Inside Iowa State: Iowa State University

November 22, 2002

Insurance rates to go up 13 percent for faculty/staff

by Debra Gibson
A week till Hanukkah, a month till Christmas and Kwanzaa and only two weeks left to make changes or additions to your ISU benefits plans. That's right --- faculty, supervisory merit and P&S staffers have until 5 p.m. Friday, Dec. 6, to make alterations to their 2003 ISU Plans.

Rates for the plans, which will go into effect Feb. 1, will increase by 13.3 percent for the coming year. Likewise, university contributions to the plans will grow by the same percentage. Much of these higher costs can be attributed to prescriptions, which are estimated to cost up to 20 percent more next year.

As in the past, the ISU Plan consists of the following health insurance choices:

Indemnity. Known as Wellmark's "Classic Blue" plan, those covered can choose any licensed physician, hospital or other medical facility. This is the least cost-effective plan for the university.
Preferred Provider Organization (PPO). This managed care plan, also administered by Wellmark Blue Cross/Blue Shield, offers both in- and out-of-network coverage. If subscribers choose a BCBS preferred provider, the plan pays higher benefits.
Health Maintenance Organization (HMO). Offering managed care through Health Alliance, this plan requires subscribers to obtain health care from a primary care physician (PCP) or to get a referral from their PCP to another approved physician within the network. Most services are paid entirely by the plan.

Now is a good time to review dental insurance coverage as well. The ISU Plan offers basic and comprehensive programs; those enrolling in the comprehensive plan must remain in that plan for at least three years.

If, after review, you decide to keep your coverage the same, there is no need to do anything. Those wishing to make changes in plans for medical, dental, flexible spending accounts (see Oct. 11 Inside), life insurance and disability coverage plans can do so online through Access Plus on the university's Web site ( http://accessplus.iastate.edu). Changes also can be made by obtaining an enrollment form from the ISU Benefits Office, 1031 Wallace Road Office Building, Room 100, 4-7680.

So what are the best plans for you? The following scenarios may help you decide. (Note: Scenarios are based on providers participating in all mentioned medical plan options.)

Happy 40th birthday! Time for your first mammogram.
Here's your part of the bill:

Indemnity: 20 percent after $300 deductible, one per calendar year
PPO: In-network: 10 percent; out-of-network: same as indemnity
HMO: free if directed by primary care physician

You've undergone major surgery, and are finally home from the hospital. You still need daily nursing care.
Here's your part of the bill, after preauthorization is granted:

Indemnity: 20 percent after $300 deductible
PPO: In-network: 10 percent; out-of-network: same as indemnity
HMO: free, if directed by primary care physician and preauthorized by the HMO medical director

That persistent toothache results in a root canal and a crown.
Here's your part of the bill:

Basic dental coverage: root canal: 50 percent; crown: 50 percent up to $750 per year
Comprehensive dental coverage: Root canal: 20 percent, after $25 deductible; crown: 50 percent, up to $1,500 per year

You haven't had a complete physical since the first George Bush was in office. Your spouse makes the appointment for you.
Here's your part of the bill:

Indemnity: exam: 20 percent, up to $500 maximum, after $300 deductible; lab tests: 20 percent after deductible
PPO: In-network: exam: free after $10 co-pay; lab tests: 10 percent; out-of-network: exam: not covered; lab tests: 20 percent after $300 deductible
HMO: exam: free with primary care physician; lab tests: free, as directed by primary care physician