered with just a copayment, so depending on the type of services you need, you may not even need to meet your deductible during the year. Most preventive care services are fully covered under BlueOptions if using in-network providers, which means you will pay no copayment or coinsurance for services such as well child and adult immunizations, routine exams, gynecological exams, mammograms and prostate specific antigen (PSA) tests. When you see providers in the Blue Preferred PPO network, you will have the lowest out-of-pocket expense because the discounts are greater.

The BlueEdge HSA has a notably higher deductible to satisfy each year, and some services, except for some of your preventive care benefits, are subject to that deductible before your coverage begins. To help offset the higher deductible, money is put into a health savings account each year on your behalf, which can be applied to your deductible or other eligible out-of-pocket medical expenses. BlueEdge HSA uses the Blue Choice PPO network, so you will have the lowest out-of-pocket costs when you use providers in the Blue Choice PPO network.

Rates

It’s important to compare the rates of each plan, while keeping in mind the benefits that come with each plan. BlueOptions provides a high level of flexibility when choosing your providers and out-of-pocket costs. BlueEdge HSA has the lowest premiums. It provides a high level of flexibility, but it has higher out-of-pocket costs than the BlueOptions plan.

Provider Access

The Blue Choice PPO network is BCBSOK’s largest network. BlueEdge HSA utilizes the Blue Choice PPO network, which means you will have the lowest out-of-pocket costs when you see providers in the Blue Choice PPO network. The Blue Preferred PPO network is BCBSOK’s second largest network, including providers in the Tulsa and Oklahoma City metro areas as well as many providers in the rest of the state. BlueOptions offers a unique tiered structure that allows you the flexibility to see providers in the Blue Choice PPO or Blue Preferred PPO networks. However, you will have the lowest out-of-pocket costs when you see providers in the Blue Preferred PPO network because the discounts are greater.

BlueOptions and BlueEdge HSA members have nationwide access to contracting providers through the BlueCard® Program when you or your covered family members live, work, or travel anywhere in the country.

Additionally, when you travel outside the United States, PPO members have access to contracting providers in more than 200 countries through BlueCard Worldwide®. You can verify that your current physicians are in the network for the plan you are considering by checking the online provider directory at bcbsok.com.

Flexibility

BlueOptions and BlueEdge HSA give you the most flexibility since you have coverage for both in-network (PPO) and out-of-network providers. Keep in mind that you will always receive your highest level of benefits and lowest out-of-pocket costs when choosing an in-network provider. BlueOptions gives you additional freedom of choice and flexibility because you can see providers in the Blue Choice PPO or Blue Preferred PPO networks and still receive benefits. (For BlueOptions members, you will have the lowest out-of-pocket costs when you see providers in the Blue Preferred PPO network.)

6515-2239

Health ID Protection

Because keeping your personal identity safe is a top priority at the university, you will use your Health ID instead of your Social Security number for all medical and dental transactions at the doctor's office and with insurance providers. Learn more about your Health ID.

Flexible Spending Accounts

Did you know that health care and dependent care reimbursement accounts can decrease the amount of taxes you pay on your income? OU and ConnectYourCare offer a debit card with the healthcare reimbursement Flexible Spending Account (FSA). Get more information on the Flexible Spending Accounts page.