USA Select Health Insurance Plan

Frequently Asked Questions

▼   Is the USA Select Health & Dental Plan right for me?

The University of South Alabama offers a narrow network plan option with the "NEW" USA Select Health & Dental Plan during open enrollment for coverage beginning effective January 1, 2021.

The USA Select Health & Dental Plan has an enhanced benefit design with no deductible or copays for hospital and physician services as long as services are within the USA Health Network. 

The plan is administered by Blue Cross Blue Shield of Alabama. 

The USA Select Health & Dental Plan is not for everyone:

  1. The employee and dependents should reside in the state of Alabama.
  2. The employee needs to understand the narrow network design.
  3. The employee should be satisfied with the medical providers offered by this Plan.
  4. 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.
  5. Employee who joins the USA Select Health & Dental Plan and then later elects to change plans may only change to the Standard Plan even if previously enrolled in the Base Plan.
▼   How much will USA Select cost me? NEW!!!

USA Select Health & Dental Plan is a narrow network design based on USA Health medical providers and BCBS PPO Providers. To supplement primary care, a Telehealth program is included, providing telephone and internet access to a physician for minor medical concerns, resulting in less cost for the employee, time saved, and convenience. Out-of-network services are not covered. The employee monthly cost sharing will be the lowest of the plans offered: 

  Single Family  
USA Base Plan $ 118 $ 394  
USA Standard Plan $ 138 $ 458  
USA Select $ 90 $ 300 ←Lowest Cost

 

USA Select Health & Dental Plan will save the employee $576 for single and $1,896 for family coverage annually as compared to the Standard Plan.  In addition, the benefit design has no deductibles or copay amounts required for hospital and physician services as well as several other services when using a USA Health provider. The pharmacy benefit will be administered by Prime Therapeutics, the dental benefit will be administered by BCBS of Alabama; and the health and dependent care flexible spending accounts will be administered by Health Equity, Inc. The pharmacy benefit and dental benefit are the same as those provided with the USA Health & Dental Plan’s Standard Plan.   

▼   Why enroll in the USA Select Health & Dental plan?

Enrollment in the USA Select Health & Dental Plan is on a voluntary basis to all benefits-eligible employees. 

  • Lowest cost program for the employee.
  • Highest benefit level (100%) provided when using the USA Health network with other BCBS PPO providers covered at 70%.
  • Enhanced benefit design with no deductible or copays for hospital and physician services when using the USA Health network.
  • 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.
▼   Who is eligible for coverage with the USA Select Health and Dental Plan?

Employees are eligible for participation in the USA Health & Dental Plan or USA Select Health & Dental 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 an employment start date prior to January 1, 2013, and a specific appointment with no termination date, occupying a permanently budgeted position, and working a minimum of 20 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.

▼   What is premium conversion?

USA Health & Dental Plan and USA Select Health & Dental 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.

▼   What is USA Select Health & Dental Plan, and what are the premiums?

The USA Select Health & Dental Plan is a narrow network design based on the USA Health network providers. To supplement primary care, a Telehealth program is included providing telephone and internet access to a physician for minor medical problems resulting in less cost for the employee, time saved, and convenience. Out-of-network services are not covered. The limited network providers have agreed to reduce their fee making this a cost effective plan. The employee monthly cost sharing will be the lowest of the plans offered:

Single Family
$ 90 $ 300

USA Select Health & Dental will save the employee $576 for single and $1,896 for family coverage annually as compared to the Standard Plan. In addition, the benefit design has no deductibles or copay amounts required for hospital and physician services when using the USA Health network. The pharmacy benefit and dental benefit is the same as provided under the Standard Plan. USA Select Health & Dental Plan is available on a voluntary basis to all employees.

  • Lowest cost program for the employee.
  • Highest benefit level (100%) provided when using the USA Health network with other BCBS PPO providers covered at 70%.
  • 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.
▼   How does the Tobacco Cessation program/wellness incentive work?

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 form is provided within the USA Health & Dental Plan and USA Select Health & Dental Plan 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 the employee 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 additional tobacco cessation resources; you may also contact the Employee Assistance Program office at 461-1346.

▼   When will my medical/dental coverage be effective if I am a new employee?
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. 
▼   May I join any of the three plans offered by the University: Base Plan, Standard Plan, or USA Select Plan?
No, if you are a new employee you may select between the Standard Plan and the USA-Select Plan. Only employees employed before January 1, 2013, are eligible for the Base Plan.
▼   Does the USA Select Health & Dental Plan offer dental benefits?

Yes, the dental benefits are administered by Blue Cross Blue Shield of Alabama. 

▼   If I join the USA Select Health & Dental Plan can I switch back to the Base Plan or Standard Plan?

No, you may only switch back to the Standard Plan and then only 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. If you decide to change from the USA Select Plan, you may only enroll in the Standard Plan; you may not enroll in the Base Plan even if you were previously in the Base Plan.

▼   Will my doctor be covered under the USA Select Health & Dental Plan?
All medical providers which are Blue Cross Blue Shield network providers are covered by USA Select. Providers affiliated with the University of South Alabama referred to as USA Health network of providers have the highest level of benefits.

 

▼   What should I consider when deciding whether or not to join the USA Select Health & Dental Plan?
You should consider that only a narrow network of medical providers will qualify for 100% coverage. Other BCBS PPO providers are covered at 70%. This may not be the best plan if you have a chronic illness and receiving medical care from a BCBS PPO provider at this time. 
▼   Why are the benefits better and the cost less for the USA Select Health & Dental Plan

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 Standard Plan benefit.

▼   How do I join the USA Select Health & Dental Plan?
You must complete an enrollment form and file it with the University’s Human Resources Department and by filing that form you will attest to the fact that you understand: 1) that the USA Select Health & Dental Plan is a narrow network plan that does not provide benefits for out-of-network medical providers; 2) that it is your responsibility to ensure that medical care is provided by a Network Provider either with USA Health or BCBS PPO; 3) that you may not change from the USA Select Health & Dental Plan except during open enrollment for coverage effective January 1st of the following year except if you have a change of residence and reside outside the state of Alabama (see the change-in-status event rule described in your Member Handbook).

 

General Information

USA Select - Summary of Benefits & Coverage
2021 USA Select Guidebook