Health Insurance
Marquette University believes it is important to offer a choice of quality plans. The Benefits Brochure will provide you with a quick summary of our four plan offerings. For detailed information about our health plans, read below.
Benefit-eligible employees (fulltime regular, fulltime temporary with at least one year appointment, and parttime regular) have the option of choosing between four insurance plans: EPO Basic, EPO Select, PPO Basic, PPO Select. Our plans cover exactly the same medical services. The main differences between our EPO and PPO plans are the monthly premium amounts, network area/physician network, deductible/coinsurance (PPO participants only) and the office copay (basic versus select).
Before make a decision, you might consider having a look at the network area map.
PPO Plan Participants
The Preferred Provider Organization (PPO) plan provides a large network area whereby participants can find in-network physicians in Wisconsin, Minnesota, Michigan and Illinois. (Please note that out-of-state physicians are more limited than those found in Wisconsin.) In this plan, out-of-network covered medical services will be paid out in accordance to the out-of-network deductible and coinsurance.
PPO participants are responsible for a copay, deductible and coinsurance. Copays do not count toward the deductible and coinsurance.
To find an in-network provider
PPO participants need to contact Health EOS.
- Website Instructions
- Website: www.healtheos.com
(User ID: 13872, Password: haxqfh) - Phone number: (800) 279-9776. Always call
Health EOS before your appointment to ensure your
provider is in-network.
To order new insurance cards, inquire about a claim or learn more information about covered medical procedures, call Fiserv Health at (800) 826-9781. Do not call Fiserv to find in-network providers as they do not have access to this information.
Click here to view the PPO Summary Plan Description.
2008 PPO MONTHLY CONTRIBUTIONS
(Effective January 1, 2008 to December 31, 2008)
Fulltime Regular Employee |
MU's Contribution |
Total |
Parttime Regular Employee |
|
PPO Basic Single |
$87 | $428 | $515 | $515 |
PPO Basic Family |
$229 | $1,120 | $1,349 | $1,349 |
PPO Select Single |
$103 | $428 | $531 | $531 |
PPO Select Family |
$274 | $1,120 | $1,394 | $1,394 |
Vision Benefit
Each covered individual under an an employee's medical plan will get $120 per calendar year. Members can choose services from a provider that is not within your plan network, and the $120 benefit per participant will still apply.
However, members should try to stay within their
network for two important reasons. First, an in-network
provider can forward a claim directly to Fiserv Health.
When services are provided by a non-network facility,
payment is necessary upfront and then the receipt of
the payment must be sent to Fiserv Health for reimbursement. Second, an in-network facility can provide services at a discounted rate, which will add value to your $120 annual vision benefit.
If you go out-of-network, submit your receipt and claim to:
Fiserv Health
Claims Administration
P. O. Box 8052
Wausau, WI 54402-8052
Prescription Drug Coverage
Click here for more information regarding prescription drug coverage.
Want to track your claims and manage your Fiserv account online?
If you're looking for a way to manage your medical expenses or just curious, Fiserv Health allows Marquette employees to view their medical claims online and their processing status. All you have to do is click here and start an account. (It's free.)
EPO Plan Participants
The Exclusive Provider Organization (EPO) plan provides "first-dollar" coverage to Aurora, Advanced Health, and some Columbia-St. Mary's facilities. As long as you are in-network for covered services and have obtained pre-authorization (if necessary), you pay your copay and the plan will pay 100%. This plan only offers out-of-network coverage if you or your covered dependent(s) are in a life or limb threatening situation.
You will not have to meet a deductible or coinsurance with the EPO plan.
To find an in-network provider
EPO participants need to contact IBS Navigator.
- Website Instructions
- Website: www.ibsinc.ws
- Phone number: (800) 251-0838. Always call
IBS Navigator before your appointment to ensure your provider is in-network.
To order new insurance cards, inquire about a claim or learn more information about covered medical procedures, call Fiserv Health at (800) 826-9781. Do not call Fiserv to find in-network providers as they do not have access to this information.
Click here to view the EPO Summary Plan Description.
2008 EPO MONTHLY CONTRIBUTIONS
(Effective January 1, 2008 to December 31, 2008)
Fulltime Regular Employee |
MU's Contribution |
Total |
Parttime Regular Employee |
|
EPO Basic Single |
$95 | $428 | $523 | $523 |
EPO Basic Family |
$254 | $1,120 | $1,374 | $1,374 |
EPO Select Single |
$135 | $428 | $ 563 | $ 563 |
EPO Select Family |
$358 | $1,120 | $1,478 | $1,478 |
Vision Benefit
Each covered individual under an an employee's medical plan will get $120 per calendar year. Members can choose services from a provider that is not within your plan network, and the $120 benefit per participant will still apply.
However, members should try to stay within their
network for two important reasons. First, an in-network
provider can forward a claim directly to Fiserv Health.
When services are provided by a non-network facility,
payment is necessary upfront and then the receipt of
the payment must be sent to Fiserv Health for reimbursement. Second, an in-network facility can provide services at a discounted rate, which will add value to your $120 annual vision benefit.
If you go out-of-network, submit your receipt and claim to:
Fiserv Health
Claims Administration
P. O. Box 8052
Wausau, WI 54402-8052
Prescription Drug Coverage
Click here for more information regarding prescription drug coverage.
Want to track your claims and manage your Fiserv account online?
If you're looking for a way to manage your medical expenses or just curious, Fiserv Health allows Marquette employees to view their medical claims online and their processing status. All you have to do is click here and start an account. (It's free.)
