Nicholls State University
Human Resources
Annual Enrollment Overview
IMPORTANT

This year members are required to make a
selection during the annual enrollment period.

All active employees who are currently enrolled in
a plan and do not make a selection by the end of
the enrollment period, will be moved into the
Pelican HRA 1000

Retirees will be moved into the plan most
comparable to their current plan if no selection is
made otherwise
Key Changes for 2015

All employees who are enrolled in a plan for
2014 MUST select a plan for 2015 or they will
be moved into the Pelican HRA 1000

All new plan offerings

New ways to enroll (paper, online, or HR)

No opportunity to make changes until next
year’s annual enrollment period (except for a
qualifying event)
NEW TIMELINE

Oct 1st Annual Enrollment Begins

Nov 30th Annual Enrollment Ends

January 1, 2015

March 1, 2015 Pelican/Magnolia plan year begins
Vantage plan & FSA plan years begin
During Annual Enrollment, you may...

Enroll in a health plan

Drop or add dependents

Discontinue OGB coverage

Determine the amount of your HSA
contribution (Active Employees only)

Enroll or change contribution to flexible
spending account (Active Employees only)
FAQs
Q:
What’s the difference between a copay and co-insurance?
A:
A co-pay is a flat fee billed by
providers for a specific service.
Co-insurance is a percentage of the
contractually allowed cost of a
specific service.
FAQs
Q:
Will my deductible and out-of-pocket
max start over in January?
A:
Yes.
Q:
Will they start over again in March?
A:
No. You will get credit for out-of-pocket
payments made in January & February.
But...
FAQs
Q:
What’s the difference between innetwork & out-of-network?
A:
In-network providers have contracts with
Blue Cross/Vantage and agree to charge
only a certain allowable amount for
services. Out-of-network providers do not
have contracts with the insurers & the
member may have to pay the difference
between the allowable amount and the
actual billed amount.
FAQs
Q:
What is balance billing?
A:
Balance billing is the difference between
the provider’s charge and the allowed
amount. For example, is the provider’s
charge is $100 and the allowed amount is
$70, an out-of-network provider may bill
you for the additional $30. An in-network
provider cannot balance bill you for the
additional amount.
Pelican Plans
 OGB’s
Pelican plans offer low premiums,
in combination with employer
contributions, to create the most
affordable options for members in 2015.
 Pelican
plans offer coverage within the
Blue Cross nationwide network, as well as
out-of-network coverage.
Pelican HRA 1000 FAQs
Q:
How does an HRA work?
A:
Your employer puts a certain amount
into an HRA account in order to help
offset your deductible. The HRA funds
are available as long as you remain
employed by an OGB-participating
employer.
Pelican HRA 1000 FAQs
Q:
Does it rollover every year?
A:
Yes. Unused funds will continue to
rollover until you reach your innetwork, out-of-pocket maximum. So,
for example, if you’re on an employee
only plan, your unused funds will
rollover until you reach $5,000.
Pelican HRA 1000 FAQs
Q:
How do I use the money?
A:
The HRA will automatically pay 100%
of covered medical expenses - up to
the $1,000 (single) or $2,000
(family)contribution.
Pelican HRA 1000 FAQs
Q:
What does it mean “prescription drugs
are not reimbursable by the Pelican
HRA?”
A:
Your HRA will not pay for prescriptions.
Prescription drugs would be an out-ofpocket expense which would apply to
the out-of-pocket maximum.
Pelican HSA 775 FAQs
Q:
How does an HSA work?
A:
A Health Savings Account (HSA) is an
employee-owned account used to pay
for qualified medical expenses, including
deductibles, medical co-pays,
prescriptions, and other eligible medical
costs. Both the employee and employer
can contribute to the HSA, but the funds
are owned by the employee.
Pelican HSA 775 FAQs
Q:
Does it rollover every year?
A:
Yes. Unused funds will rollover year
after year. You won’t lose your
money if you don’t spend it within the
year.
Pelican HSA 775 FAQs
Q:
How do I use the money?
A:
You will receive a BCBS MySmartSaver
Visa debit card that can be used to
pay for eligible expenses.
Magnolia Plans

Magnolia plans offer lower deductibles than the Pelican
plans in exchange for higher premiums.

The Magnolia Local and Local Plus are traditional plans that
offer $25 primary care co-pays (excluding wellness visits)
and $50 specialty care co-pays.

The Magnolia Open Access Plan differs from the other
Magnolia plans in that members enrolled in the open
access plan will not pay co-payments at physician visits.
Instead, once a member’s deductible is met, he or she will
pay 10% of the allowable charge for in-network care and
30% of the allowable charge, plus 100% of the difference
between the allowable charge and billed amount for outof-network care.
Magnolia Local
Only for members who live in the Baton
Rouge (East & West Baton Rouge and
Ascension Parishes), Shreveport (Caddo
and Bossier Parishes), and New Orleans
communities (Orleans and Jefferson
Parishes).
Magnolia Local Plus FAQs
Q:
Will the Magnolia Local Plus plan
cover out-of-state specialists?
A:
If the out-of-state specialist is
contracted with BCBS, eligible
charges will be covered.
Magnolia Local Plus FAQs
Q:
Can I keep my current physician on
this plan since it “similar” to the current
HMO plan?
A:
Providers should remain the same.
Please check the provider list on the
BCBS website or contact BCBS
customer service to verify.
Magnolia Local Plus FAQs
Q:
What is subject to the deductible?
A:
Any service that is not subject to a copay.
Q:
Will we have to meet the deductible
before we pay only co-pays?
A:
No. If your plan has a co-pay amount
(such as $25 for a physician visit), then the
deductible does not apply.
Magnolia Local Plus FAQs
Q:
Since the plan does not cover out-ofnetwork, does that mean the expense
to me will be unlimited?
A:
If you choose to use a doctor,
hospital, or service that is out-ofnetwork, you will pay an unlimited
amount out-of-pocket.
Vantage HMO FAQs
Q: What do the tiers mean?
A:
Tier 1 Providers: Most providers fall into this category.
Members would pay the Tier 1 co-pays, co-insurance,
and deductibles listed. Tier 1 includes Affinity Health
Network, the Vantage Tier 1 Network, and Verity
Health Network. Tier 1 providers may not balance bill
members.
Tier 2 providers: Members who choose to see Tier 2
providers must pay an additional 20% co-insurance in
addition to their Tier 1 cost share. No out-of-pocket
max and Tier 2 providers may not balance bill
members.
Vantage HMO FAQs
Q:
How do I find out which providers are
in the different networks:
A:
Visit www.VHP-stategroup.com or call
Vantage Member Services at 888-823-1910.
Which plan is most like your current plan?
2015 Plan:
Comparable To:
Pelican HRA 1000
None (new offering)
Pelican HSA 775
CDHP
Magnolia Local
None (new offering)
Magnolia Local Plus
HMO
Magnolia Open Access
PPO
Vantage Medical Home HMO
Vantage Medical Home HMO
What’s Different?


Current PPO plan
Magnolia Open Access Plan

Increased In-Network Deductible: $500 to $1,000 for Active Employee
(Retirees from $300 to $1000)

Coinsurance In-Network: No Change (90/10)

Network: No Change – Blue Cross Nationwide Network

Coverage: No Change in out-of-network coverage (70/30)

Out-of-Pocket Max increase for In-Network: $1,500 to $3,000
Employee Only
CDHP - HRA 1000 & HSA 775

Yearly plan contributions that rollover to cover out of pocket
expenses

Lower premiums

Higher deductibles
What’s Different?

Current HMO plan
Magnolia Local Plus Plan

Increased primary care and specialty co-pays: PCP $15
to $25, SCP $25 to $50

ER and hospital co-pays: ER $100 to $150; Hospital – no
change

Network: No Change

Coverage: No out-of-Network coverage on the Local
Plus Plan and Local Plan

Deductible and co-insurance on services where co-pay
does not apply

Out-of-Pocket Max In-Network Increase - $1,000 to
$3,000 Employee Only
FAQ’s
Q:
Is my network changing?
A:
If you are enrolled in a Blue Cross
plan, you will have access to the
same nationwide network as last year.
The only exception is the Magnolia
Local plan (for BR, NO, & S’port only)
or if you enroll in the Vantage plan.
FAQ’s
Q:
If I enroll through the online portal,
how will I know my information was
received?
A:
You will see a confirmation page
once you submit your selection. You
can print that page for your records.
FAQ’s
Q:
What if I choose a plan and then change
my mind?
A:
If you wish to change your plan selection
during the annual enrollment period,
simply visit the annual enrollment portal
and select a new plan. Your most recent
choice will be considered valid. If you
change your mind after annual enrollment is
over, you won’t be able to change your plan
until next year’s annual enrollment period
unless you experience a qualifying event.
FAQ’s
Q:
What does it mean when there is no out-ofnetwork coverage available?
A:
Out-of-network coverage is coverage
outside of your available network. OGB’s
plans offer Blue Cross’s nationwide network,
making it easy to stay in-network for your
care. Several OGB plans also offer options for
out-of-network care, including OGB’s Pelican
plans and the Magnolia Open Access plan.
No matter which plan you choose,
emergencies are covered both in and out of
network.
Resources
 Annual
Enrollment Site:
https://www.annualenrollment.groupbenefits.org/
 Main
OGB site: www.groupbenefits.org
 Customer
Service: 1-800-272-8451