Medical/Dental/Vision Insurance
Eligibility:
All regular full-time University employees and part-time employees who are regularly scheduled to work at least 30 hours per week
Who Pays:
University & Employee
Effective Date:
Upon employment
Description:
老司机传媒 offers three health plans to all eligible employees. This package includes medical, dental, and vision benefits administered by ASR Health Benefits (ASR) and prescription drugs through (Navitus and Novixus). All employees enrolled in the medical, dental, and vision insurance are required to pay employee contributions. This amount is automatically deducted from your paycheck.
老司机传媒 is a self-insured employer and ASR is a third party administrator, which means that ASR pays your claims from a bank account that is fully funded by 老司机传媒. Payment will be made directly to your doctor or other provider under the terms of your health plan. If you have paid the bill and should be reimbursed under the terms of your plan, payment will be sent to you if you complete the appropriate reimbursement form and submit a paid receipt to ASR.
Login at ASR Health Benefits () to:
- view your plan benefits
- plan document and summary plan description
- claim status
- search for a medical provider
Claim Questions:
Please call ASR. A specially trained phone representative will be able to answer questions regarding your claim and benefit plan. It is important to have your ID number (located on your health insurance card) ready when you call.
To reach a claims analyst call: 800.968.3033
If your last name begins with the letter A-L, please use extension 3127.
If your last name begins with the letter M-Z, please use extension 3106.
Otherwise please use extension 0 and ask to speak with a claims analyst on Team A.
The difference between in-network and out-of-network providers:
The medical benefits of the Plan may be obtained from a provider participating in the PhysiciansCare (ASR) Network, Lakeland Care Inc. Network, Multi-Plan PPO Network, Cigna Network or an out-of-network provider.
This Plan has elected to work with the network listed above, called preferred (or in-network) provider organizations. Because these preferred providers have agreed to charge reduced fees to persons covered under the Plan (called the fee schedule), the Plan can afford to offer a lower out-of-pocket cost for the benefit.
Therefore, when a covered person uses a preferred provider, they will incur fewer out-of-pocket expenses that would a covered person who chooses to use a non-preferred provider. It is the covered person's choice as to which provider to use.
Covered persons are responsible for charges over the fee schedule amount when a non-preferred (out-of-network) provider is used.
Preferred Providers:
A listing of the preferred providers can be found at:
- Physicians Care Network ()
- Lakeland Care ()
- Cigna Network ()
- Multiplan Network ()
Prescription Drug Benefits:
This benefit is included with the University health insurance. When the covered person's health insurance card is presented to a participating pharmacy, the covered person will be responsible for the copayment or with the high deductible health plan, the discounted amount if the Benefit Period deductible has not been reached, then co-insurance. The pharmacist will submit the remaining cost to Navitus for payment.
| Generic versus Brand Name Drugs | Generic drugs will be dispensed unless a generic equivalent is not available. If an available generic equivalent is refused, even if the prescribing physician has requested “Dispense as Written” (DAW), the covered person will be required to pay the brand co-payment plus the difference in price between the brand-name drug and its generic equivalent. |
Dental and Vision Care Benefits:
Coverage for dental and vision benefits is a combined enrollment. Covered Persons cannot elect coverage for one benefit type without the other. Please submit your receipts and reimbursement form to PhysiciansCare/ASR Corp.
Vision: Coverage includes one (1) routine exam per Benefit Period. The co-pay for an eye examination is $15.00 after which insurance coverage is at 100% of reasonable and customary charges. The plan will pay up to $250.00 per Benefit Period for eyeglass frames and eyeglass/contact lenses. Any amount over $250 is the covered person's responsibility.
Dental: The plan covers preventative, minor, and major dental services such as cleaning, bridgework, crowns, dentures, emergency treatment, fillings, oral exams, orthodontics, root canals, treatment of gum disease, and x-rays. Please refer to the plan document for complete dental benefit information. Maximum benefit is $1,100 per person total per benefit year on Type I, Type II, and TypeClass III Benefits. ASR's payment for Class IV Benefits will not exceed a lifetime maximum of $1,760 per eligible person.
Open Enrollment:
Employees can make any new additions or changes to the health plan during the "Open Enrollment Period." Open enrollment is once a year and changes are effective on July 1st of the same calendar year. Changes submitted after the open enrollment deadline will be applied in the plan year after the next with all conditions remaining the same, unless the member experiences a qualifying event.
Extended Coverage Option:
Employees who are terminating employment may be permitted to continue with their health insurance under their own expense for up to twelve (12) months after termination. For more information on this issue, please contact Benefits Office.
Health Savings Account (HSA):
Forms
Forms are available when you log in at www.andrews.edu/go/mybenefits. If you have any questions, please contact benefits@andrews.edu.
- Phone: 269-471-3302
- Email: hr@andrews.edu