Summary of Medical Options 2009

Disease Management Program

The university offers you and your covered family members a valuable health service called BluePartners, a disease management program provided by Blue Cross Blue Shield of Nebraska. The program is available at no additional cost to members who are dealing with any of four chronic medical conditions: diabetes, heart disease, chronic pulmonary disease and asthma.

The BluePartners program offers personalized attention, from a team of health care professionals, custom-designed to fit individual needs, lifestyle and doctor's instructions. BluePartners strives to educate and empower program participants by providing a wide variety of support: personal phone contact with a registered nurse, educational materials and internet tools. Health care professionals can answer questions about specified chronic conditions, as well as consult with you and your doctor regarding treatment plans. The university and BluePartners are working together to reach those who would benefit most from this program.

Be Sure the Option You Select is "Cost Efficient"

In selecting your medical option, you are strongly encouraged to compare the annual difference in price tags between options, to the difference in medical cost exposure (deductible and stop-loss) between options. In most instances, the Basic Option is a more economical choice than the High Option, regardless of the medical expenses you may incur. In such cases, the difference in the deductible, coinsurance and stop-loss amounts you receive through the High Option cannot equal the savings in premium expense provided by the Basic Option for the same coverage category. For most employees, the Basic Option is always the best choice, from a purely economic perspective.

Some individuals may still select the High Option, for cash management purposes preferring to pay more per month in order to assure a more affordable deductible and coinsurance payment when medical expenses do occur. You are urged to be aware of the cost of your choice, however, because the savings can be significant, depending on your coverage category and medical claims experience.

Issues to Consider

• You and your dependents may enroll in any medical option without proof of insurance or pre-existing condition limitation.
• If you are covered by your spouse's medical plan, duplicate coverage may not be the most cost effective approach.
• If you use the Health Care Reimbursement Account to pay non-covered medical expenses, you may want to elect a medical option with a higher deductible.
• If your spouse is employed by the university and is benefits eligible, your Campus Benefits Office should be contacted for the applicable medical plan price tags.
• Enrollment of any dependent into one of the Blue Cross Blue Shield medical options requires completion of the "Medical, Dental, and Vision Care Insurance Dependent Information Request Form," which is included in the appendix.
• If you use the services of a non-Blue Cross Blue Shield network provider (Non-PPO provider), you may experience higher out-of-pocket costs due to potential balance billing by the provider.
• Participation in the prescription drug program is dependent upon your enrollment in the Blue Cross Blue Shield medical plan and does not require any additional premium to participate.

Medical Insurance Notice

If you are declining medical insurance enrollment for yourself or your dependents (including your spouse) because of other medical coverage, you may in the future enroll yourself or your dependents in one of the university provided options, provided that you request enrollment within 31 days after your other coverage ends. In addition, if you have a new dependent as a result of marriage, birth, or adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 31 days after the marriage, birth or adoption.

Blue Cross Blue Shield Insurance Benefits Summary 2009