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Anthem's HMO Choice Point-of-Service health plan changed to Cigna's Open Access Plus (OAP) Copay Plan effective 1/1/2012.
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.
Members covered by the HMO Choice Point-of-Service plan who live outside Maine may be responsible for greater out-of-pocket costs since non-emergency services will be treated as out-of-network and subject to a deductible and co-insurance.
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 1/1/11
- HMO Choice POS Summary Plan Description 1/1/11
- HMO Choice POS Amendment - Employees
- HMO Choice POS Amendment - ERRP 12/1/10
2011 HMO Choice / POS Premiums
TOTAL MONTHLY GROUP HEALTH PREMIUMS
HMO CHOICE / POINT-OF-SERVICE HEALTH PLAN
Single Coverage |
Single +One Coverage |
Family Coverage |
| $547.66 | $1,204.82 | $1,533.40 |
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, UMPSA and Non-Represented Salaried - Monthly Premium |
61.61 | 148.68 | 192.22 |
Non-Rep. Hourly/University Supervisors, Police, Service & Maintenance, & COLT - Biweekly Premium |
28.44 | 68.63 | 88.72 |
Eligible Part-time Active Employees |
Single Coverage |
Single +One Coverage |
Family Coverage |
Regular Employees Working 50%-74% time (except PATFA) – Monthly Premium |
273.83 | 602.41 | 766.70 |
Regular Employees Working 50%-74% time - Biweekly Premium |
126.38 | 278.04 | 353.86 |
Regular Employees Working 75%-99% time (except PATFA) - Monthly Premium |
219.06 | 481.93 | 613.36 |
Regular Employees Working 75%-99% time - Biweekly Premium |
101.11 | 222.43 | 283.09 |
| Temporary PATFA – Monthly Premium | 219.06 | 481.93 | 613.36 |
| Regular PATFA - Monthly Premium | 273.83 | 602.41 | 766.70 |
*Subject to ratification and execution of collective bargaining agreements where appropriate.
Related Information
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
See also: Understand Your Pay Stub
Contact the Employee Benefits Center
The above is a brief summary of benefits offered by the University of Maine System. If you have a question about benefits enrollment, call toll-free 866-269-9635 (or 973-3373) or email benefits@maine.edu. Have your Employee ID number for faster service.
Last Updated: January 4, 2012