LSU First

 

Benefits Snapshot
LSU First Medicare Retiree Plan
 
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Coronavirus (COVID-19)

TELEMEDICINE OFFERED THROUGH LSU FIRST EFFECTIVE NOVEMBER 1, 2019

Webtpa now offering paperless eobs

2020 Plan

The 2020 plan year runs for a full twelve months, from January 1 – December 31, 2020. All Health Reimbursement Accounts (HRAs), remaining deductibles, and out-of-pocket maximums were reset to the full amount on January 1, 2020. Any remaining HRA dollars, up to and the maximum from 2019 have been rolled over to the 2020 plan.

2021 Plan

LSU First offers members access to 100% coverage for First Choice providers and generic prescriptions. This means that members will not incur any out-of-pocket expenses for covered services from First Choice Providers and/or generic prescriptions. Note that there is a $150 Emergency Room Copay, regardless of network. This copay is waived if admitted to the hospital. LSU First also includes an employer-paid health reimbursement account (HRA) that can be used to offset deductible and other out-of-pocket medical expenses throughout the year. Any unused HRA funds roll over, up to a maximum, allowing members to build up balances that cover eligible medical expenses.

The 2021 plan year runs for a full twelve months, from January 1 – December 31, 2021. All Health Reimbursement Accounts (HRAs), remaining deductibles, and out-of-pocket maximums will reset to the full amount on January 1, 2021. Any remaining HRA dollars, up to and the maximum from 2020 will be rolled over to the 2021 plan. Beginning January 1, 2021, MedImpact will be the Pharmacy Benefit Manager (PBM). LSU First will have a 3% premium increase for 2021. There will be no plan design changes for 2021. All enrolled members will receive a new ID card, so please make sure your address is up to date with your employer.

If members need to obtain prescriptions after January 1, 2021 and have not yet received their ID cards, they can present the below information to the pharmacy along with their Member Number found on your 2020 ID card.
RxBIN: 003585
RxPCN: ASPROD1
RxGRP: LSU01

 

first choice providers + generic drugs = Covered 100% (after HRA is exhausted)

no referrals for specialist, preventative care covered at 100%, optional home delivery for perscriptions

 

The LSU First Team

The LSU First team is comprised of the following partners working together for your health care benefits:

  • LSU - LSU is financially responsible for paying your claims
  • WebTPA - Medical Claims Administrator. They have a dedicated team of employees for LSU to answer your calls and process your claims.
  • eQHealth - Medical Management and Care Coordination. They certify pre-authorizations and proactively reach out to members with specific health care risks
  • MedImpact - Pharmacy Benefits Manager. They provide customer service and administer prescription programs such as Step Therapy, Prior Authorization and Drug Quantity Management. They also provide mail order services for home delivery of maintenance and specialty medications.
  • Verity HealthNet - Local Network Administrator for the First Choice and Verity networks
  • Aetna ASA - National Network Administrator and web-based Employee Assistance Program (EAP) provider

The LSU First Networks

  • First Choice (FC) - The First Choice network is a network of local providers within Louisiana. Services are covered at 100% after your HRA is exhausted. This means you pay no out of pocket for covered services with these providers.
  • Verity HealthNet - The Verity Network is a network of local providers within Louisiana. After your HRA is exhausted and you meet your deductible, the Plan will pay 80% and you are responsible for 20%.
  • Aetna ASA - The Aetna ASA Network is a nationwide network for providers outside of Louisiana and/or providers within Louisiana that are not in the First Choice or Verity networks. After your HRA is exhausted and you meet your deductible, the Plan will pay 80% and you are responsible for 20%.
  • Out-of-Network - Any providers not participating in the above networks will be considered Out-of-Network. This may include ancillary services, such as emergency room providers, radiology, anesthesiology, etc. After your HRA is exhausted and you meet your deductible, the Plan will pay 60% of the Maximum Allowable Charge (MAC). Members can be balance billed by Out-of-Network providers for billed services outside of the MAC.

Online Resources

lsufirst.webtpa.com – Members can create an online account with WebTPA. Once registered, the WebTPA portal allows members to track their HRA, deductible, and out-of-pocket balances, view claims, and print ID cards. Note that any spouse and/or dependents over the age of 18 will need to have their own account to view claims information.

medimpact.com – Members can create an online account with MedImpact. Once registered, members can look on prescription drug coverage, drug costs, compare prices for medications, view medication history, and find an in-network pharmacy.