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My Benefits Plan 2015

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I’d like to… Actions You Need to Take
Keep my Prime Care Advantage, Prime Care Choice, or Out-of-Area Plan*

If you completed the PHA with biometric health values in 2014 by September 30, you will automatically maintain your current plan for 2015. No further action is required for medical plan enrollment.

If you did not complete the PHA with biometric health values in 2014 by September 30, you will be automatically enrolled in the Basic PPO (or Basic Out-of-Area, if applicable), effective January 1, 2015. No further action is required for medical plan enrollment.

Change from the Basic PPO to a Prime Care Advantage, or Prime Care Choice Plan If you completed the PHA with biometric health values in 2014 by September 30, you must actively enroll in the plan you want during Open Enrollment or you will not have coverage in 2015.
Keep the Basic PPO If you did not complete the PHA with biometric health values in 2014 by September 30, you will remain in the Basic PPO (or Basic Out-of-Area, if applicable). No further action is required for medical enrollment.
Keep my Prime Care Connect Plan*

If you completed the PHA with biometric health values in 2014 by September 30, you must reapply during Open Enrollment and meet the eligibility requirements to continue participating in the plan. Be sure to enroll in one of the other Ohio State medical options during Open Enrollment to ensure you have coverage during 2015 while your ap¬plication is being reviewed by the OSU Health Plan.

If you did not complete the PHA with biometric health values in 2014 by September 30, you will be automatically enrolled in the Basic PPO (or Basic Out-of-Area, if applicable), effective January 1, 2015.

Not currently enrolled in an Ohio State medical plan but want to have Ohio State coverage in 2015

If you completed the PHA with biometric health values in 2014 by September 30, you must actively enroll in the plan you want during Open Enrollment or you will not have coverage in 2015.

If you did not complete the PHA with biometric health values in 2014 by September 30, your only option for coverage in 2015 is to actively enroll in the Basic PPO (or Basic Out-of-Area, if applicable), effective January 1, 2015.

Keep contributing to a Flexible Spending Account in 2015 You must re-enroll—for either the Health Care Flexible Spending Account or Dependent Care Flexible Spending Account—if you wish to continue contributing in 2015.

Managing Prescription Drug Costs

New for 2015, we are introducing Step Therapy to help us better manage the rising cost of prescription drugs. Step Therapy requires people who take medications regularly for certain medical conditions, such as high cholesterol, diabetes or depression, to first try preferred medications before covering higher-cost medications to treat those conditions. For new prescriptions, youmay be required to first try a generic or a lower-cost formulary medication before higher-cost formulary brands or non-formulary medications will be covered. However, if you are already taking medications identified for Step Therapy, you will be able to continue use of those medications.

Step Therapy Drug Categories:

  • ADHD Non-Stimulant
  • ADHD Stimulant
  • Antidepressant
  • Brand gabapentin
  • HMG-CoA Reductase Inhibitor (statin)
  • Inhaled Corticosteroid
  • Nasal Steroid
  • Proton Pump Inhibitor (PPI)
  • Tetracycline Oral
  • Topical Acne
  • Topical Corticosteroid
  • Triptan

2015 Benefits Confirmation

View/Print Your Statement

You may view/print your Benefits Confirmation Statement November 19 - November 26