Policies, Union Contracts, Handbooks > Faculty & Academic Staff Handbooks > Faculty Handbook > Faculty and Academic Staff Retirement and Benefit Programs

Health Plan Coverage

VII. FACULTY AND ACADEMIC STAFF RETIREMENT AND BENEFIT PROGRAMS (Cont.)

OPTIONAL BENEFITS (Cont.)¹

Health Plan Coverage

If active faculty/academic staff members enroll in health plan coverage within 60 days of initial appointment to an eligible status or during an Open Enrollment, faculty/academic staff members and their eligible dependents are covered for health care services.  Coverage is currently provided by Community Blue PPO or Physicians Health Plan.  In addition, a Blue Cross Blue Shield of Michigan Transition Plan is available to those who have a mix of Medicare and non-Medicare eligible family members.  Enrollment can be retroactive to the appointment date if a new employee enrolls within 60 days of the appointment. Specific coverage details under these plans differ. In general, the following apply:

Eligibility

A faculty/academic staff member appointed 50% time or more for nine months or more may enroll themselves, their spouse or MSU recognized same-sex domestic partner, and their eligible dependents. Failure to enroll during the initial 60-day eligibility period will result in the faculty/academic staff member having to wait until the next annual open enrollment period.

Eligible spouses (or MSU recognized same-sex domestic partners) who are eligible to enroll for health plan coverage through other employment must enroll in that coverage if the annual premium cost to the spouse/partner is $600 or less.  MSU's health plan coverage then becomes the secondary payer.

Coverage

The health plans offered through the University provide coverage for semi-private hospital room charges up to 365 days and additional hospital expenses, including intensive care, recovery room, anesthetics, etc.. Surgical benefits, diagnostic X-ray and lab tests are provided whether performed in or out of the hospital. The plans provide coverage for office calls subject to either a co-payment and/or satisfaction of an annual deductible amount. Most other medically necessary out-of-pocket expenses are also covered subject to a deductible and co-payment.  Physicians Health Plan is primarily available to employees who live in the service area. Community Blue PPO is a preferred provider organization that offers both in- and out-of-network coverage. Out-of-network services require a higher out-of-pocket cost.

Prescription Drugs

The prescription drug plan is a co-pay plan for generic and brand drugs and is administered through Caremark. Caremark has a large network of over 51,000 participating retail pharmacies, including some of the largest drug store chains. Employees may choose to purchase their prescriptions at a participating retail pharmacy, at an MSU pharmacy (Olin Health Center or the MSU Clinical Center pharmacies) or through Caremark's mail order program: 

Cost

MSU provides a monthly University contribution toward the premium for health plan coverage for eligible faculty/academic staff. If an additional premium is required, it will be deducted from the faculty/academic staff member's paycheck. The University does not make a contribution during periods when a faculty/academic staff member does not receive a paycheck.

¹For benefit purposes only, half-time is defined as 50.0-64.9 percent time; three-quarter time is defined as 65.0-89.9 percent time; full-time is 90.0-100.0 percent time.

============

Next:  Optional Benefits - Waiver of Health Care Coverage

Previous:  Optional Benefits - Employee-Paid Life

Index:  Faculty Handbook Index

TOC:  Faculty Handbook Table of Contents