Administered by WebTPA and Citizens Rx
2018 Plan Changes
The following plan changes are effective January 1, 2018:
- In-Network providers will be covered at 80%/20% coinsurance
- Brand Name and Specialty medications will be covered at 80%/20% coinsurance, following the satisfaction of the deductible, up to a maximum of a $150 co-pay for a 30-day supply
- Rollover HRA will apply to First Choice providers and generic medications
- Rollover HRA maximum will be capped at 1 time Current Year HRA
The LSU First Plan
The LSU First Health Plan is a self-insured plan. Utilizing WebTPA as the Claims Administrator, Aetna ASA as the nationwide network of providers and the Medical Manager, Citizens Rx as the Pharmacy Benefit Manager, and Verity HealthNet for local and First Choice Provider network administration.
- 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.
- In most cases, no costs are due up front.
Two options available - Option 1 and Option 2. The difference between Option 1 and Option 2 is the member responsibility is higher under option 2. The monthly premium is lower as a result of the higher out-of-pocket responsibility of the member under Option 2. Option 2 may be a good choice if you expect to have minimal healthcare costs during the Plan Year.
- Option 1: Summary of Benefits & Coverage
- Option 2: Summary of Benefits & Coverage
- New Hire Proration Guide
- 2018 LSU First Benefits Snapshot
Citizens Rx will continue managing the pharmacy portion of the plan. Home delivery
and specialty medications will continue through Praxis Rx. There will be no changes
to the prescription drug co-pays. Members will be responsible for paying a $40 co-pay
for a 30-day supply of Brand Name drugs and a $150 co-pay a 30 day supply of Specialty
drugs. These co-pay amounts do count towards the out of pocket maximum.
*Please note that generic drugs are covered at 100% throughout the plan.
If you do not have your LSU First member card with the Citizens Rx information, please provide the following information to the pharmacy to fill prescriptions until you receive a new card:
Rx Bin: 015284
Rx PCN: CRX
Rx Group: LSYA
Online Employee Assistance Program
Need a replacement ID card?
To print a temporary LSU First health insurance card go to www.lsu.edu/lsufirst, click on “My Accounts,” then click on “Access WebTPA for health plan information.” You’ll be directed to a new webpage where you will select “Register Now” on the lower right side of the page. Complete the required section with the member information to create an account. Then click on print/view temporary card. *It is also good to verify that the address shown on the online account is correct, including apartment/complex numbers. If the address or any other information is incorrect, please contact our office for assistance. You may also call LSU HRM at 225-578-8200 and we can request a card on your behalf.
Need to file a claim?
At times you may have to pay out of pocket for medical services or for 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 the LSU First. LSU First/WebTPA 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.
Anyone with questions is encouraged to call an HR Generalist for immediate assistance at 225-578-8200 or email email@example.com. You may also contact WebTPA customer service at 1-855-346-5781.