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Group Health Insurance
The University of Maine System offers a choice between two different medical plans, both of which cover a wide range of services, from hospitalization to doctor’s office visits, from prescription drugs to surgery. Whichever medical plan selected, employees can be sure that it is there to protect them from financially burdensome medical bills. Both plans are insured with Anthem Blue Cross Blue Shield. Click here to view a Side By Side Plan Comparison Chart.
Both plans offer:
- View claims & member details via MyAnthem
- 24/7 NurseLine 800-607-3262
- 360° Health (Health Information & Services)
- Maine Pharmacies offering 90-day supply for 2 co-pays
The employee and University share the cost of coverage for both employee and dependents, the cost to the employee will depend on employment status.
COMP-CARE
COMPREHENSIVE GROUP HEALTH PLAN
The COMP-CARE Plan allows complete freedom of
provider choice so that participants needing care
may select any medical care provider they wish.
However, before charges are covered, participants must
satisfy an annual deductible and pay 20% of the provider’s billed charges. Once the annual out
of pocket charges are satisfied, covered services
are paid at 100%.
This program requires pre-certification and
utilization review by Anthem BCBS for inpatient
hospital stays and other listed procedures.
COMP-CARE Plan Documents
- COMP-CARE Overview - Employees 1/1/08
- COMP-CARE Summary Plan Description
- COMP-CARE Amendment - Employees
COMP-CARE Premiums
TOTAL MONTHLY GROUP HEALTH PREMIUMS
COMPREHENSIVE COMP-CARE HEALTH PLAN
Single Coverage |
Single +One Coverage |
Family Coverage |
| $490.18 | $1,078.42 | $1,372.47 |
EMPLOYEE SHARE OF GROUP HEALTH PREMIUMS
COMPREHENSIVE COMP-CARE HEALTH PLAN*
Full-time Regular Active Employees Also includes BR status employees, shared appointments, and partial/phased retirement. |
Single Coverage |
Single +One Coverage |
Family Coverage |
Faculty – Monthly Premium |
$52.68 | $127.13 | $164.35 |
Non-Represented Professional (including Law School) Faculty and UMPSA - Monthly Premium |
$55.15 | $133.09 | $172.05 |
Non-Rep. Classified Confidential/University Supervisors, Police, Service & Maintenance, & COLT - Biweekly Premium |
$25.45 | $61.42 | $79.41 |
Eligible Part-time Active Employees |
Single Coverage |
Single +One Coverage |
Family Coverage |
Regular Employees Working 50%-74% time – Monthly Premium |
$245.09 | $539.21 | $686.24 |
Regular Employees Working 50%-74% time - Biweekly Premium |
$113.12 | $248.87 | $316.72 |
Regular Employees Working 75%-99% time - Monthly Premium |
$196.07 | $431.37 | $548.99 |
Regular Employees Working 75%-99% time - Biweekly Premium |
$90.49 | $199.09 | $253.38 |
| Temporary Faculty – Monthly Premium | $196.07 | $431.37 | $548.99 |
*Subject to ratification and execution of collective bargaining agreements where appropriate.
HMO CHOICE
POINT-OF-SERVICE (POS) PLAN
The POS plan offers a higher level of benefits than
the COMP-CARE Plan, overall.
The POS plan is a managed care program that
utilizes a network of health care providers.
The Anthem BCBS network currently includes
all hospitals in Maine and is the largest physician
network in Maine. The network includes
primary care physicians, as well as specialty providers such as internists, chiropractors, cardiologists and neurologists.
Each participant must choose a network
provider to act as his or her Primary Care
Physician (PCP) and provide the Benefits office with each covered member's PCP identification number. To find a PCP, visit Anthem's online Network Provider Directory or call Anthem directly at 1-800-527-7706 to obtain a hardcopy.
PCP's are
responsible for coordinating the care of their
patients to ensure that patients receive the most
appropriate care available.
Participants in the POS program have the option
to use network or non-network providers.
Participants using network providers are covered
100% for hospitalization and pay only a co-payment
for physician services. There are no
deductibles or claim forms when using network
providers.
Participants choosing to use non-network providers receive benefits similar to the COMPCARE Plan, but with a higher out-of-pocket maximum. When participants receive care outside the network, this program also requires pre-certification and utilization review by Anthem BCBS for inpatient hospital stays and other listed procedures.
HMO Choice - POS Plan Documents
- HMO Choice POS Overview - Employees 1/1/08
- HMO Choice POS Summary Plan Description
- HMO Choice POS Amendment - Employees
HMO Choice / POS Premiums
TOTAL MONTHLY GROUP HEALTH PREMIUMS
HMO CHOICE / POINT-OF-SERVICE HEALTH PLAN
Single Coverage |
Single +One Coverage |
Family Coverage |
| $460.95 | $1,014.07 | $1,290.63 |
EMPLOYEE SHARE OF GROUP HEALTH PREMIUMS
HMO CHOICE / POINT-OF-SERVICE HEALTH PLAN*
Full-time Regular Active Employees Also includes BR status employees, shared appointments, and partial/phased retirement. |
Single Coverage |
Single +One Coverage |
Family Coverage |
Faculty – Monthly Premium |
$52.68 | $127.13 | $164.35 |
Non-Represented Professional (including Law School) Faculty and UMPSA - Monthly Premium |
$51.86 | $125.15 | $161.79 |
Non-Rep. Classified Confidential/University Supervisors, Police, Service & Maintenance, & COLT - Biweekly Premium |
$23.93 | $57.76 | $74.67 |
Eligible Part-time Active Employees |
Single Coverage |
Single +One Coverage |
Family Coverage |
Regular Employees Working 50%-74% time – Monthly Premium |
$230.48 | $507.04 | $645.32 |
Regular Employees Working 50%-74% time - Biweekly Premium |
$106.37 | $234.02 | $297.84 |
Regular Employees Working 75%-99% time - Monthly Premium |
$184.38 | $405.63 | $516.25 |
Regular Employees Working 75%-99% time - Biweekly Premium |
$85.10 | $187.21 | $238.27 |
| Temporary Faculty – Monthly Premium | $184.38 | $405.63 | $516.25 |
*Subject to ratification and execution of collective bargaining agreements where appropriate.
PRESCRIPTION DRUG COVERAGE
Both medical plan options offered by the
University of Maine System provide employees
with prescription drug coverage.
All employees are covered for both generic drugs
and brand name drugs. Because brand name
drugs are typically more expensive than generic
drugs, you should ask your physician to
prescribe a generic drug, if appropriate.
All HMO Choice (POS) and COMP-CARE
enrollees have the opportunity to use the mail
order program. The mail order program allows
the convenience of having a three-month
supply of maintenance drugs delivered right to
their home!
Any questions on how to best utilize prescription drug coverage should be directed to Anthem BCBS at 1-800-527-7706.
Related Information
Premiums
Benefits Corner Premium Change (Explains 7/07 Changes)
Health Plan Premium Chart effective 01/01/2008
See also: Understand Your Pay Stub
Domestic Partner Benefits
Anthem Claim Form (PDF)
Employee Assistance Programs (EAP)
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Notice of Privacy Practices - Revised 9/03
Authorization for the Use and/or Disclosure of Protected Health Information
UMS Health and Wellness
Family Leave Policies
Paid Leave (Vacation & Sick Time)
Retirees Health Plans
COBRA Continuation of Coverage
Contact Benefits
The above is a brief summary of benefits offered by the University of Maine System. Detailed brochures/booklets are available online, at the local University Office of Human Resources, or at the System Office of Human Resources.
If you have a question about your benefits coverage, benefit deduction amounts or any other benefit related question, contact your Campus Benefits Office. Be prepared to give your Employee ID number.
Last Updated: September 30, 2008