If an employee wants to continue waiving medical insurance, what should they do?

If an employee has waived coverage in the past, they can continue doing so without resubmitting documentation. If an employee wants to waive medical coverage for the first time, then they must provide proof of other medical coverage to the benefits office.

 2.

What do I do if I my preferred physician is not in the BlueLincs HMO network?

HMO networks are generally smaller than PPO networks. If your preferred primary care physician (PCP) is not currently in the HMO network, you have a few choices.

• You may still choose the BlueLincs HMO and designate a different PCP. If your preferred PCP joins the network at a later date, you can change your designated PCP at that time by contacting BlueCross.
• You can choose to participate in the BlueChoice PPO plan for this year. The PPO plan has a higher premium, does not require the designation of a PCP, and has a physician network approximately twice as large as the HMO network. During annual enrollment next year, you would have an opportunity to choose again between the HMO and PPO plans.

 3.

Can employees get a 90 day prescription filled through a walk-in pharmacy the same as they can through mail order?

Yes. Three months for the cost of two.

 4.

Why is autism excluded from benefits with the rising increase in children with autism? In particular, why is the therapy for autism excluded? This is an insurance industry standard currently being challenged in the Oklahoma Legislature.

5.

If an employee elects the HMO, does their PCP need to refer them to a specialist who is in the network?

Yes. However, if there is not a specialist in the network, BCBS will work with them to find a specialist.

6.

For two married OU employees, will OU allow one employee to waive their coverage and be enrolled as a dependent on their spouses’ insurance?

No. It is not to any employee’s financial advantage. In future years that could change depending on the University’s contribution to dependent coverage.

 7.

Can the out of pocket maximum for two OU employees be linked?

Yes, Blue Cross has agreed to do that.

8.

What do two married OU employees covering a child need to do when they both reach their annual deductible?

Contact BCBS. BCBS can revise their EOB to reflect the correct deductible. Call when the maximum for a family is reached.

 9.

Does out of pocket maximum include the deductible?

Yes.

 10.

How do I designate my Primary Care Physician (PCP) if I’m choosing Community Care in the Tulsa area?

You should enter the last name only of your selected PCP in the appropriate field within Employee Self-Service.

 11.

What is the default plan? The plan OU pays for?

The BlueChoice PPO plan for employee only is the plan considered the default plan for OU employees.

 12.

Does the HMO provide Emergency Room care?

Yes. There should be no problems with coverage of emergency room care that is associated with a hospital.

Is Emergency Room care available out-of-state?

Yes on all the plans.

How do I find out if my physician is in a network?

Go to the physician’s directory at https://www.bcbsok.com/OU/.

Which plan covers traveling overseas?

The BlueChoice PPO plan.

What is the age limit for college-age dependents?

Through age 24 for full-time students; coverage stops at age 25. If the dependent is not a student, then coverage is available through age 18; coverage stops at age 19.

Will there still be a credit for those waiving the University’s medical insurance?  Will the credit amount be the same?

Yes, and the amount, $50, will be the same.

Is there a way to opt out of mail solicitations with BCBS?

Yes. Contact BCBS.

Will new or replacement insurance ID cards be mailed through U.S. mail or campus mail?

US mail to home addresses

Will there be someone available at the Benefits Fair to discuss supplemental medical insurance for Medicare retirees?

Yes

How do the HMO and PPO Networks compare in size?

The HMO network is half as big.

Is there a phone tree when employees call BCBS?

Yes, gives them options to reach Delta Dental or PayFlex.

What is the hold time when employees call in?

Average hold time is 21 seconds.

What if allergy injections cost less than the co-pay?

The full office visit co-pay is charged.

Where does the $500.00 come from for the HCA Plan?

From BCBS through premiums.

What is the difference between mail order and the drugstore for prescriptions for maintenance drugs?

The cost is the same; some prefer the convenience of home delivery.

Do co-pays count toward the out-of-pocket maximum?

No, they do not.

Why do physicians elect to participate in one network and not the other?

Physicians make a decision based on their own cost analysis.