Who Pays for your IU Medical Care Coverage?
There are often misunderstandings about who pays for your IU medical care coverage—and the impact of increased cost of services. The below questions and answers are being provided to all IU Southeast employees enrolled in the PPO $900 Deductible, Blue Preferred Primary POS, and IU HDHP PPO & Medical Savings medical care plans.
Who pays for your medical care coverage at IU?
Not Anthem. You and Indiana University pay for it. Large employers, like IU, have self-insured plans and do not need an insurance company that shares risks among many plan participants. As a result, IU only uses Anthem to:
- gain access to negotiated discounts with medical providers such as Norton Healthcare;
- process medical claims;
- pay medical providers and bill IU for these payments; and, then
- inform you of the portion that you are to pay.
Indiana University pays Anthem a fixed monthly fee for administrative services and reimburses Anthem for the amount it pays medical providers.
Who pays when hospital and physician fees increase?
Since you and Indiana University pay for medical costs, when hospitals and physicians raise their fees, we pay for the increase; not Anthem. As a large, self-insured employer, these increases are passed on immediately to you and IU.
Who pays when Norton Healthcare’s fees increase?
You and Indiana University pay the cost of medical services at Norton Healthcare; therefore, we pay for increases in fees. When Norton raises its rates, we pay the cost of these fee increases, and Anthem continues to provide the services listed above for the same fixed monthly fee.
Indiana University’s desire is that Norton Healthcare renew its contract with Anthem, whose PPO and POS fee schedules allow IU's employees to receive affordable medical services within the community. A decision by Norton Healthcare not to do so will be harmful to Indiana University and its employees.
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