Medical and Pharmacy

Employees who are appointed to work on more than a 50% Annual Full-time Equivalency basis are eligible to enroll for medical benefits with an employer contribution from Wright State University. The university provides medical coverage through Anthem Blue Cross and Blue Shield.

Employees are eligible to choose the Anthem Blue Access PPO 90/10, PPO 80/20 or the Anthem Lumenos HDHP coverage.

Non-Bargaining-Unit Faculty members, Classified and Unclassified staff may choose to enroll for medical, dental, and/or vision coverage for themselves and eligible dependents. These coverages are not linked and can be elected on an individual basis. There are employee contributions for each coverage and coverage level selected.

Further information about the services provided by Anthem Blue Cross and Blue Shield, including an on-line directory of member physicians and hospitals, can be found at the Anthem website. Information can also be obtained by calling 800-826-7987.

PPO 90/10

PPO 80/20

HDHP

Plan Comparison

To compare all three Anthem plans, click on the below link:

Plan Comparison (PDF)

Premiums

Below is the link to the premiums for all staff and non-bargaining unit faculty:

Premiums (PDF)

Definitions

The following are a few definitions which may be helpful when making your health plan choices. More definitions can be found in the Summary of Benefits and Coverage.
Covered Services. A medically necessary service or supply for which the benefit plan will reimburse expenses according to the plan’s limits.

Co-Payment. The fixed dollar amount you pay each time you receive specific services, supplies or prescriptions.

Deductible. The specified amount of covered medical expenses you pay for yourself and/or covered dependents each calendar year before any additional covered medical expenses are paid by the Plan. Applies to covered services noted as percentages.

Co-Insurance. After the annual calendar-year deductible met, co-insurance will apply. Co-insurance is your share of the cost of a covered service. The cost is calculated as a percent of the allowed amount for the service.

Out-of-Pocket Maximum. The maximum amount you pay in co-insurance for covered expenses in a calendar year before the Plan pays 100%.

Usual, Customary & Reasonable (UCR). A fee usually established by health insurance or government agency that is considered to be the “usual” cost of a specific medical service. The fee is commonly based on the amount the company or agency will pay for that service and may vary with geographic area.

Generic Prescription Drug. A prescription drug that is produced by more than one manufacturer. It is chemically the same as brand and usually costs less than the brand name prescription drug for which it is being substituted and will produce comparable effective clinical results.

Brand Name Prescription Drug. A prescription drug that has been patented with the brand name and is produced by the original manufacturer under that brand name.

 

Disclaimer: The benefits information contained in this site provides a summary for employees of Wright State. This information does not list all the provisions and does not supersede the individual provisions of our group insurance contracts, benefit plans and university policies that it describes. Similarly, the information presented does not guarantee that the university, the state of Ohio, and/or others responsible for these contracts, plans, programs, and policies will not make future changes in the provisions applicable to each.