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Health Insurance

Administrators, Faculty, AFSCME 3200 and FOP

View the links below to view deductibles, co-insurance, plan year maximums, office visit co-pays and coverageĀ for a variety of categories.

2022-23 Benefits Guide

Effective July 1, 2022- June 30, 2023

2021-22 Benefits Guide

Effective July 1, 2021- June 30, 2022

    AFSCME 1699 Bargaining Unit

    The Collective Bargaining Agreement will supersede the following information in case of discrepancies.

    2022-23 AFSCME 1699 Benefits Guide

    Effective July 1, 2022- June 30, 2023

    2021-22 AFSCME 1699 Benefits Guide

    Effective July 1, 2021- June 30, 2022

    Anthem Blue Cross/Blue Shield

    Ohio University's PPO medical plan is administered by Anthem Blue Cross/ Blue Shield. Employees may contact Anthem directly with questions regarding their coverage. Anthem also offers a web portal where members can log in and manage their accounts.

    The PPO plan is a "preferred provider organization." A PPO is a program in which a network of doctors, hospitals and other healthcare providers agree to provide medical services to plan enrollees at special, negotiated rates. Each healthcare provider in the network must meet and maintain strict quality requirements.

    When you use network providers for your healthcare, you will have to pay a co-payment at the time of your service. Most services are covered at 80% after the deductible has been met. You will still receive coverage when you see healthcare providers outside of the network, although you will receive a lower benefit level.

    Transparency in Coverage (TIC) regulations require health insurers and group health plans to create machine readable files (MRFs) that contain the negotiated rates for in-network providers and allowed amounts derived from historical claims for out-of-network providers. These files will be available on July 1, 2022 on Anthem's website ( . Ohio University's tax ID number, 31-6402113, is needed to access information.

    Opt-out/ Waive Insurance Coverage

    Employees with medical coverage outside of the university may choose to waive Ohio University health insurance.

    Pre-existing Conditions

    There are no pre-existing condition limitations for Ohio University's medical plans. You can change plans during open enrollment without concern that your present medical conditions would not be immediately covered.

    Pre-certification Requirement

    Ohio University follows Anthem's standard predetermination and pre-certification requirements for both inpatient and outpatient procedures. Some procedures may require authorization prior to services being rendered. Call 1-866-776-4793 or check with your provider to determine whether your procedure requires prior authorization. All inpatient hospital admissions require pre-certification.

    Notice of Privacy Practices

    The Affordable Care Act (or health care reform law) requires that all members receive a Summary of Benefits Coverage (SBC). This document, provided by Anthem Blue Cross/ Blue Shield, may be downloaded below or a hard copy requested by emailing

    Ohio University is legally obligated to provide the following document which details what the plan provides and how it operates.