USA Select Health Insurance Plan
Teledoc and Telehealth: Understanding the Difference
Transparency in Coverage Rule
The link below leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
USA Select Plan
University of South Alabama
Frequently Asked Questions
The USA Select Plan is a narrow network plan designed with no deductibles or copay amounts required when you use a USA Health network provider. Other BCBS PPO providers are covered at 70%. By using a USA Health provider, this will ensure that you receive the very best benefit possible. The pharmacy benefit is paid at 100% after the applicable copay. This is the same benefit as offered in the USA Choice Plan. The dental benefit is also the same as offered in the USA Choice Plan.
The plan is administered by Blue Cross Blue Shield of Alabama.
The USA Select Plan is not for everyone:
- The employee and dependents should reside in the state of Alabama.
- The employee needs to understand the narrow network design.
- The employee should be satisfied with the medical providers offered by this Plan.
- Employees who select this Plan during open enrollment for the 2021 benefit year will be required to remain in the Plan until the next benefit year.
- Employees with base premiums that elect the USA Select Plan and later make a change back to the USA Choice plan will be required to have standard premiums.
Access the USA Select Plan - Plan Benefits here.
The USA Select Plan is a narrow network design based on USA Health medical providers and providers from the BCBS PPO network. To supplement primary care, a Telehealth program is included, providing telephone and internet access to a physician for minor medical concerns, resulting in a lower cost for the employee, time saved, and convenience. The employee monthly cost sharing will be the lowest of the plans offered:
|USA Choice Plan - Base||$124||$ 415|
|USA Choice Plan - Standard||$144||$ 479|
|USA Select||$ 90||$ 300||←Lowest Cost|
Premiums above include the non-tobacco wellness incentive of $50
Narrow network health plans provide the best benefits to specific hospitals, physicians and other medical providers. A narrow network design offers value to consumers through a lower premium, enhanced benefits and access to select medical providers concentrating on improved medical outcomes and preventive health.
The USA Select Plan will save the employee $648 for single and $2,148 for family coverage annually as compared to the USA Choice Plan. In addition, the USA Select Plan benefit design has lower deductibles or copay amounts required when you use a USA Health network provider. Other BCBS PPO providers are covered at 70%. By using a USA Health provider, this will ensure that you receive the very best benefit possible. The pharmacy benefit is paid at 100% after the applicable copay. This is the same benefit as offered in the USA Choice Plan. The dental benefit is also the same as offered in the USA Choice Plan.
To help combat the rising cost of medical care we are implementing a copay structure to some benefits for the USA Health Network, in the USA Choice & USA Select Plans. Effective January 1, 2023, the following will have a copay when you use these benefits:
$15 copayment for Physician, Physical, Occupational and Speech Therapy visits
$150 Outpatient Surgery copayment
$200 Emergency Room copayment/waived if admitted
Employees with base premiums that elect the USA Select Plan and later make a change back to the USA Choice plan will be required to have standard premiums.
Enrollment in the USA Select Plan is on a voluntary basis to all benefits-eligible employees.
- Lowest cost program for the employee.
- Highest benefit level provided when using the USA Health network with other BCBS PPO providers covered at 70%.
- Enhanced benefit design with lower deductible or copays for hospital and physician
services when using the USA Health network:
- $15 copayment for Physician, Physical, Occupational and Speech Therapy visits
- $150 Outpatient Surgery copayment
- $200 Emergency Room copayment/waived if admitted
- Select providers concentrating on better medical outcomes.
- Preventive health for early detection and treatment of illness and chronic conditions.
- Telehealth to improve access and convenience for treatment of minor medical conditions.
- A voluntary offering for those employees who elect to participate.
The USA Choice Plan and the USA Select Plan pharmacy annual deductible is $100 per individual (maximum of 3 per family).
The USA Choice Plan and the USA Select Plan copay structure 6-tier plan6-tier plan:
• Generic (preferred) COPAY $10
• Generic (non-preferred) COPAY $10
• Preferred Brand Name COPAY $50
• Non-Preferred Brand Name COPAY $75
• Specialty (preferred) COPAY $150
• Specialty (non-preferred) 50% COINSURANCE
Employees are eligible for participation in the USA Choice Plan or the USA Select Plan based solely on hours of service. The Affordable Care Act requires an offer of coverage to employees credited with 30 hours of service per week or 130 hours of service per month on average. The Plans may defer the offer of coverage if the employee is determined as having “variable hours” in which case benefits-eligible status will be determined using a 12-month measurement period with a corresponding 12-month coverage period in compliance with the Affordable Care Act.
Eligible Employees include:
An employee with a specific appointment with no termination date, occupying a permanently budgeted position, and working a minimum of 30 hours per week on a regular basis.
An employee with an employment start date on or after January 1, 2013, who is credited with 30 hours of service per week or 130 hours of service per month on average.
Eligible Employees may also enroll their legal spouse, as recognized by the state of Alabama, and children under age 26. Coverage with the selected Plan will begin on the first day of the month following the first day of employment, contingent upon timely application to the Human Resources department and payment of any required employee contribution.
The USA Choice Plan and the USA Select Plan premiums are deducted before any Federal, State or Social Security taxes are withheld. Your gross income is reduced by the amount of your premiums and therefore, you pay fewer taxes. New employees are automatically enrolled in Premium Conversion. However, Premium Conversion is optional for employees. Contact the Human Resources department for information regarding opting out of Premium Conversion.
The University of South Alabama encourages all employees to adopt healthy lifestyle choices. That effort will benefit you, your family and your fellow employees. The University’s Fringe Benefits Committee recommended, and the University adopted, a tobacco cessation program which is intended to help employees stop using tobacco products. Tobacco use and especially smoking will increase your risk of heart disease, stroke, respiratory diseases such as emphysema and bronchitis, as well as cancer including: lung, throat, mouth, esophagus, pancreas, bladder, and leukemia. The benefits from stopping the use of tobacco are almost immediate regardless of how long you have been smoking or using tobacco.
For new employees the Tobacco Declaration information/election is provided within the USA Health & Dental insurance enrollment form.
Existing employees that do not currently participate in this wellness incentive may begin participation by completing the Tobacco Declaration form. On this form employees will declare that they and their covered spouse do not use tobacco products; and have not used tobacco products within six months prior to the date on the form. This will qualify for a wellness incentive of $50 per month (one per family). The wellness incentive will be applied to the monthly insurance premium effective the pay period following the date on the Tobacco Declaration form (payroll deadlines can affect when this discount will be applied).
For employees enrolled in any of the University sponsored health plans seeking assistance with tobacco cessation please call 866) 784-8454 or visit https://www.quitnow.net/Alabama to obtain information about the Blue Cross Blue Shield - Quit for Life Program. The Program is provided at no cost to employees and covered spouses who want to stop using tobacco products and offers a 24-hour support hotline, customized phone counseling sessions and nicotine replacement patches, gum or lozenges.
For additional tobacco cessation resources you may also contact the Employee Assistance Program office at 461-1346.
Yes, the dental benefits are administered by Blue Cross Blue Shield of Alabama.
No, you may only switch back to the USA Choice Plan during the annual open enrollment month for coverage starting January 1st of the following benefit year. You may not switch coverage during the year unless you have a change in your residence and you reside outside the state of Alabama.
No, out-of-network medical providers are not covered.
This is due to the fact that the medical providers have agreed to accept a lower fee. It is also due to medical providers working to achieve better medical outcomes through quality of care thereby reducing the cost of complications. The USA Select Plan benefits are better for medical services and the pharmacy and dental benefits are the same as the USA Choice Plan benefit.
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|2023 Summary of Benefits and Coverage - Select plan #67307|
|USA Select - Plan Benefits|