Administered by WebTPA and Citizens Rx
2019 Plan Changes
The following plan changes are effective January 1, 2019:
- Option 2 will no longer be available for the 2019 Plan Year. Employees who are currently enrolled in Option 2 and do not make an election during Annual Enrollment will be defaulted into Option 1 for 2019.
- $150 Emergency Room Copay, regardless of network tier, waived if admitted.
The LSU First Plan
The LSU First Health Plan is a self-insured plan. WebTPA provides medical claim administration. They have a dedicated team of employees to answer calls and process claims. eQ Health Solutions provides Medical Management and Care Coordination. They certify pre-authorizations and proactively reach out to members with specific health care risks. Citizens Rx is the Pharmacy Benefits Administrator. They provide customer service and administer the prescription drug programs such as Step Therapy, Prior Authorization and Drug Quantity Management. Praxis Rx is the mail order pharmacy that provides home delivery and specialty medication services. Verity HealthNet provides local network administration for the First Choice and Verity networks. Aetna Signature Administrators (ASA) is the nationwide network administrator and provides the web-based Employee Assistance Program (EAP).
- Plan members receive a Health Reimbursement Account (HRA) - these funds are used to cover allowable services. Unused dollars, up to a maximum, will roll over for future use.
- Plan members control which doctors they see.
- Plan members have access to three networks within LSU First: First Choice Network (statewide), Verity HealthNet Network, (statewide), and Aetna ASA Network (nationwide).
- The First Choice Network is covered at 100%, after the HRA is exhausted
- The Verity and Aetna Networks are covered at 80%, after the HRA is exhausted and your deductible is met.
- A current listing listing of network providers for the LSU First plan is accessible at any time on the LSU First website.
Citizens Rx administers the pharmacy portion of the plan. Home delivery and specialty medications are provided through Praxis Rx.
- Generic medications are covered at 100% after the HRA is exhausted.
- Brand name and specialty medications are covered at 80% after the HRA is exhausted and the Deductible is met. Members are responsible for 20% of the drug cost, up to a maximum of $150 for a 30-day supply.
Online Employee Assistance Program
Need a replacement ID card?
To print a temporary LSU First health insurance card go to lsufirst.webtpa.com. You will need to register for an account. Complete the required section with the member information to create an account. Then click on print/view temporary card.
*Please verify the address shown on the online account is correct, including apartment numbers. If the address or any other information is incorrect, please contact our office for assistance.
Need to file a claim?
At times you may have to pay out of pocket for medical services or prescriptions, particularly if you have received services from a non-network provider. In the event that you do pay out of pocket for services, you can be reimbursed for these services. You will need to complete and submit a claim form and a copy of the invoice to LSU First will then reimburse you according to the plan's guidelines.
Authorization for Release of Protected Health Information: HIPAA Form - Authorizing the use and disclosure of protected health information to an individual other than member.