Page 4 - 2018 USI Benefit Guide
P. 4
Medical
The University of Southern Plan Highlights
Indiana offers a robust medical You have the option of choosing one of two medical plans. The plans are
insurance program to our administered by Anthem BlueCross of Indiana with a Preferred Provider
employees. We partner with Organization (PPO) network of doctors and medical facilities. The wide
Anthem BlueCross BlueShield to range of in-network providers offers you access to quality care with the
offer this coverage. least amount of out-of-pocket expenses to you when you receive services
from in-network providers.
Anthem’s Member Site
The Anthem BlueCross BlueShield member site, www.anthem.com offers
many valuable services including the following.
X In-network providers and pharmacy searches
X Prescription drug formulary
X Access to temporary ID cards and means to order another ID card
X Information regarding paid and pending claims
Employee Contributions
Bi-Weekly Monthly
Salary below $41,000 Core Plan
Employee Only $57.98 $115.96
Employee and Spouse $127.71 $255.42
Employee and Child(ren) $96.20 $192.40
Employee and Family $159.07 $318.14
HSA Plan
Employee Only $27.89 $55.78
Employee and Spouse $61.45 $122.90
Employee and Child(ren) $46.29 $92.58
Employee and Family $76.54 $153.08
Salary $41,000 and Above Core Plan
Employee Only $68.21 $136.42
Employee and Spouse $150.25 $300.50
Employee and Child(ren) $113.17 $226.34
Employee and Family $187.15 $374.30
HSA Plan
Employee Only $37.10 $74.20
Employee and Spouse $81.75 $163.50
Employee and Child(ren) $61.57 $123.14
Employee and Family $101.81 $203.62
4 2018 Benefits Enrollment
The University of Southern Plan Highlights
Indiana offers a robust medical You have the option of choosing one of two medical plans. The plans are
insurance program to our administered by Anthem BlueCross of Indiana with a Preferred Provider
employees. We partner with Organization (PPO) network of doctors and medical facilities. The wide
Anthem BlueCross BlueShield to range of in-network providers offers you access to quality care with the
offer this coverage. least amount of out-of-pocket expenses to you when you receive services
from in-network providers.
Anthem’s Member Site
The Anthem BlueCross BlueShield member site, www.anthem.com offers
many valuable services including the following.
X In-network providers and pharmacy searches
X Prescription drug formulary
X Access to temporary ID cards and means to order another ID card
X Information regarding paid and pending claims
Employee Contributions
Bi-Weekly Monthly
Salary below $41,000 Core Plan
Employee Only $57.98 $115.96
Employee and Spouse $127.71 $255.42
Employee and Child(ren) $96.20 $192.40
Employee and Family $159.07 $318.14
HSA Plan
Employee Only $27.89 $55.78
Employee and Spouse $61.45 $122.90
Employee and Child(ren) $46.29 $92.58
Employee and Family $76.54 $153.08
Salary $41,000 and Above Core Plan
Employee Only $68.21 $136.42
Employee and Spouse $150.25 $300.50
Employee and Child(ren) $113.17 $226.34
Employee and Family $187.15 $374.30
HSA Plan
Employee Only $37.10 $74.20
Employee and Spouse $81.75 $163.50
Employee and Child(ren) $61.57 $123.14
Employee and Family $101.81 $203.62
4 2018 Benefits Enrollment
