Administered by WebTPA and MedImpact
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. MedImpact 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. MedImpact Direct 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.
|Medical Coverage||Employee Only||Employee +1 (Spouse or Child)||Employee + Children||Family|
|Employer Contribution to HRA||$1,000||$1,500||$1,500||$2,000|
|Coinsurance (First Choice)||0%||0%||0%||0%|
|Out-of-pocket max (in-network)*||$4,500||$6,750||$6,750||$9,000|
|Out-of-pocket max (out-of-network)*||Unlimited||Unlimited||Unlimited||Unlimited|
*Out-of-Pocket Maximums include HRA, Deductible, and Coinsurance.
MedImpact administers the pharmacy portion of the plan. Home delivery and specialty medications are provided through MedImpact Direct.
- 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