General information on the Ball State University's PPO Health Insurance plans, the deductibles, premiums and contact information for claims and finding a network provider are provided below. Links to find more in depth information and any benefit form are available under "Related Links".

Comparison Chart (See Related Articles at Right)

Deductibles - Per Calendar Year

MEDICAL:                

DENTAL:

(No PPO Network for Dental Coverage)      

$50 per person /$100 per family

PRESCRIPTIONS:

(No PPO Network for Prescription Drugs)

Descriptions

• PPO - This is a Preferred Provider Organization.  A PPO is a network of doctors, hospitals and outpatient facilities (providers) who give employees a discount on their charges due to the use of the network.  Covered members who choose Providers within the network will have less out of pocket expenses due to the Providers discounted fees. If members choose to see Providers who are not in the network, the discounted fees do not apply and the percent of their co-pay is higher.. You may access the list of eligible providers at www.encoreconnect.com or 1-888-446-5844.  Please see our PPO Plan Document in the Related Links at right.

• Endorsed Physicians - The American Health Data Institute AHDI is an independent organization which evaluates physicians for their quality of preventive care, practice patterns that result in low total costs, and accurate and timely clinical and billing practices. Physicians who meet the protocols of care are rated as "Endorsed". Employees whose Providers are both in the network and endorsed will have the lowest out of pocket expenses due to 10% decrease in their co-pay. Once you determine that your Provider is in the Encore network, go to www.ahdi.com to see if your Provider is endorsed.

• Non-Endorsed Physicians - If a physician is evaluated by AHDI and does not meet all the criteria to be rated endorsed they are considered "Non-endorsed". Employees who use physicians who are in the network but rated as non-endorsed will have a 10% higher co-pay than if their physician was endorsed.

Inquiries

• Claims - Contact Key Benefit Administrators at 1-800-871-2335 or 1-317-284-7100 enter group number 9009, or fax to 1-317-284-7469 

• Eligibility - Contact PEB 1-765-285-8461

• Plan Questions - Contact PEB 1-765-285-8461