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

63-0477348

https://www.bcbsal.org/web/tcr

 

Frequently Asked Questions

▼   Is the USA Select Plan right for me?

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:

  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. 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.

▼   How much will USA Select cost me? 

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:

  Single Family  
USA Choice Plan - Base $122 $ 408  
USA Choice Plan - Standard $142 $ 472  
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 $624 for single and $2,064 for family coverage annually as compared to the USA Choice Plan. In addition, the USA Select Plan benefit design has 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.

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. 

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

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 (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.
▼   Pharmacy Benefit: Deductible and 6-tier copay structure New!!!!

USA Choice Plan and the USA Select Plan – Pharmacy Benefit changes effective January 1, 2022

The USA Choice Plan and the USA Select Plan pharmacy annual deductible will be $100 per individual (maximum of 3 per family).

The USA Choice Plan and the USA Select Plan copay structure for pharmacy benefits will change to a 6-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

▼   Who is eligible for coverage with the USA Select Plan?

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.

▼   What is premium conversion?

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.

▼   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 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.

▼   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. 
▼   Does the USA Select Plan offer dental benefits?

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

▼   If I join the USA Select Plan can I switch back to the USA Choice Plan ?

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. 

▼   Will my doctor be covered under the USA Select 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 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 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 USA Choice Plan benefit.

▼   BCBS of Alabama Mobile Apps and Online Tools

Take Blue With You Mobile App: Get on-the-go access to health information and tools available on your smartphone or mobile device. Members and non-members can download for free to access must-have tools and features. They'll help you be prepared for almost anything!

Baby Yourself Mobile App: Track your pregnancy and baby's development to ensure the best possible health during pregnancy. This app is available to all expectant mothers—members and non-members.

myBlueCross: Log in to myBlueCross, where it really is all about you!

▼   How do I join the USA Select 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 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 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

2022 USA Select - Summary of Benefits & Coverage
2023 Summary of Benefits and Coverage - Select plan #67307
USA Select - Plan Benefits