The latest work-life information at IU
No. 61
October 2013


University Human Resources
hr.iu.edu
Informed Employee

Transparency Tool

Indiana University provides a Transparency tool to all employees and their adult family members enrolled in an IU-sponsored medical plan. The tool helps employees find in-network medical services based on price and quality of care.

The healthcare system can be complex and confusing, but Castlight's Transparency tool makes healthcare decision-making easier. And, prices for medical services are usually not known until the bill is received, which could be weeks after an appointment. The Transparency tool allows plan members to search for primary care doctors; know where they are in their deductible; and estimate personalized costs for medical services based on their plan enrollment.

Learn more and register for the tool at hr.iu.edu/benefits/castlight.html.

 


 

screen shotIU Tobacco-free Program

As an incentive for the non-use of tobacco and to promote a healthy life, the University provides the IU Tobacco-free Program which includes two features.

For details, see the Open Enrollment packet and visit hr.iu.edu/benefits/gethealthy.html.

 


Understanding In-network and Out-of-network Benefits

Using in-network providers is key to receiving the highest level of healthcare benefits. Services from a provider other than an in-network one are considered out-of-network, except for emergency or urgent care away from home. For better understanding, see the definitions below.

Plan members who receive in-network services have lower out-of-pocket expenses.

Plan members who receive out-of-network services have higher out-of-pocket expenses.

An exclusive provider plan, such as IU Health Quality Partners, does not cover out-of-network services other than emergency care, urgent care when away from home, and services authorized by the plan in advance.

Network and non-network deductibles, co-insurance, and out-of-pocket maximums are separate and do not accumulate toward each other.

Definitions

A provider includes hospitals, outpatient facilities, physicians, labs, radiology facilities, pharmacies, and other healthcare professionals.

An in-network provider has contracted with the Plan administrator to provide healthcare services to plan members at discounted rates called allowed amounts. In-network providers accept these amounts as payment in full which means members are not billed above the allowed amount.

An out-of-network provider has not contracted to provide healthcare services at discounted rates. The plan member is responsible for paying amounts above the allowed amount. Even when an in-network refers an out-of-network provider, out-of-network benefits still apply unless approved in advance by the Plan.

 


Vision Wear

Beginning January 1, 2014, for the HDHP PPO, $500 Deductible, and $900 Deductible plans, the annual eye exam coverage will be converted from a medical benefit to a separate Vision benefit administered by Anthem Blue View Vision. Those enrolled in an IU PPO medical plan will receive the vision benefit with no separate enrollment. Benefits include:

The Vision Wear Program (Voluntary Benefits Program) administered by EyeMed will be discontinued December 31, 2013.

Note: Medical eye exams, such as for treatment of glaucoma or retinal detachment, remain a covered benefit under medical plans; however, they will be subject to the medical plan deductible and co-insurance.

 

 

UHRS

Page updated: 11 October 2013
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