Welcome to the NWOSU
Insurance Program Information Site

The purpose of the University's insurance program is to:

Prospective employees, as well as current, may want to see our Benefits Overview to see "who pays what." 

NATIONAL HEALTHCARE REFORM, REFERRED TO AS THE RECENTLY PASSED "PPACA LAW."

Required Posting of Amendment to OKHEEI High Option Medical Plan

Required Posting of Amendment to OKHEEI Basic Option Medical Plan

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OPTION PERIOD 2012 IS COMING!!!  Mark your calendars for October 10-12, 2011.

What is Option Period?  It's that once-a-year chance to enroll in/change plans, or add/drop dependent coverage.  Caution:  Mid-year changes are allowed only when there is a bona-fide family status change, such as marriage, divorce, birth/death of a dependent, child's 26th birthday, dependent losing other group coverage, etc.

Helpful Links to Option Period Material:

The best group medical coverage NWOSU has to offer Active Employees and their families, as well as Retirees under 65, Vested Continuees, and COBRA participants, is the BCBSOK-OKHEEI "High Option."  It is also the most expensive. 

A brief medical plan summary is the quickest way to compare our plan with a spouse's plan which may be available with their employer.  Before Option Period week, be sure to check out the medical plan summary for cy 2012.  (Be sure to choose down arrow to go to page 2.)

Another option for medical coverage is referred to as the BCBSOK-OKHEEI "Basic Option."   Please contact the Human Resources Office before changing to this plan.

Mandatory HIPAA Notification of Members' Rights under BCBSOK

The OKHEEI group offers an excellent group dental plan with BCBSOK.  Dental plan summary for 2012.

Before coming to Option Period 2012, be sure to compare our OKHEEI plans with other ones available to you and your family, and to research which "Network Providers" are available for each plan.  The employee is responsible for optimizing their medical, dental, and vision coverage by going to service providers who are contracted with OKHEEI to save members money.

The official money-saving OKHEEI-BCBSOK Network for Medical is called "Blue Choice."  When traveling in the United States and in many foreign countries, in-network savings can be realized through the "Blue Card Program."

The official OKHEEI-BCBSOK Network for Dental is called "Blue Care."  Your doctor's office  may need to know this used to be called the Traditional network.

 

 

 

OKHEEI Board Agenda for August 9, 2011 Meeting

 

 

January 1, 2010, 11 colleges and universities in Oklahoma joined together to form group Medical, Dental, and Vision insurance plans. 

There are 3 categories of insureds in the OKHEEI group, referred to as:  "Active," "Pre-Medicare," and "Medicare-Eligible." 

For Active (regular full-time employees) Insureds: 

 Medical and Dental are with BCBSOK (BlueCross BlueShield of Oklahoma), and vision is with VSP (Vision Service Plan.)

For OKHEEI Pre-Medicare Retirees:  Medical and Dental are with BCBSOK, and Vision is with VSP. 

For our OKHEEI Medicare-Eligible Retirees:  Supplement to Medicare ("Sr. Supplement") is with UHC (UnitedHealthCare), Dental is with BCBSOK, and Vision is with VSP.

MORE INFORMATION ABOUT RETIREE INSURANCE IS FOUND AT THE BOTTOM OF THIS WEB PAGE.

Before January 1, 2010, these schools' retirees' monthly premium payments were handled directly by the Oklahoma State and Education Employees Group Insurance Board in coordination with the OTRS (Oklahoma Teachers Retirement System).  Now, a company called HealthSmart assists the OKHEEI schools with billing and collecting premiums for former employees and dependents.  The OTRS continues to pay $100 to $105 per month toward the cost of qualifying retirees' health coverage.   

Group Term Life Insurance

Northwestern Oklahoma State University currently contracts with Standard Life Insurance Company to provide group term life insurance coverage for all full-time employees, at Northwestern's expense.  If proper application is made in time, new employees are covered the first day of the month following the date of hire in a full-time "benefited" position. 

Monthly dependent coverage cost (AD&D is an accidental death double indemnity):

Option 1

Spouse Benefit $10,000

Child Benefit $5,000

$2.40 per month without AD&D

$2.65 per month with AD&D

Option 2 Spouse Benefit $20,000

Child Benefit $10,000

$4.80 per month without AD&D

$5.30 per month with AD&D

Option 3 Spouse Benefit $50,000

Child Benefit $10,000

$12.00 per month without AD&D

$13.00 per month with AD&D

When leaving Northwestern, be sure to visit with the HR Director about how all, or parts, of this valuable coverage can be extended by submitting required paperwork to the company in a timely manner. 

For example, a retiree may be able to "port" the additional voluntary life coverage they elected and paid for as an Active Employee, without providing proof of medical insurability. 

Existing dependent coverage can often be extended into retirement by providing the NWOSU payroll officer with a supply of post-dated personal checks. 

Resigning employees are sometimes eligible to "port" (take with them) life insurance coverage they enjoyed as an Active Employee at NWOSU.  Call 580-327-8530 for more information.  Exiting employees are encouraged to consider Portability before Conversion, since the Conversion option is more expensive.

Conversion to a whole life policy may be an option for a dependent child losing coverage due to age, student status, or marriage.  However, conversion is much more expensive than portability.  

(See the Whole Life Conversion Rate Chart link below.  Compare to The Standard's RUSO Portability Rate Chart below.)   

Life Highlights (Voluntary Employee Life Coverage Rate Chart on page 5)

Standard Life-RUSO Group Term Life Certificate (Policy)

Standard Life Change Form

FAQs for 010106 conversion to The Standard from HighMark

The Standard's RUSO Portability Rate Chart and Application Packet

The Standard's Whole Life application form

The Standard's Whole Life Conversion rate chart

Evidence of Insurability EOI form for Conversion to Standard.  Do not send to Human Resources--send directly to The Standard at the address on the form--to the attention of E.O.I. Dept.- C4E.  It's a good idea to send this form by certified mail, return receipt requested.

This form is required by The Standard when:

1)  an employee wishes to enroll in the RUSO dependent life program after their "Open Period" has expired.  For more information call 327-8530,

2)  an employee wishes to participate in the "Additional-Voluntary Life" program after their "Open Period" has expired.  Call 327-8530 for more information,

3) an employee wishes to increase either their current level of dependent life coverage or their current level of employee Additional-Voluntary life coverage, or

4) an employee returns to eligible-for-benefits status after a break in employment of more than 90 days.

"Eligible Dependent" is defined as your spouse, your unmarried child dependent up to age 21, your student dependent child 21 or older but under 25, who is a registered full-time student, and, in some instances, your handicapped child. Contact the Human Resources Office for an eligibility determination on your child or stepchild.

Long-Term Disability

After working full-time for at least six full months at Northwestern, regular full-time employees are automatically enrolled with The Standard for salary protection equivalent to 60% of regular annual salary in the event of total disability.  This benefit is offset by estimated or real value of disability income from other sources, such as Social Security, worker's compensation, and Oklahoma Teacher's Retirement.

The basic benefit, paid for by the University, requires a six-month Elimination Period (i.e., this is how long you have to wait before drawing the benefit) upon diagnosis and proof of disability. At the employee's option and expense, that elimination period of six months may be reduced to just three months.  The Elimination "time clock" starts on the last day you're able to work.  Ask the Human Resources Director about the cost of this "LTD BUY-UP."

LTD Benefits at a Glance Certificate for Policy 135140

Vision Coverage (after January 1, 2010)

Currently, regular benefited full-time University employees are covered for vision insurance through the OKHEEI group plan with: Vision Service Plan

At the employee's option and expense, eligible dependents may be covered.

Check dependent eligibility rules in the Medical Insurance section below.  It is the employee's responsibility to make sure the dependents they want to have coverage are actually enrolled.  Be careful and thorough when filling out forms at Option Period.

Before making an appointment for an eye exam, the member is responsible for making sure a prospective network doctor accepts new patients.  Also, realize that some network providers will only accept patients over a certain age.

Features of the VSP vision plan.

Vision Insurance Monthly Cost for Calendar Years 2010, 2011 and 2012:
Company Employee Spouse Only One Child Only Two or More Children Only Spouse + One Child Spouse + Two or More Children

 CY 2010, 2011

0 7.12 6.84 8.12 17.24 17.24
Monthly
Premiums
for CY 2012

0

6.36

6.10

7.24

15.36

15.36

One question frequently asked:  How do you file a claim with VSP if you use an out-of-network provider?

Answer:  To optimize your VSP benefit, always go to a VSP Signature CHOICE network provider.  However, VSP reimburses for services received from any licensed optometrist, ophthalmologist, or optician.  If you receive services from a non-participating provider, you must pay the provider in full, then submit itemized receipts to VSP for reimbursement.  Here's what you will need to send the company:

*  The covered member's Social Security number, name, phone number and address

*  The patient's name, date of birth, phone number and address

*  The patient's relationship to the covered VSP member

*  A copy of the itemized bill/receipt listing services received

*  The name, address and phone number of the out-of-network provider

*  The name of our group, Oklahoma Higher Education Employees Insurance ("OKHEEI")

Please keep a copy of the information for your records and send the originals to the following address:

Call 800-877-7195 for more instruction.

Dental Insurance (after January 1, 2010)

Full-time employees may choose to enroll in and pay for dental coverage for themselves and their families. Employees must be insured by the OKHEEI dental plan if they want dependent coverage. Follow same eligibility rules listed in the Medical Insurance section below.

If you enroll in BlueCross BlueShield of Oklahoma (BCBSOK) Dental, you will get a better benefit by going to a "network provider" dentist.  Blue Cross Blue Shield of Oklahoma now has a working website for OKHEEI Insureds. 

 It is especially useful in helping locate the nearest Blue network provider.  Follow the hyperlink labeled Search for Doctors, Dentists, Hospitals & Other Providers in Your Area.  Next, enter a zip code in the Location box.  Be sure to choose the correct Network Type

To find a Network dentist, drop to bottom of the page and choose Find a Dentist under More Searches.  Be careful!  Only the Blue Care Network (formerly called "Traditional") applies to OKHEEI.  Going out-of-network can cost you plenty of extra money that would have been waived by a Network Provider!

Make sure you have found a network provider that you want to use.  You will not be allowed to drop dental mid-year.  Make sure you know the plan's eligibility rules described in the Medical section below.  It is the employee's responsibility to avoid paying premiums for ineligible children.  Our office must be promptly notified of any change in a family member's status.

Dental Insurance Monthly Cost for Calendar Year 2012 :
Name of Plan

BlueCare Network

Employee Employee + Spouse Employee + One Child Employee + Two of More Children Employee + Spouse + One Child Employee + Spouse + Two or More Children

OKHEEI-BCBSOK

37.90 77.70 53.00 68.30 108.00 108.00
Dental Insurance Monthly Cost for Calendar Year 2011 :
Name of Plan

BlueCare Network

Employee Employee + Spouse Employee + One Child Employee + Two of More Children Employee + Spouse + One Child Employee + Spouse + Two or More Children

OKHEEI-BCBSOK

34.90 71.50 48.80 62.80 99.40 99.40

Medical Insurance (after January 1, 2010)

Employees are encouraged to check out BCBSOK's Wellness program by visiting their website at http://www.bcbsok.com

Other available Wellness resources:  The Oklahoma Tobacco Helpline (1-800-QUIT-NOW).

Northwestern Oklahoma State University currently contracts with BlueCross BlueShield of Oklahoma (BCBSOK) for group medical coverage through a plan known as OKHEEI (Oklahoma Higher Education Employees Insurance group.  OKHEEI is made up of 13 Oklahoma state universities and colleges, and employees of the RUSO (Regional University System of Oklahoma) governing board.

At the time of new hire enrollment and once a year thereafter, regular full-time employees are allowed to make certain elections for insurance coverage for themselves and eligible family members.  Option Period is the once-a-year chance to add/drop dependents, add/drop dental, with changes effective the next January 1.

DEPENDENT ELIGIBILITY REQUIREMENTS* FOR OKHEEI GROUP COVERAGE PRIOR TO MAY 1, 2010:

Eligible dependents include spouse and unmarried children up to age 25 (termination age), as long as the member is responsible for the child's support. 

*    Natural, adopted, or stepchildren as long as they are primarily dependent on you for support, or you have been court-ordered to provide insurance coverage

*    Children who live with you in a regular parent-child relationship--a special form must be submitted and approved by BCBSOK

*    Children, regardless of age, who are incapable of self-support because of a mental or physical condition that began before age 25--a special form must be submitted and approved.

*IMPORTANT UPDATE:  In keeping with the spirit of recent federal health-care reform legislation, BCBSOK has extended the termination age for OKHEEI dependents from 25 to 26 for MEDICAL and DENTAL, regardless of marital status or gainful employment.   This change was effective May 1, 2010, months before the mandated change date written in federal law. 

If this child-dependent is (or becomes) employed in a job which provides employer-sponsored medical coverage, he or she must enroll in that coverage.  Ask Human Resources for an interpretation regarding your child's situation.

We have been informed by American Fidelity Assurance (our Section 125 administrators) that a similar extension will also apply to pre-taxing of premiums and URM (Unreimbursed Medical) reimbursement claims for dependent children's medical/dental/vision out-of-pocket expense claims.  As long as the child is not expected to reach age 27 in a given tax year.

It is the employee's responsibility to promptly notify Northwestern's Human Resources of any and all changes to family status.

Whenever a dependent ceases to be a dependent, they should ask the Human Resources Office about COBRA.  COBRA is a way to continue this valuable medical/dental/vision coverage after losing eligibility status.  Proper and timely application must be made in order to begin COBRA coverage, and payments must be made in a timely fashion in order to continue it. 

 Former spouses can continue as long as 36 months or until fully covered on another group plan, whichever occurs first.  The same is true of former child dependents.  However, there must be a bona fide qualifying event in order to apply for COBRA coverage. 

HealthSmart is the company contracted to handle collecting and remitting OKHEEI COBRA monthly premiums to BCBSOK and VSP.  Please do not discard any mailings from HealthSmart.

We are no longer under the State's "Insure-one-insure-all rule."  If it is your intent to cover an eligible dependent in medical/dental/vision, make sure that person is listed on your Option Period Confirmation of Benefits when you go through the line at Option Period.  If not, bring it to the attention of Human Resources staff.

Helpful numbers:

BCBSOK Medical:  Customer Service:  800-672-2567, Precertification:  800-672-2378, Network Provider Locator:  800-810-2583, Rx Tech Support:  877-353-0992, Rx Customer Service:  877-546-2779.  Prescriptions (Rx) are serviced by PrimeTherapeutics.  Specialty Drugs serviced by Triessent.

BCBSOK Dental:  Customer Service:  888-381-9727, Network Provider Locator:  888-381-9727.

The 2011 deductible for BCBSOK Medical High Option is $500 per person, maximum of $1500 per family.  Also, if you go out-of-network, plan to pay more in co-insurance.  Your BCBSOK High medical co-insurance goes to 50% out-of-network.   In addition, the member is responsible for the amount over and above what BCBSOK considers "usual/reasonable and customary," if they go OUT-OF-NETWORK.  This could be a small amount, or it could be very high.  This amount will be waived if the insured person stays IN-NETWORK.

 
Medical Insurance Monthly Cost for Calendar Year 2012:
Name of Plan:  BlueChoice Network Employee Employee + Spouse Employee + One Child Employee + Two or More Children Employee + Spouse + One Child Employee + Spouse + Two or More Children
BCBSOK (High Option) 0.00 496.40 189.10 378.20 874.70 874.70
BCBSOK (Basic Plan)

Please contact Tami Cooper, HR Director, before enrolling in this plan.  580-327-8530

Medical Insurance Monthly Cost for Calendar Year 2011:
Name of Plan: BlueChoice Network Employee Employee + Spouse Employee + One Child Employee + Two or More Children Employee + Spouse + One Child Employee + Spouse + Two or More Children
BCBSOK (High Option) 0.00 496.40 189.10 378.20 874.70 874.70
BCBSOK (Basic Plan)

Please contact Tami Cooper, HR Director, before enrolling in this plan.  580-327-8530

Section 125 Flexible Benefit Plan AFA Emblem

American Fidelity Assurance Company  currently administers the Section 125 Plan (commonly called the "Cafeteria Plan") for full-time employees. 

NEW!!!!  Current participants, quickly access a list of URM or DDC expenses the IRS currently considers reimbursement-eligible. 

There are two parts to the Plan:

____________________________________________________________________________________

THIS SECTION IS DEVOTED TO NORTHWESTERN'S RETIREES:

New:  Medicare Notice required posting (02232011)

Mandatory HIPAA Notification of Members' Rights under BCBSOK

Update: 

Option Period is a once-per-year chance to add/drop vision for the next calendar year, or adjust the level of Part D prescription coverage (the latter only applies to Medicare-qualifieds). 

OKHEEI Retirees can drop OKHEEI dental and/or medical, but will never be able to return to that coverage in the future.  Also, cancelling Retiree OKHEEI medical coverage requires OTRS to cancel their monthly health premium subsidy, a final decision for the retiree. 

Eligible dependents can only be added mid-calendar-year to OKHEEI medical and dental coverage when there is a bona fide family status change, such as marriage, birth of a child, or spouse loses other group medical/dental.  Call Tami Cooper at 580-327-8530 for more information. 

Retirees should watch their home mail closely for more information from NWOSU or HealthSmart.  And do not forget to stay IN-NETWORK for the most savings.  Read on for more information on Networks.

2012 OKHEEI Premium Chart for 65 and Older Retirees

2012 OKHEEI Premium Chart for Retirees Under 65

Answers to Questions I would be asking if I were a retiree/pre-retiree.   --Tami Cooper, Human Resources Director.

(At NWOSU, we welcome calls from each retiree, spouse, Durable Power of Attorney, or appointed Guardian.  Due to privacy laws, POAs and Guardians must fax proof to our office before we can discuss protected health information.  Our fax number is 580-327-8538.)

Questions should be directed to:

NWOSU Human Resources Office
709 Oklahoma Boulevard
Alva, Oklahoma 73717
Phone: 580-327-8530 or 580-327-8531


Last Updated: 12-22-11


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