Choosing Well

To find the right healthcare care for you and your family, take a look at the options USG offers.

The University System of Georgia offers four comprehensive healthcare options. Regardless of the plan you choose, each plan protects you and your family’s health. The main differences between the plans come down to things like how much you pay when you get care, how much you pay each paycheck, how much flexibility you have in choosing providers, and where you can receive care.

• Anthem Consumer Choice HSA

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  The Consumer Choice HSA plan, offered through Anthem, is a high deductible plan with a lower monthly premium but higher deductible that must be met before the plan’s coinsurance kicks in, except for in-network preventative care. This plan uses the Open Access POS network that provides in- and out-of-network coverage and access to a pre-tax Health Savings Account (HSA), with an employer HSA match. 

  2024 Consumer Choice HSA Plan

  Benefit Description	Benefit Amount
  Lifetime maximum benefit	Unlimited
  Network	Anthem Open Access POS
  Annual deductible If enrolled in the individual tier, once the individual deductible is met, the plan will start sharing in the cost of coverage.  If enrolled in the family tier, the entire family deductible must be met, the plan will start sharing in the cost of coverage. In- and out-of-network deductibles are reached separately Both healthcare and pharmacy coinsurance amounts count toward the deductible.	In-Network Individual: $3,000 Family: $6,000 Out-Out-Network Individual: $6,000 Family: $12,000
  Annual out-of-pocket maximum Both healthcare and pharmacy coinsurance amounts apply toward the out-of-pocket maximum.  In- and out-of-network maximums are reached separately	In-Network Individual: $4,700 Family: $9,400 Out-Out-Network Individual: $9,400 Family: $18,800
  Preventive Care Preventive care is not subject to the deductible.	In-network 100% covered, not subject to the deductible Out-of-Network 60% covered, not subject to deductible
  Primary Care Office Visit	In-network 80% covered after the deductible Out-of-Network 60% covered after the deductible
  Specialist Visit	In-network 80% covered after the deductible Out-of-Network 60% covered after the deductible
  Prescription Drugs Provided under Caremark	Both medical and pharmacy coinsurance apply toward the deductible and OOP limit. See the Pharmacy page for details on prescription drug coverage.
  Telemedicine	Virtual care video visit: flat dollar before the deductible. Login through Sydney app. or the Anthem website for the fee schedule and visits.    Virtual primary care of specialist doctors visits: Standard Office Visit coinsurance applies, after deductible
  Hospital  Inpatient & outpatient	In-network 80% covered after the deductible Out-of-Network 60% covered after the deductible
  Urgent Care	In-network 80% covered after the deductible Out-of-Network 60% covered after the deductible
  Emergency Care	In-network 80% covered after the deductible Out-of-Network 60% covered after the deductible

• Anthem Comprehensive Care

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  The Comprehensive Care, offered through Anthem, is a traditional healthcare plan with deductibles, copays, and coinsurance. This plan also utilizes the Open Access POS network, with in-network and out-of-network coverage. 

  2024 Comprehensive Care Plan

  Benefit Description	Benefit Amount
  Lifetime maximum benefit	Unlimted
  Network	Anthem Open Access POS
  Annual deductible If enrolled in the individual tier, once the individual deductible is met (even if enrolled in the family tier), the plan will start sharing in the cost of coverage. If enrolled in the family tier, each member is responsible for the single deductible, the OOP amount within the family deductible or OOP amount up to the maximum In- and out-of-network deductibles are reached separately	In-Network Individual: $1,300 Employee + 1: $2,600 Family: $3,900 Out-Out-Network Individual:  $3,900 Employee + 1: $7,800 Family: $11,700
  Annual out-of-pocket maximum Member deductible, copays, and coinsurance apply toward the annual healthcare out-of-pocket maximum. Prescription benefits have a separate out-of-pocket maximum. In- and out-of-network maximums are reached separately	In-Network Individual: $2,850 Employee + 1: $5,700 Family: $5,700 Out-Out-Network Individual:  $8,550 Employee + 1: $17,100 Family: $17,100
  Preventive Care Preventive care is not subject to the deductible.	In-network 100% covered, not subject to the deductible Out-of-Network Not Covered
  Primary Care Office Visit	In-network $25 copay,  not subject to the deductible Out-of-Network 60% covered after the deductible
  Specialist Visit	In-network $50 copay,  not subject to the deductible Out-of-Network 60% covered after the deductible
  Prescription Drugs annual out-of-pocket-maximum Provided under Caremark	Individual: $1,500 Employee + 1: $3,000 Family: $4,500 See the Pharmacy page for details on prescription drug coverage.
  Telemedicine	Virtual Care Video Visit: First 3 visits free. Login through Sydney app. or the Anthem website for visits Virtual primary care of specialist doctors visits: Standard office visit copay/coinsurance
  Hospital  Inpatient & outpatient	In-network 90% covered after the deductible Out-of-Network 60% covered after the deductible
  Urgent Care	In-network $50 copay,  not subject to the deductible Out-of-Network 60% covered after the deductible
  Emergency Care	In-network 90% covered after a $300 copay per visit, subject to the deductible. copay. copay waived if admitted within 24 hours Out-of-Network 60% covered after the deductible

• Anthem Blue Choice HMO

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  The BlueChoice HMO plan, offered through Anthem, has the highest premium but more predictable copayment costs when you use the plan. This plan does not have a deductible and offers in-network coverage only (except in the case of an emergency). Although costs are more predictable, it lacks the flexibility to see specialists and requires a primary care physician (PCP) and referrals for specialists.

  2024 Blue Choice HMO

  Benefit Description	Benefit Amount
  Lifetime maximum benefit	Unlimited
  Annual deductible	None
  Annual out-of-pocket maximum Member copays and coinsurance apply toward the annual healthcare out-of-pocket maximum. Prescription benefits have a separate out-of-pocket maximum.	In-Network Individual: $5,500 Family: $9,900 Out-Out-Network Not Covered
  Preventive Care Preventive care is not subject to the deductible.	In-network 100% covered Out-of-Network Not Covered
  Primary Care Office Visit	In-network $40 copay Out-of-Network Not Covered
  Specialist Visit	In-network $90 copay Out-of-Network Not Covered
  Prescription Drugs annual out-of-pocket-maximum Provided under Caremark	Individual: $1,500 Employee + 1: $3,000 Family: $4,500 See the Pharmacy page for details on prescription drug coverage.
  Telemedicine	Virtual Care Video Visit: First 3 visits free. Login through Sydney app. or the Anthem website for visits Virtual primary care of specialist doctors visits: Standard office visit copay/coinsurance
  Hospital  Inpatient & outpatient	In-network Inpatient: $750 copay Outpatient: $400 copay Out-of-Network Not Covered
  Urgent Care	In-network $70 copay Out-of-Network Not Covered
  Emergency Care	In-network $500 copay Out-of-Network Not Covered, except in case of Emergency
  Out-of-network services are not covered

• Kaiser Permanente HMO

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  The Kaiser Permanente HMO is a plan that offers in-network coverage only, through Kaiser Permanente facilities (except in the case of emergency). There is no deductible and you pay a flat copay at the time of service. While this plan lacks the flexibility to see providers outside of the network, all of your care is coordinated by your Kaiser primary care physician (PCP), and most of the services you need like specialty, lab, and pharmacy are all under one roof. Like a traditional HMO,  referrals are required for specialists.

  Click here for an informational video about Kaiser Permanente plans. 

  2024 Kaiser Permanente HMO Plan (In-network only)

  Benefit Description	Benefit Amount
  Lifetime maximum benefit	Unlimited
  Network	Kaiser Permanente network
  Deductible	None
  Out-of-pocket maximum	Individual: $6,350 Employee + 1 or more: $12,700
  Wellness/preventive care	100% covered
  Primary care office visits	$40 copay
  Specialist visits	$75 copay
  Prescription drugs Annual out-of-pocket maximum	$1,500 per covered person See the Pharmacy page for details on prescription drug coverage.
  E-visits (telemedicine)	100% covered
  Hospital (inpatient)	$600 copay
  Hospital (outpatient)	$400 copay
  Urgent care	$75 copay
  Emergency care	$400 copay
  Out-of-network services are not covered

  See the Pharmacy page for details on prescription drug coverage.

Eligibility

Active employees who work 30 hours or more per week are eligible for USG Healthcare plans. When you elect coverage for yourself, you may also cover your eligible dependents, which include::

• Your legal spouse
• Your natural, adopted or stepchildren, up to age 26
• Your disabled child(ren), over the age of 26 with proof of disability

Documentation is required to add dependents to your coverage. Common examples include a marriage certificate, birth certificate, income tax return, and/or joint utility. Visit oneusgconnect.usg.edu and select Manage Benefits for a complete list of requirements. 

Surcharge Certifications

Tobacco Use

When you enroll in USG healthcare coverage, you'll need to indicate if you or your covered family members age 18 or older are a tobacco-use. You will be charged an additional $150 per month for yourself, spouse, and children age 18+r who uses tobacco products or is defaulted by not taking completing the certification during enrollment. Additionally, you must re-certify your tobacco use status each annual enrollment period. 

Learn more about the tobacco use certification and surcharge. 

 

Planning to Quit: Tobacco Cessation Resources

We know it’s not easy to quit, but we’ll give you the support you need. Tobacco cessation programs are available at no cost to you and your dependents. Please review the Tobacco Cessation options on the USG Well-being website.  

Once you complete a cessation program or become tobacco-free, you must update your tobacco user status with OneUSG Connect - Benefits at 844-587-4236. Your surcharge will be removed on the first day of the month following the change to your status. 

 

Working Spouse 

If you enroll your spouse in USG healthcare coverage, you will also need to indicate whether your spouse has coverage available through an employer outside of USG. If so, a monthly working spouse surcharge of $150 will apply. The working spouse surcharge does not apply to retirees.

Learn more about the working spouse certification and surcharge.

When you certify your tobacco use or working spouse status, you are attesting that the information is true and correct to the best of your knowledge. USG expects employees to uphold the highest standards of intellectual honesty and integrity, in compliance with the USG Ethics policy. Therefore, you should respond honestly in regard to your status. If you knowingly and willfully make a false or fraudulent statement to the University System of Georgia regarding your insurance coverage, you may be subject to criminal prosecution.

 

Coverage costs

Find the monthly rates for all plans on the Employee Premiums and Surcharges pages. Access your benefits enrollment and premiums for plans you’re enrolled in, by logging onto OneUSG Connect- Benefits, click Manage Benefits. For additional detail about how coverage works for specific services, see your plan documents.