Medical and Pharmacy Insurance

On this page:

• New Hires
• Qualifying Life Events
• Plans
• Definitions
• Sydney App
• Tobacco Cessation Program

New Hires

Employees who are appointed to work on more than a 75% Full-time Equivalency basis are eligible to enroll for medical benefits with an employer contribution from Wright State University. The university provides medical and pharmacy coverage through Anthem Blue Cross and Blue Shield.

Benefits are effective on the first day of the month following the date of hire.  Employees have 31 days from their hire date to enroll in benefits.

Eligible employees can choose between three medical plans, the Anthem Blue Access PPO 80/20, the Anthem High Deductible Health Plan (HDHP), or the Anthem Blue High Performance Network (HPN).  They 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 premiums for each coverage and coverage level selected. 

Further information about the services provided by Anthem Blue Cross and Blue Shield, including an online directory of member physicians and hospitals, can be found on the Anthem website. Information can also be obtained by calling 844-422-7714.
 

Qualifying Life Events

Within 31 days of experiencing a qualifying life event, you may be eligible to make consistent changes to your benefits. Please see our Qualifying Life Events section for more information.
 

Plans

Definitions

The following are a few definitions that 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.

Sydney App 

All member and benefits information can be accessed via the Anthem Sydney App or, as always, on www.anthem.com.

You will be able to perform action such as estimate costs, find care, access claims, check benefits, view ID cards, etc. In addition, there will be new actions such as chatting with a doctor or ordering medicine.

You will need to download the Sydney App and establish a new username and password in order to use this tool.

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.

 

Tobacco Cessation Program

All employees enrolled in a Wright State medical plan will be required to declare tobacco usage by completing an affidavit. Employees are considered a tobacco user if they use any form of tobacco products that are smoked (e.g., cigarettes, electronic cigarettes, cigars, pipes), applied to the gums (e.g., dipping, chewing tobacco, or snuff) and/or inhaled within in the last six months.

Employees enrolled in a university medical plan who declare themselves tobacco users, as well as those who fail to complete the affidavit timely, will incur a $50 monthly surcharge (paid biweekly at $25 per pay for applicable employees).  This surcharge is intended to encourage employees who use tobacco to consider quitting tobacco while also offsetting the higher costs associated with covering tobacco users.

Ready to quit? We’re here to help.

Wright State is committed to assisting tobacco users who choose to quit tobacco use. The university is taking a variety of steps to assist employees. A reasonable alternative to the tobacco usage fee is to participate in the University’s Tobacco Cessation Program.  Tobacco users can participate in up to five resources at no cost and the $50 monthly usage fee will be initially waived.

Tobacco Cessation Program: Start today by taking a step toward a healthier tomorrow!

1. The EX Program is a digital tobacco cessation program that personalizes the quitting journey for each participant. This program includes video and digital content on preparing to quit and how to build a support system, as well as interactive tools to identify triggers and track tobacco use patterns, with tailored emails about a participant’s quit status. Versions are available to participants in both English and Spanish.
    
2. Impact Solutions, the university’s Employee Assistance Provider, offers six life-coaching sessions to help you quit. Their website and App also contain a comprehensive library of articles and tip sheets that may help.
    
3. Smokefree.gov offers a variety of resources for participants in every stage of their quit journey, from the initial wanting to quit to staying tobacco-free after quitting. Resources include a free texting program, personalized quit plans, access to quitting support apps, articles to help people prepare to quit, and information about using Nicotine Replacement Therapy.
    
4. 1-800-QUIT-NOW provides unlimited phone coaching to help you quit smoking. When you call 1-800-QUIT-NOW, you can speak confidentially with a highly trained quit coach.
    
5. Visit your Primary Care Physician (PCP). Your doctor can provide counseling advise on Nicotine Replacement Therapy, and may prescribe medication to help you quit.  Click Here to view the Nicotine Replacement Therapy covered by Wright State’s medical plan at no cost to you.

Tobacco Cessation Program Participants

Periodically, program participants will be asked to provide a progress report with the expectation that participants become tobacco free. If this occurs, participants will be moved to a tobacco free status.  If a tobacco free status is not achieved, the participant’s progress will determine continued eligibility for the waiver of the $50 a month surcharge.

Additional Resources:

QuitGuide App helps you understand your smoking patterns and build the skills needed to become and stay smoke free. Use the app to track your cravings by time of day and location, and get motivational messages for each craving you track.

QuitSTART App helps you quit smoking with tailored tips, inspiration, and challenges.