草榴社区

Skip to main content
Human Resources

MEDICAL BENEFITS

草榴社区 is proud to offer employees three medical plan options, which include prescription and vision coverage, to help you care for your and your family's medical needs. 

Spending accounts are also available for each plan. Enrollment in our medical plans also allows you to access telemedicine through Independence Blue Cross's partnership with Teladoc.  You can also choose to elect dental coverage and enhanced vision coverage.

The University pays a percentage of the premium cost for single coverage and employee/dependent coverages (current rate sheet); employee shares may be paid free of federal income tax. Employees can also save up to $225 by attending our annual on-campus biometric screening event or having your doctor complete the physician affidavit form. If you have coverage elsewhere, you may elect not to participate in the medical plan. Coverage for full time staff and faculty is effective immediately on the first day of the month following the first day of work, unless otherwise noted.

PLANS

KEYSTONE HEALTH PLAN EAST HEALTH MAINTANENCE ORGANIZATION (HMO)

An HMO is a managed care program that provides a wide range of healthcare services through an organized network of physicians and hospitals. You are required to select a primary care physician (PCP), from the Keystone network to guide your care. Referrals from the PCP are required for specialist visits.

Under the HMO plan, most services are paid at 100% with no deductibles or 100% after a small co-payment for physician visits. Referrals from the PCP are required for specialist visits. For more details, please review the Summary of Benefits Coverage for the HMO plan. 

If you will be traveling out of the area for at least 90 days, please learn more about the .

PREFERRED PROVIDER ORGANIZATION (PPO)

The PPO plan provides you in and out of network benefits and allows you to select your own doctors and hospitals. You do not need to select a Primary Care Physician and referrals are not required. By staying in the Blue Cross network you will maximize your benefits. However, if you choose to see an out-of-network provider, you will incur higher out-of pocket costs. Premium costs in the PPO plan will be higher than the HMO but network flexibility will be greater.

For more details, please review the Summary of Benefits Coverage for the PPO plan.

CONSUMER DRIVEN HEALTH PLAN (CDHP)

The CDHP plan is similar to the PPO plan in that it provides you in and out of network benefits and allows you to select your own doctors and hospitals. You do not need to select a Primary Care Physician and referrals are not required. By staying in the Blue Cross network you will maximize your benefits. However, if you choose to see an out-of-network provider, you will incur higher out-of pocket costs. The CDHP with Health Savings Account (HSA) is a different approach to how you pay for today鈥檚 health care and save for your future. It is a lower-premium, high-deductible health insurance plan, which means you pay less out of your paycheck for premiums and more out of pocket at the point of service鈥攂efore the plan pays for services that are not considered preventive. 草榴社区鈥檚 CDHP meets the minimum federal requirements that allow an enrollee to also qualify for a tax-advantaged HSA.

For more details, please review the Summary of Benefits Coverage for the CDHP plan and watch this .

Notices

Privacy

HIPAA Notice of Privacy Practices

Transparency in Coverage Information

  • Amerihealth HMO

1. What is this Form 1095-C?

The 1095-C is a new tax form that is sent to you by 草榴社区 that includes information about your healthcare insurance coverage. All full-time benefit eligible faculty and staff will receive this form. It serves as a 鈥減roof of insurance statement鈥� that shows the IRS that you have been properly covered by 草榴社区. You鈥檒l take information from it to use in your tax filing, similar to how you take information from your W-2 form and transfer it to your tax forms.

View a . 

2. Why am I even receiving a Form 1095-C?

 It鈥檚 required that you get it as part of the .

3. When will I receive my Form 1095-C?

You should receive your 1095-C form in February.

4. What will I need to do with my Form 1095-C?

As mentioned in the previous question, your 1095-C will contain information that you will transfer to your 1040, 1040A or 1040EZ tax form. You do not need to submit the 1095-C form with your 1040. In fact, most people will only have to check a box on their 1040s stating that they (and their dependents if applicable) were covered by 草榴社区 for the year.

5. Where can I get more information about the Form 1095-C?

You can find more Form 1095-C information on the .

You can also view a .

6. Who can I contact if I have questions?

Please contact the Human Resources Department at 610-519-7900.

   

ELIGIBILITY

All full-time employees are eligible for coverage under the University鈥檚 medical, dental and life insurance programs beginning on the first day of the month following the first day of work. Registration in these plans is NOT automatic. No participation can begin without completion of the required enrollment materials, either during your New Employee Orientation, during the annual Open Enrollment Period (generally in April with choices in effect June 1-May 31) or within 31 days of a Life Status Change. Important Note: The open enrollment period is the only time during the year when you can enroll, cancel coverage, add or remove dependents, and change supplemental or dependent life insurance. The only exception to this is if you have a 鈥淨ualified Life Status Change,鈥� which is further described in the Pathways brochure.

**All supporting documentation for a Qualified Life Status Change must be uploaded to the benefit enrollment system and not emailed to HR.

The Internal Revenue Service defines a Life Status Change as a change in coverage due to the following:

  • Marriage or divorce
  • Birth or adoption of a child
  • Death of a spouse or child
  • Change in employment status of you or your spouse
  • Open Enrollment period for your spouse or certain other changes that impact coverage
  • Change in full-time student status of your unmarried dependent child
  • Judgment, decree or order
  • Medicare entitlement
  • Termination of Medicaid or CHIP coverage (notification must be made within 60 days)
  • Eligibility for Premium Assistance under Medicaid or CHIP (notification must be made within 60 days)

Any benefit change must be consistent with a life status change. You must notify Human Resources within 31 days of the life status change except as indicated above. After this grace period, you will not be able to make any changes in your coverage until the next Annual Open Enrollment.

Dependent children are eligible to be covered until age 26 (except for dependent life which provides coverage until age 25 for full time students). When a dependent is no longer eligible for benefits, it is the employee鈥檚 responsibility to contact Human Resources for continuation of coverage for dependents under COBRA provisions.

Employees can save up to $225 annually on their annual medical plan contribution through participating in on-campus biometric screenings or by completing a physician health screening form. 

Faculty and staff who participate receive $150 off annual medical plan contribution. In addition, spouses that are enrolled in the University medical plans qualify for a $75 annual medical plan contribution if they complete the physician health screening form as well.  If you are enrolled in either the HMO or PPO plans, this contribution will be applied as a premium discount. If you are enrolled in the CDHP plan, this contribution will be made into your HSA account. 

   

HELPFUL LINKS

Step by Step Life Event Instructions

How To Access the Medical Care Cost Estimator

How to Access Worldwide Healthcare