Human Resources

University of Mississippi

State and School Employee’s Health Insurance Plan

The University of Mississippi offers an array of pre- and post-tax insurance benefits. A brief description of each benefit is provided along with links to each provider website.

Provider:

The State and School Employees’ Health Plan

Contact Information:

The State and School Employees’ Health Plan

Eligibility:

Benefits-eligible employees, their spouses and children

Coverage:

An employee may choose Base Coverage or Select Coverage at initial enrollment.  If timely application is made and the appropriate premium amount is paid, the effective date of coverage for the employee and any eligible dependent(s) begins the first day of employment. If an employee does not enroll or if he waives coverage within 31 days of employment, application may be made only during an open enrollment or as a result of a qualifying event.

Cost:

The University pays 100% of the premium for employee coverage under the Base Plan (high deductible health plan) and a portion of the employee premium for the Select Plan. The employee is responsible for the cost of dependent coverage.

2019 Monthly Premium Rates

Rates

The State and School Employees’ Health Insurance Plan will experience a premium/rate change effective January 1, 2019.  To review the new rates you can visit the knowyourbenefits website. The State and School Employees’ Health Insurance Plan is a self-funded plan that provides 2 plan options (the Select Plan and the Base Plan, also referred to as the high deductible health plan-HDHP). Under both options the participant must meet a calendar year deducible before the Plan is responsible for payment of covered expenses.

2019 Monthly Premium Rates

More Information

Plan Information

Detailed information about each plan option is available in the Plan’s Summary Plan Description.  This document provides detailed information about plan deductibles, co-insurances, medical benefits, pharmacy benefits, adult wellness/preventive and well-child benefits in addition to other important Plan information.The following link will provide you with a comparison of benefits for the Base Coverage (high deduchttp://knowyourbenefits.dfa.ms.gov/publications/tible health plan) and Select Coverage; rate for active employees, retirees, and COBRA participants; and federal notices and summaries of coverage.

Rates & Coverage

Provider Listings

AHS State Network (In-State)

Blue Card Program (Out-Of-State)

Wellness & Preventative Coverage

Refer to the following link for a comprehensive explanation of the wellness & preventive coverage.

http://knowyourbenefits.dfa.ms.gov/wellness-preventive-coverage/

Adult Care

Wellness and preventive care benefits are provided at 100 percent of the allowable charge for certain diagnostic tests and up to two office visits each year. Wellness services are not subject to the calendar year deductible. Diagnostic tests are based on the participant’s age and gender. Wellness and preventive care benefits are only provided when a participating provider renders the service and the wellness services are filed with a wellness diagnosis.

Well-Child Care

Benefits are provided for well-child care services for covered dependents up to age 18 at 100 percent. Services are not subject to the calendar year deductible. Benefits are only provided when a participating provider renders the service and the wellness services are filed with a wellness diagnosis.

Well-newborn nursery care is covered at 100 percent while a newborn is hospital-confined after birth. Well-newborn nursery care includes room, board and other normal care provided for which a network hospital or physician makes a charge. Also, well-child physician office visits, certain diagnostic tests and immunizations are covered at 100 percent.

Wellness/Preventive Coverage Guidelines

If you have questions about this coverage, please contact Blue Cross & Blue Shield of Mississippi at 800-709-7881.

Pharmacy Benefits

Prime Therapeutics LLC, “Prime”, is the pharmacy benefit manager (PBM) for the Plan’s prescription drug program and serves approximately 26 million members across the country. Prime processes prescription claims from participating pharmacies, mail order claims and paper claims filed by participants.

Prime’s focus is keeping prescriptions affordable while providing a customer service experience that makes it easy to get necessary medicines.

For information on the 2019 NetResults FormularyACA Preventive Drug List, exclusions or specialty medicines, go to www.MyPrime.com.

Online Provider Visits (Telemedicine)

Employees and their family members who are enrolled in the State and School Employees’ Health Insurance Plan have the opportunity to seek online services for minor medical care. Telemedicine services through Amwell provides an opportunity to consult with a board-certified medical care provider for common medical issues, such as, headache, fever, rashes, sore throat, cold and flu, insect bites, and constipation. Generally, a diagnosis can be made and treatment prescribed but in some cases, the patient may receive a referral for in-office services. There are times when symptoms alone are not enough to provide diagnosis so lab work or diagnostics may be necessary.

Learn More

Resources

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