1. 2019 Health Plan
ASU is a self-insured health plan. Employees and ASU pay premiums into the plan, and those premiums are used to pay claims, administrative fees, and excess loss insurance for our very large claims.
Each year we analyze the costs to the health plan and adjust premiums or cost sharing to ensure we have enough funding in our plan to pay projected claims.
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2. Keeping Health Care Affordable
You can help keep our health plan affordable by:
Selecting a primary care physician. He or she will:
Provide preventive care and teach healthy lifestyle choices;
Identify and treat common medical conditions;
Assess the urgency of your medical problems and direct you to the best place for that care; and
Make referrals to medical specialists when necessary.
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3. Keeping Health Care Affordable
You can also help keep our health plan affordable by:
Visit to help manage your health care. You can:
Find doctors and compare costs and quality rates;
Track your claims, account balances, and deductibles;
Print a temporary ID card.
Seeking appropriate non-emergency care after-hours. You can:
Seek care at an urgent care center;
Call your physician’s office – they may have a nurse available by phone on nights and weekends; or
Call the toll-free number on the back of your card to speak to a nurse who can help you decide where and when you should get treatment.
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4. Health Plan Options ASU offers 2 different health plan options.
The Classic Plan utilizes the Arkansas True-Blue PPO Network and is a good choice for employees who primarily use Arkansas providers or providers in Memphis who are part of the Baptist network.
The Premier Plan utilizes the National Blue Card Network and is generally the best choice for employees who utilize providers outside the state of Arkansas including Methodist in Memphis.
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5. Medical Plan Comparison Summary
Classic
Lower Premiums
Higher Deductible
Higher Out-of-Pocket Maximum
Primarily Arkansas Network but does include the Baptist Network in Memphis
Premier
Higher Premiums
Lower Deductible
Lower Out-of-Pocket Maximum
National Blue Card Network including both Baptist and Methodist in Memphis
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6. Health Plan
A list of providers for the network is available on the Arkansas Blue Advantage website at:
For Classic select
True Blue PPO
For Premier select
Nationwide Providers
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7. Health Plan Premiums – Employee Cost
CLASSIC PLAN
PREMIER PLAN
 12 Month Employees - 24 Pay Periods
Employee Only
Employee and Spouse
Employee and Child(ren)
Family
$44
$163
$133
$180
$54
$181
$148
$202
9 Month Employees – 18 Pay Periods
$58.67
$217.33
$177.33
$240.00
$72.00
$241.33
$197.33
$269.33
10 Month Employees – 20 Pay Periods
$52.80
$195.60
$159.60
$216.00
$64.80
$217.20
$177.60
$242.40
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8. Health Plan Cost Sharing – In Network
CLASSIC PLAN
PREMIER PLAN
Deductible (amount employee pays before plan starts paying if service subject to deductible)
$1,500 individual/$3,000 family
$1,000 individual/$2,000 family
Coinsurance (percent of covered service employee pays)
20%
Out-of-pocket Maximums (includes deductibles, co-insurance, and copays) - Excludes Pharmacy
$4,000 per individual
$8,000 per family
$3,000 per individual
$6,000 per family
Outpatient Provider Services
Primary Care Physicians
Mental Health Provider
Specialist Services
$35 copay
$50 copay
(additional services in office may also be subject to co-insurance)
Urgent Care
Emergency Room (for non-emergency services)
$35 copay (additional services may be subject to co-insurance)
Covered 80% after deductible, plus $200 copay
Telemedicine (new for 2019)
$20 copay
Outpatient Rehabilitation
Physical Therapy
Occupational Therapy
Speech Therapy (20 visits per year)
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9. Health Plan Cost Sharing– In Network
CLASSIC PLAN
PREMIER PLAN
 Hospital and Outpatient Services (e.g., diagnostic services, medical procedures, advanced imaging, surgery)
Covered 80% after deductible
Preventive Care
Annual GYN Exam
Wellness & Adult Immunizations
Well Child Care & Immunizations
$0 copay
Pregnancy
Physician Charges - Prenatal Care & Delivery
Hospital Charges
Breast Feeding Equipment Rental
Covered 80% deductible waived
Covered 100%
Inpatient Mental Health/ Substance Abuse
Chiropractic Services – Limit of 20 visits per year
50% coinsurance deductible waived
Prescription Drugs (participating pharmacy)
Generic
Preferred Brand
Brand
Maximum Annual Out of Pocket
$12
$50
$80
$2,000 Individual/$4,000 Family
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10. Health Plan Cost Sharing – Out of Network
CLASSIC PLAN
PREMIER PLAN
Deductible (amount employee pays before plan starts paying if service subject to deductible)
$3,000 individual/$6,000 family
$2,000 individual/$4,000 family
Coinsurance (percent of covered service employee pays)
40%
Out-of-pocket Maximums (includes deductibles, co-insurance, and copays) - Excludes Pharmacy
$8,000 per individual
$16,000 per family
$6,000 per individual
$12,000 per family
Outpatient Provider Services
Primary Care Physicians
Mental Health Provider
Specialist Services
Covered 60% after deductible
Urgent Care
Emergency Room (for non-emergency services)
Covered 60% after deductible, plus $200 copay
Telemedicine (new for 2019)
Not available
Outpatient Rehabilitation
Physical Therapy
Occupational Therapy
Speech Therapy (20 visits per year)
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11. Health Plan Cost Sharing– Out of Network
CLASSIC PLAN
PREMIER PLAN
Hospital and Outpatient Services (e.g., diagnostic services, medical procedures, advanced imaging, surgery)
Covered 60% after deductible
Preventive Care
Annual GYN Exam
Wellness & Adult Immunizations
Well Child Care & Immunizations
Available in-network only
$0 copay children under age 19
Pregnancy
Physician Charges - Prenatal Care & Delivery
Hospital Charges
Breast Feeding Equipment Rental
Covered 80% deductible waived
Covered 80% after deductible
Covered 100%
Inpatient Mental Health/ Substance Abuse
Chiropractic Services – Limit of 20 visits per year
Not covered
No covered
Prescription Drugs
Non-participating pharmacies
Not Covered
No Covered
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12. ASU Wellness Benefits Routine Physical Exam
One annual wellness exam In-Network paid at 100%
Must be billed with a “routine diagnosis” or wellness visit
Routine Gynecological Exam
One In-Network per calendar year paid at 100%
Mammography
One In-Network screening per calendar year, paid at 100%
Age one exam; Age 40 and over annual exam
Immunizations
Covered adult and child immunizations are paid at 100%. Vaccines covered are subject to recommended age and population
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13. Pharmacy Plan 31-day supply Generic copay - $12*
07/16/96
Pharmacy Plan
31-day supply
Generic copay - $12
Preferred brand name copay - $50
Non-preferred brand name copay - $80
90-day supply
Generic copay - $36
Preferred brand name copay -$150
Non-preferred brand name copay - $240
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