Eligibility: The College offers medical insurance coverage to full-time and part-time benefit-eligible employees in accordance with the federal Affordable Care Act. Employees working 30 hours per week over 9 months, are eligible for medical coverage at the “full-time premium rate.” Part-time employees working at least 1,000 hours per year, are eligible for medical coverage at the “part-time premium rate.”
The College offers three medical plan options, through Independence Blue Cross (IBC), for 2025, consisting of: Keystone HMO, Personal Choice PPO, and a High Deductible PPO Plan (HDHP) with HSA.
Differences between HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) plans include network size, ability to see specialists, costs, and out-of-network coverage. Compared to PPOs, HMOs typically cost less in premiums. However, PPOs generally offer greater flexibility in seeing specialists, have larger networks than HMOs, and offer some out-of-network coverage.
An HMO gives you access to certain doctors and hospitals within its network. A network is made up of providers that have agreed to lower their rates for plan members and also meet quality standards. But unlike PPO plans, care under an HMO plan is covered only if you see a provider within that HMO’s network. In addition, referrals are needed from a primary care physician in order to see specialists.
PPO plans provide more flexibility when selecting a doctor or hospital. Referrals from a primary care physician are not required in order to see specialists. PPO plans also feature a network of providers, but there are fewer restrictions on seeing “non-network” providers. In addition, the PPO insurance plan will cover some of your cost if you see a non-network provider, although it may be at a lower rate and with out-of-pocket cost.
A High Deductible Health Plan (HDHP) is a PPO-based plan and requires greater member out-of-pocket expense in exchange for lower monthly premiums. This plan also features a Health Savings Account (HSA).
Keystone HMO Plan
Health Maintenance Organization – Important points to remember about this plan:.
- Primary Care Physician (PCP) – You must select a PCP when enrolling, and treat with that physician before treating with a participating specialist.
- Referrals – Specific documentation required from your PCP, authorizing care at a participating specialist for covered services.
- Preapproval/Precertification - Approval from Independence Blue Cross (IBC) for non-emergency or elective hospital admissions and procedures prior to the admission or procedure. Your participating provider will contact Independence Blue Cross for authorization.
For more details regarding the HMO plan, please refer to the HMO Plan and Rx Summary. View the HMO Summary of Benefits and Coverage
Personal Choice PPO Plan
Preferred Provider Organization – Important points to remember about this plan:
The Personal Choice PPO Plan provides you greater freedom of choice by allowing you to select from an expansive network of doctors and hospitals. You can maximize your coverage by accessing care through Personal Choice's network (In-network) of hospitals, doctors and specialists, or by accessing care through preferred providers that participate in the BlueCard PPO program across the country. With Personal Choice, you also have the freedom to select providers who do not participate in the Personal Choice network or BlueCard PPO program (Out-of-network). However, if you receive services from out-of-network providers, you will have higher out-of-pocket costs and may have to submit paid claims for reimbursement.
With Personal Choice PPO:
- You do not need to specify a Primary Care Physician (PCP)
- You never need a referral to see a specialist / you can go directly for care
For more details regarding the PPO plan please refer to the PPO Plan and Rx Summary. View the PPO Summary of Benefits and Coverage.
High Deductible Health Plan (HDHP)
The PPO-based High Deductible Health Plan (HDHP) provides you greater freedom of choice by allowing you to select from an expansive network of doctors and hospitals. You can maximize your coverage by accessing in-network care through the Personal Choice PPO network of hospitals, doctors and specialists, or by accessing care through preferred providers that participate in the Blue Card® PPO program across the country. With the HDHP, you also have the freedom to select out-of-network providers who do not participate in the Personal Choice PPO network or BlueCard PPO program. However, if you receive services from out-of-network providers, you will have higher out-of-pocket costs and may have to submit paid claims for reimbursement.
With the HDHP:
- You are responsible for higher initial out-of-pocket expenses, because of the higher deductible
- You do not need to specify a Primary Care Physician (PCP)
- You never need a referral to see a specialist / you can go directly for care
For more details regarding the HDHP plan please refer to the HDHP Plan and Rx Summary. View the HDHP Summary of Benefits and Coverage.
IBC Programs / Resources
- Achieve Well-being Tokens
Pick from hundreds of programs to create a personalized Action Plan to help you earn tokens and badges and meet your goals. - myStrength Plus
You have access to myStrength Plus from Teladoc Health (Teladoc), a flexible and convenient digital program with proven tools and dedicated support for stress, depression, sleep, and more. - Shatterproof Treatment Atlas
You can now access Atlas, a free online tool that connects you and your loved ones with trustworthy, in-network addiction treatment. - Teladoc Telemedicine
Teladoc is a leader in whole-person virtual care. With Teladoc General Medical, you get 24/7 access to low-cost, high- quality virtual health care for common health concerns like cough, sore throat, fever, rashes, allergies, asthma, ear infections, pink eye, nausea, and more. - Livongo Diabetes Management
An advanced blood glucose meter and as many strips and lancets as you need, paid for by your employer.