Administered by WebTPA and MedImpact
LSU First offers members access to 100% coverage with First Choice providers and generic prescriptions. This means that members will not incur any out-of-pocket expenses for covered services from First Choice Providers* and/or generic prescriptions. LSU First also includes an employer-paid health reimbursement account (HRA) that can be used to offset deductible and other out-of-pocket medical expenses throughout the year. Any unused HRA funds roll over, up to a maximum, allowing members to build up balances to cover eligible medical expenses.
* The fees below apply to all networks, including the First Choice network.
- $150 Emergency Room co-pay, waived if admitted
- $150 Penalty for MRIs and CT scans performed at a hospital facility (No penalty if performed at free-standing imaging center)
2023 LSU First Benefit Snapshot
Medical Coverage
| Medical Coverage | Employee Only | Employee + Spouse | Employee + Children | Family |
|---|---|---|---|---|
| Employer Contribution to HRA | $500 | $750 | $750 | $1,000 |
| Deductible | $500 | $750 | $750 | $1,000 |
| Coinsurance (First Choice) | 0% | 0% | 0% | 0% |
| Coinsurance (in-network) | 20% | 20% | 20% | 20% |
| Coinsurance (out-of-network)** | 40% | 40% | 40% | 40% |
| Out-of-pocket max medical (in-network)* | $4,500 | $6,750 | $6,750 | $9,000 |
| Out-of-pocket max medical (out-of-network)* | Unlimited | Unlimited | Unlimited | Unlimited |
*Out-of-Pocket Maximums include HRA, Deductible, and Coinsurance.
**Based on the Maximum Allowable Charge
Prescription Coverage
| Prescription Coverage | Member Responsibility for 30-day supply |
|---|---|
| Tier 1 - Generic | $0; covered at 100% |
| Tier 2 – Preferred Brand | 20% up to $150 |
| Tier 3 – Non-preferred Brand | 20% up to $150 |
| Tier 4 - Specialty | 20% up to $150 |
| Prescription Coverage | Employee Only | Employee + Spouse | Employee + Children | Family |
|---|---|---|---|---|
| Drug Maximum Out-of-Pocket | $4,500 | $6,750 | $6,750 | $9,000 |
MedImpact administers the pharmacy portion of the plan. Home delivery and specialty
medications are provided through MedImpact Direct.
- Generic medications are covered at 100%
- Brand name and specialty medications are covered at 80% after the HRA is exhausted and the Deductible is met. Members are responsible for 20% of the drug cost, up to a maximum of $150 for a 30-day supply.
LSU First members have the option of receiving a 90-day supply of maintenance medications by mail order through MedImpact Direct or through multiple retail pharmacies nationwide, including CVS, Walgreens, and Wal-Mart, through MedImpact’s Choice90 program
Online Employee Assistance Program
LSU First Health Plan offers members the Employee Assistance Program (EAP) Resource via the www.mylifevalues.com website. View more information and how to access the site.
Username: peaceofmind
Password: solutions