2015 Annual Enrollment Guide For Employees of the Louisiana State University System

Transcription

1 2015 Annual Enrollment Guide For Employees of the Louisiana State University System

2 WHAT S INSIDE Benefits Overview 2 Changes 3 AE Schedule 4 LSU First 5 Office of Group Benefits 6 Dental 7 Vision 8 Life with optional AD&D 9 AD&D 10 Long-Term Disability 11 Flexible Spending Accounts 12 Critical Illness (NEW) 13 Accident Protection (NEW) 14 BENEFITS OVERVIEW The Louisiana State University System is proud to offer a comprehensive benefits package to eligible, full-time employees who work 30 hours or more per week and are appointed for a duration of at least one semester or 120 days. This comprehensive benefit package is briefly summarized in this booklet, however for a full description of the benefit plan terms and conditions please refer to the summary plan descriptions or certificates of coverage provided by the administrator of each respective benefit plan offered. You share the costs of your health insurance premium with the LSU System. In addition, there are voluntary benefits that you can purchase through LSU payroll deductions. Annual Enrollment occurs from October 1st through October 31st, Any changes made during this period will become effective January 1, During this time you can enroll, cancel or make changes to your health and voluntary benefit plans. We encourage you to review your benefit elections and make selections/changes consistent with your individual needs. BENEFIT PLANS OFFERED Medical LSU First Option 1 Option 2 Office of Group Benefits Pelican HRA 1000 Pelican HSA 775 Dental Vision Magnolia Local Magnolia Local Plus Magnolia Open Access Vantage Medical Home HMO Life Insurance with optional AD&D Accidental Death and Dismemberment Long-Term Disability Flexible Spending Accounts Critical Illness (NEW FOR 2015) Accident Protection (NEW FOR 2015) This guide is designed to be a brief overview of the 2015 benefit offerings for active employees. We encourage you to contact your HR department or the carriers directly if you have questions about any of the information in this booklet. If differences exist between this summary and your Certificate of Coverage, the Certificate of Coverage will govern. 2

3 BENEFIT LSU First Office of Group Benefits Health Plans Dental Vision Life with optional AD&D Stand Alone AD&D Long-Term Disability Flexible Spending Account(s) Critical Illness Accident Insurance 2015 CHANGES LSU First will continue to be administered by WebTPA and Express-Scripts. The Maximum Out-of-Pocket will increase but will include the deductible, medical coinsurance, and pharmacy co-pays. Pre-authorization is now required on certain medical procedures. Massage therapy and acupuncture will no longer be covered. Out-of-network services will be covered at 60% of MRC. Critical Illness will now be offered as a voluntary benefit and will not be included within the Health Plan. There will be a 5% increase in premiums. OGB has restructured and renamed all of their Health Plans. Current OGB participants will be receiving a separate mailing from OGB with information about 2015 plan offerings. You can access information on 2015 OGB health plans at Dental insurance will be administered by UnitedHealthcare. The Basic Plan premiums will remain the same, and will include an annual $50 deductible for employees, up to $150 for family coverage. The Enhanced Plan will have a slight premium increase but will include a rollover feature. Preventive Care will not apply to the Annual Max for either plan. Vision insurance will be administered by UnitedHealthcare. Eye exams are covered at 100% and there is a $130 allowance for frames. There will be a premium decrease for Life insurance will be administered by UnitedHealthcare. If you do not currently have Voluntary Life insurance, you can enroll during the month of October for up to three times your annual salary, not to exceed $300,000, with no medical underwriting. There will be a premium decrease for Stand Alone AD&D insurance will be administered by UnitedHealthcare. There are no plan changes for There will be a premium decrease for LTD will be administered by UnitedHealthcare. If you are not currently enrolled in LTD, you can enroll during the month of October with no medical underwriting. There will be a premium decrease for Healthcare and Dependent Care Spending Accounts will continue to be administered by Boon-Chapman. There are no changes for Critical Illness and Accident insurance are two NEW benefits offerings for Both will be administered by UnitedHealthcare. More information on these offerings is located in this guide. IMPORTANT NOTE Current OGB Participants: BCBS HMO, This year there will be a positive enrollment for all OGB Health plan participants. Unlike previous years, OGB participants MUST actively select a health plan for their 2015 coverage. If you are an OGB health plan participant and do not actively select a plan during open enrollment, you will be defaulted into OGB s HRA 1000 Plan. You will not be able to change your health plan until the following open enrollment. 3

4 ANNUAL ENROLLMENT SCHEDULE Annual Enrollment occurs from October 1 through October 31, Any changes made during this period will become effective January 1, During this time you can enroll, cancel or make changes to your health and voluntary benefit plans. We encourage you review your benefit elections and make selections/changes consistent with your individual needs. During the month of October, Benefit Fairs and presentations will be held throughout the state to inform LSU employees of the 2015 benefit offerings. We encourage you to attend one of the fairs or presentations in your area! Date Time Campus Address Meeting Thursday 10/2 2-4PM LSU A&M LSU Student Union - Capital Chamber Room Baton Rouge, LA Monday 10/6 1-4PM LSU Ag Center 212 Macon Ridge Road Winnsboro, LA Tuesday 10/7 12-3PM 12PM LSU Alexandria 8100 Hwy. 71 South Alexandria, LA Fair Wednesday 10/8 10-2PM 12PM LSU Shreveport One University Place Shreveport LA Fair Thursday 10/9 10-4PM 10AM; 2PM LSU Health Sciences Center Shreveport 1501 Kings Highway Shreveport LA Fair Tuesday 10/ AM LSU A&M LSU Student Union - Capital Chamber Room Baton Rouge, LA Wednesday 10/ PM 10AM LSU Health Sciences Center New Orleans Medical Education Building - 3 rd Floor, Rooms 4 and Perdido St New Orleans, LA Fair Thursday 10/16 8-4PM LSU A&M LSU Student Union Cotillion Ballroom Baton Rouge, LA Monday 10/ PM LSU Ag Center 214 Efferson Hall Baton Rouge, LA Tuesday 10/ AM LSU A&M LSU Student Union - Capital Chamber Room Baton Rouge, LA Fair Tuesday 10/21 2-4PM Pennington Biomedical Research Center 6400 Perkins Road Baton Rouge, LA Wednesday 10/22 2-8PM Lallie Kemp Medical Center Hwy 51 South Independence, La Thursday 10/ PM LA Legislature 1051 North 3rd - Room B-45 Baton Rouge, LA Friday 10/ PM LSU Ag Center 157 Cherokee Drive Crowley, LA Tuesday 10/28 2:30-4:30PM LSU A&M LSU Student Union - Capital Chamber Room Baton Rouge, LA Fair 4

5 LSU FIRST HEALTH PLAN Administered by WebTPA and Express-Scripts Comprehensive and preventive healthcare coverage is important in protecting you and your family from the financial risks of unexpected illness and injury. LSU First is a self-insured plan that gives you options and control over how to spend your healthcare dollars. There are two options: Option 1 has a higher premium, but a lower deductible. Option 2 has a lower premium, but a higher deductible you must meet before the Plan pays at the co-insurance/co-payment levels. Option 2 may be a good choice if you have rollover HRA dollars from previous plan years or if you know you will have minimal healthcare costs during the Plan Year. LSU First includes a Health Reimbursement Account (HRA), with the ability for unused dollars to be rolled over from year to year. After the HRA is exhausted, you have a deductible that must be met. The deductibles vary based on plan option and can be seen below. After both the HRA is exhausted and the deductible is satisfied, the Plan will pay medical claims at 90% In-Network (you are responsible for 10%) and 60% of Maximum Reimbursable Charge (MRC) Out-of-Network (you are responsible for 40% plus any amount over the MRC). If you exhaust your HRA and meet your Deductible, you will pay a co-pay for your prescriptions. Generic drugs will have a $0 co-pay, brand name drugs will have a $40 co-pay per 30-day supply and specialty drugs have a $120 co-pay per 30-day supply. An advantage of the LSU First Health Plan is the First Choice Network, a specialized network of doctors and hospitals within Louisiana. Once you have exhausted your HRA, services by First Choice Providers will be covered at 100%. Additionally, once you have exhausted your HRA, generic drugs will be covered at 100%. HRA Option 1 Deductible LSU First Annual HRA and Deductible Employee Only Employee + Spouse Employee + Child(ren) Employee + Family Option 2 Deductible $1,000 $500 $1,500 $1,500 $750 $2,250 $1,500 $750 $2,250 $2,000 $1,000 $3,000 LSU First has two additional networks Verity Health- Net, a localized network in Louisiana, and Aetna ASA, a national network. Both networks will pay at the 90%/10% coinsurance. Providers that are not a part of these networks (First Choice, Verity, or Aetna ASA) will be paid at the 60% of MRC. 12 Month Employee Option 1 Option 2 Employee Only $ $ Employee + Spouse $ $ Employee + Child(ren) $ $ Family $ $ Month Employee Employee Only $ $ Employee + Spouse $ $ Employee + Child(ren) $ $ Family $ $ Retiree with No Medicare/Rehired Retiree Employee Only $ $ Employee + Spouse $ $ Employee + Child(ren) $ $ Family $ $ Retiree with one member on Medicare Employee Only $89.25 $77.17 Employee + Spouse $ $ Employee + Child(ren) $ $ Family $ $ Retiree with two members on Medicare Employee + Spouse $ $ Family $ $ Scan the code to go to the LSU First website Website: lsufirst.webtpa.com Customer Service: 1 (855) Policy Number: LSUFIRST 5

6 OFFICE OF GROUP BENEFITS HEALTH PLANS Administered by Blue Cross Blue Shield of Louisiana and Vantage The Office of Group Benefits has developed an all-new set of Medical plans that offer members a variety of coverage options. Whether you are looking for low premiums, a large coverage network, or predictable co-payments, they have options that work for you and your family and have developed tools that will help you make the best choice for your circumstances. OGB publishes their own guide and we encourage you to familiarize yourself with their offerings. There is a POSITIVE EN- ROLLMENT for all OGB participants for 2015 which means that if you currently have OGB coverage (HMO, PPO, CDHP or Vantage Home HMO) and do not select one of their new plan designs or LSU First, you will be defaulted into the OGB Pelican HRA You will not have the opportunity to change plans until the following annual enrollment. Please contact the Office of Group Benefits or your local Human Resource Management office for ways to actively enroll in the OGB Health Plans. Contact Information OGB Customer Service Blue Cross Blue Shield of Louisiana Vantage Annual Enrollment Hours Monday Saturday 7:00 a.m. 7:00 p.m. Annual Enrollment Hours Monday Friday 8:00 a.m. 5:00 p.m. Annual Enrollment Hours Monday Friday 8:00 a.m. 8:00 p.m Pelican HRA 1000 Pelican HSA 775 Magnolia Local Magnolia Local Plus Magnolia Open Access Vantage HMO Benefits Employer contribution to HRA or HSA X X Out-of-Network coverage X X X X Disease Management X X X X X X Wellness X X X X X X Emergency Coverage X X X X X X Available to Retirees without Medicare X X X X X (800) (800) (800) (800) (800) (800)

7 DENTAL INSURANCE Administered by UnitedHealthcare Good oral care enhances overall physical health, appearance and mental well-being. Keep your teeth healthy and your smile bright with the LSU dental plan offered through UnitedHealthcare. The Basic plan is designed with two goals in mind: to promote good dental hygiene through preventive care and to provide you with the dental care you need at a low cost. The Basic Plan pays 100% of the Usual and Customary (U&C) fee allowance for Preventive Services and features a benefit schedule for all other services. The benefit schedule lets you know up front, in fixed dollar amounts, how much the Plan pays for Basic and Major services. To use these schedules, check your dentist s fee and then determine how much the Plan will pay according to the scheduled amounts. The Basic Plan has an annual deductible of $50/person up to $150/family. The Enhanced Plan offers comprehensive dental coverage in an easy-to-use format. The Plan will cover a percentage of U&C charges, including 100% of preventive claims. All dentists in network have agreed to honor the negotiated rates, and most dentists not in the network charge similarly, helping you to limit your out-of-pocket costs. Orthodontia is also included in the Enhanced Plan, making it a good choice for families with more extensive dental needs. The Enhanced Plan does not have a deductible. For 2015, you can enroll, change plan options, add or delete dependents, or cancel your dental coverage. To do so, complete the Voluntary Benefits Enrollment Form and submit to your local HR department. Basic Plan Deductible Preventive Services Basic Services Major Services Annual Maximum Orthodontia Applies to basic and major services only - $50 per person, up to $150 per family Exams, cleanings, x-rays 100% coverage (Does not apply to Annual Max) Fillings, simple extractions charges are based on a Fee Schedule Oral surgery, root canals, crowns charges are based on a Fee Schedule The Basic plan pays a maximum of $1,500 per year per covered person. Not Covered Enhanced Plan Deductible Preventive Services Basic Services Major Services Annual Maximum Orthodontia No deductible Exams, cleanings, x-rays 100% coverage (Does not apply to Annual Max) Fillings, simple extractions - Plan pays 80% of U&C Oral surgery, root canal, periodontics, dentures, crowns, implants Plan pays 50% of U&C The Enhanced plan pays a maximum of $1,500 per year per covered person. *Rollover Feature* The Enhanced plan pays a maximum of $1,500 per lifetime per covered person. Monthly Premium BASIC DENTAL Employee Only $17.88 Employee + Spouse $33.60 Employee + Children $46.45 Employee + Family $62.16 Monthly Premium ENHANCED DENTAL Employee Only $32.87 Employee + Spouse $64.33 Employee + Children $78.19 Employee + Family $ Scan the code for a short video about the Dental benefit Website: Customer Service: 1 (877) Policy Number:

8 VISION INSURANCE Administered by UnitedHealthcare Regular eye examinations can not only determine your need for corrective eyewear but also may detect general health problems in their earliest stages. LSU partners with UnitedHealthcare to provide you and your family with valuable vision insurance at affordable rates. The Vision plan meets the needs of you and your family by including coverage for exams, lenses, frames, and contacts. Access the care your family needs through UnitedHealthcare s network and select retail partners, such as Walmart, Sam s Club, and Costco. In 2015, there will be one plan design, which will include a free eye exam at in-network providers. You can enroll, add or delete dependents, or cancel your vision coverage during Annual Enrollment. To do so, complete the Enrollment Form and submit to your local HR department. In-Network Out-of-Network Eye Exam once every 12 months Included $40 allowance LENSES ONCE EVERY 12 MONTHS Single Vision Bifocal Trifocal Progressive Standard Premium MATERIALS ONCE EVERY 12 MONTHS Contact Lenses Elective Medically Necessary Fit and Follow-Up Included Included Included Included $150 Copay Formulary: 4 Boxes Non-Formulary: $130 Allowance Included Formulary: Included Non-Formulary: Applies to allowance $25 allowance $40 allowance $50 allowance $50 allowance $130 allowance Frames $130 Allowance + 30% Off $130 allowance Monthly Premium VOLUNTARY VISION Employee Only $7.39 Employee + Spouse $12.45 Employee + Children $12.72 Employee + Family $20.50 Scan the code for a short video about the Vision benefit Website: Customer Service: 1 (800) Policy Number:

9 LIFE INSURANCE WITH OPTIONAL AD&D Administered by UnitedHealthcare No one wants to think about the possibility of death, but it s important that you ensure your family s financial security in the event that something happens. Term Life insurance offers financial security for you, your spouse, and your child (ren). For 2015, there will be a one-time open enrollment for employees to enroll in Life coverage with no medical underwriting. If you are currently enrolled: Employee = you can increase your coverage up to 3 times your annual salary, up to $300,000, without medical underwriting. If you currently have over $300,000 coverage, you can increase 1 time your annual salary, up to $500,000, without medical underwriting. Spouse = you can increase $5,000, up to a total amount of $100,000, without medical underwriting. Maximum coverage cannot exceed 50% of employee coverage. Eligible children (up to age 26) = increments of $5,000, up to $20,000. No medical underwriting is required. If you are not currently enrolled: Employee = you can enroll for coverage 3 times your annual salary, up to $300,000, without medical underwriting. Spouse = you can enroll for $5,000 coverage without medical underwriting. Maximum coverage cannot exceed 50% of employee coverage. Eligible children (up to age 26) = increments of $5,000, up to $20,000. No medical underwriting is required. Coverage Child(ren) Life Coverage and Rates Monthly Premium $5,000 $0.35 $10,000 $0.70 $15,000 $1.05 $20,000 $1.40 Employee and spouse premiums are age-based; therefore, premiums will increase each time you move up an age band. Child(ren) rates are based on amount of coverage. To calculate your monthly premium, multiply the rates below by the amount of coverage you would like to purchase. Please note the rates are per $10,000. For example, if you would like $50,000 you would multiply your rate by 5. Age Bands Amounts per $10,000 Rates < 24 $ $ $ $ $ $ $ $ $ $ $ $ $ < $68.66 Optional AD&D coverage provides benefits to employees and spouses due to certain injuries or accidental death. If purchased, coverage amount must equal coverage amount of life insurance. AD&D Rates Rates Per $10,000 $0.31 Scan the code for a short video about the Life Insurance benefit Customer Service: 1 (888) Policy Number:

10 ACCIDENTIAL DEATH & DISMEMBERMENT Administered by UnitedHealthcare An accident that ends in death or disabling injury has a devastating effect on the lives of your loved ones. The loss of a family wage-earner puts strain on a family and raises concerns as to how they will manage financially. Even if you are unmarried, remaining family members could be left with fulfilling your financial responsibilities or taking care of you. LSU partners with UnitedHealthcare to provide you and your family with valuable AD&D insurance at affordable rates. This benefit pays in the event of death or dismemberment resulting from an accident. You may select coverage for yourself, your spouse and/or your children. Family members may be insured for a portion of your principal sum: Spouse = 50% your principal sum or 40% if you have eligible children Eligible children = 15% your principal sum or 10% if you have an eligible spouse You can apply for this benefit at any time without medical underwriting. Benefits are effective the first of the month following your signed application. To enroll, fill out the Enrollment form and submit to your HR department. Below is a list of injuries and payouts based on your amount of coverage. Please see plan document for more information on covered benefits. Injury Benefit Paid Death 100% Loss of both hands or feet 100% Loss of sight in both eyes 100% Quadriplegia 100% Paraplegia 75% Loss of one hand or foot 50% Coma 50% Loss of speech or hearing 50% Thumb and Index Finger 25% Employee Only Family AD&D Premiums $27,500 $0.83 $1.24 $55,000 $1.65 $2.48 $82,500 $2.48 $3.71 $110,000 $3.30 $4.95 $165,000 $4.95 $7.43 $220,000 $6.60 $9.90 $275,000 $8.25 $12.38 $300,000 $9.00 $13.50 Scan the code for a short video about the AD&D benefit Customer Service: 1 (888) Policy Number:

11 LONG-TERM DISABILITY Administered by UnitedHealthcare A lengthy disability can be devastating and may be more common than you think. Your ability to earn an income may be your most important asset. People don t think twice about insuring their homes, cars, or health, but many do not recognize the need to insure their income. LSU partners with UnitedHealthcare to provide affordable Long Term Disability coverage to help you continue to meet your family s needs in the event of a disabling illness or injury. If you become disabled and qualify for benefits, LTD coverage will pay you 60% of your monthly salary, up to a maximum of $12,000 a month. Disability benefits are paid if you are considered disabled and you satisfy a waiting period of 90 days and exhaust your sick leave. If you are disabled before the age of 60, the benefit will continue until Social Security Normal Retirement Age. If you are disabled after you turn 60, a reduced benefit period applies based on the age you become disabled. During annual enrollment, you can enroll for Long-Term Disability coverage with no medical underwriting. After annual enrollment ends, you can apply for the coverage at any time, with medical underwriting. Your premium is based on your salary. To calculate your monthly premium, calculate your monthly salary by dividing your annual salary by 12. Multiply your monthly salary by Rates Per $100 $0.482 Below are examples of your monthly premium based on the annual salaries shown. This will give you a range of what you could expect to pay for LTD coverage. Annual Salary Monthly Premium $30,000 $12.05 $40,000 $16.07 $50,000 $20.08 $75,000 $30.13 $100,000 $40.17 Scan the code for a short video about the Long Term Disability benefit Customer Service: 1 (888) Policy Number:

12 FLEXIBLE SPENDING ACCOUNT(S) Administered by Boon-Chapman This benefit provides you with the opportunity to set aside pre-tax dollars for out-of-pocket health care or dependent care expenses incurred by you and/or your eligible dependents. You must determine an annual target amount to be withheld. You should determine the amount to be withheld by forecasting your out-of-pocket health care and/or dependent care expenses for the entire Plan year, plus the grace period (January 1 through March 15). For healthcare spending accounts, you will be provided with a pre-loaded debit card with this amount for your use throughout the Plan Year. The deduction is made before taxes, thus making the spending account dollars tax-free. To access the money in your account, you can either use your FSA Debit Card at the time of service, or you can file a paper claim requesting reimbursement for eligible, out-of-pocket expenses. The Premiums Only Plan (POP) allows you to tax shelter your qualified insurance premiums. This means that your premiums for medical, dental, and vision insurance can be automatically deducted before taxes from your paycheck. There is no cost or tax liability. Due to the tax advantages under this program, you can only change or cancel this election during Annual Enrollment or if you experience a qualifying event. For 2015, you must re-enroll and elect your contributions. Contact your HR department for instructions on how to enroll. Types of Accounts Minimum Contribution Maximum Contribution Health Care Spending $100 $2,500 Dependent Care Spending $100 $5,000 Eligible Expenses include: Health Care Spending = medical or prescription expenses, dental care and orthodontia, eye exams and glasses or contacts Dependent Care Spending = Day-care costs for children 12 and younger; before and after school care for children 12 years or younger Flexible Spending Accounts have a USE IT OR LOSE IT provision. This means that if you do not use your full election by the end of the plan year, you will forfeit the remaining balance. Monthly Fee Tax-Saving Benefits FSA 12 Month EEs $5.10 FSA 9 Month EEs $6.80 Website: Customer Service: 1 (800)

13 CRITICAL ILLNESS Administered by UnitedHealthcare The Critical Illness Insurance is a NEW offering for LSU partners with UnitedHealthcare to provide you and your family with valuable Critical Illness insurance. This benefit is designed to help protect you and your family s financial health. Critical Illness insurance can help fill a financial gap if you or a family member experiences a severe, life-threatening illness, such as cancer, heart attack, and major organ transplant. Upon diagnosis of a covered illness, you can receive a lump-sum benefit. Covered illnesses include the following: Category 1 (Cancer) Cancer-100%; Carcinoma in Situ-25% Category 2 (Cardiovascular) Heart Attack, Stroke, Heart Transplant, Ruptured Aneurysm-100%; Coronary Artery Bypass-25% Category 3 (Other) Chronic Renal Failure, Paralysis, Severe Burns, Severe Brain Damage, Coma, Major Organ Transplant-100% You are eligible to receive payment one time for each category listed. There is a reoccurrence/restoration rider you may be eligible for after 12 months. For example, if you receive a lump sum payment due to a critical illness diagnosis and then are later diagnosed with another critical illness in the same category, this restoration benefit would pay an additional one time benefit for the same category. This insurance plan also provides a wellness benefit. It will pay out $100 per year for certain health-screening tests, such as mammograms, colonoscopies, and chest x-rays. A more detailed list can be found in the Plan Document. For 2015, you can enroll for employee only, employee/ spouse, employee/child(ren), or family coverage with no medical underwriting. Employees have two options when purchasing this coverage: A low option of $10,000; and a high option of $20,000. Spouses can be covered for 50% of the employees coverage at either $5,000 or $10,000. The child(ren) benefit is $2,500. Coverage Levels Lump Sum Amounts Employee $10,000 $20,000 Spouse $5,000 $10,000 Child(ren) $2,500 Rates for employee and spouse are the same and based on age of employee. The child(ren) rate is $0.56. To calculate your monthly premium, look for the employee age band and coverage amount you would like. Add spouse rate and child (ren) rate, if applicable. Age Bands $5,000 $10,000 $20,000 < 24 $1.85 $3.70 $ $2.92 $5.84 $ $3.65 $7.29 $ $4.89 $9.77 $ $6.90 $13.80 $ $9.87 $19.74 $ $13.79 $27.58 $ $19.03 $38.05 $ $26.42 $52.83 $ $35.45 $70.90 $ $49.31 $98.62 $ < $62.72 $ $ Scan the code for a short video about the Critical Illness benefit Customer Service: 1 (888) Policy Number:

14 ACCIDENT PROTECTION Administered by UnitedHealthcare The Accident Protection is a NEW offering for If an accident occurs, on or off the job, you may be surprised at the expenses that can add up. This insurance is designed to protect your finances by helping you pay for those unexpected costs associated with an accidental injury. This benefit covers a wide range of common injuries and covered accidents. If you or a covered family member become injured, Accident protection will pay you a direct cash benefit. The amount of money you receive depends on the type and severity of the injury and can be used any way you choose. Accident Monthly Premium Employee Only $9.15 Employee + Spouse $13.60 Employee + Children $12.36 Employee + Family $16.81 LSU partners with UnitedHealthcare to provide you and your family with valuable accident protection. For 2015, you can enroll in accident protection for you and your family. There is no medical underwriting with this benefit. Below is a summary of the cash benefit you could receive based on the type of service received for an accident. More services and their benefit payout can be located in the Plan Document. Benefit Paid Doctor Visit $40 Ground Ambulance $200 Emergency Room $100 Hospital Admission $800 Coma $10,000 AD&D $20,000 Scan the code for a short video about the Accident benefit Customer Service: 1 (888) Policy Number: