Important Notices and Changes

Benefit Changes for 2024:

No plan changes this year.

Lifetime and Annual Limits:

Affordable Care Act prohibits health plans from putting a "lifetime" dollar limit on most benefits you receive. The act also restricts the "annual" dollar limits a health plan can place on most of your benefits. Effective January 1, 2011, all annual and lifetime limits on the dollar value of benefits under ISU's health plan will no longer apply. Individuals whose coverage ended by reason of reaching a lifetime limit under the plan are eligible to enroll in the plan

Adult Children:

Individuals whose coverage ended, or who were denied coverage, or were not eligible for coverage, because the availability of dependent coverage of children ended before attainment of age 26 are eligible to enroll in ISU's health plan. Individuals may request enrollment for such children during Open Enrollment each year or, with a qualifying event, through "Special Enrollment". Children are eligible to stay on the plan until the end of the year they attain age 26.

Pre-existing Conditions:

Under the Affordable Care Act, health plans cannot limit or deny benefits or deny coverage simply because the person has a pre-existing condition. There are no pre-existing conditions limitation on ISU's health plan for anyone.

Privacy Notice:

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This notice describes how health Information about you may be used and disclosed. Please review it carefully.

Medicaid and the Children's Health Insurance Program (CHIP):

If you are eligible for health coverage from your employer but are unable to afford the premiums, some states have premium assistance programs that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums. 

 More Information »

Special Enrollment:

If you have declined enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your/or your dependents in ISU's plan if you or your dependents lose eligibility for other coverage (or if the employer stops contributing toward your or your dependents' other coverage). However, you must request enrollment within 30 days after your or your dependents' other coverage ends (or after the employer stops contributing toward the other coverage).

In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption or placement for adoption.

Finally, you and/or your dependents may have special enrollment rights if coverage is lost under Medicaid or a State health insurance (SCHIP) program, or when you and/or your dependents gain eligibility for state premium assistance. You have 60 days from the occurrence of one of these events to notify Employee Benefits and enroll in the plan.

To request special enrollment or obtain more information, contact Staff Benefits, 300 Rankin Hall or call ext. 4114.

Newborn's and Mother's Health Protection Act (NMHPA):

Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96hours).

Women's Health and Cancer Rights Act:

Under Federal law, Group Health Plans and health insurance issuers providing benefits for mastectomy must also provide, in connection with the mastectomy for which the participant or beneficiary is receiving benefits, coverage for:

• reconstruction of the breast on which the mastectomy has been performed;
• surgery and reconstruction of the other breast to produce a symmetrical appearance;
• prostheses and physical complications of mastectomy, including lymphedemas;

These services must be provided in a manner determined in consultation between the attending Physician and the patient. For more information regarding your rights after a mastectomy go to: http://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/whcra

Affordable Care Act and Health Insurance Marketplace/Exchange

The Marketplace is available online at HeathCare.gov.  This is part of the Affordable Care Act that will help you get quality health coverage at a price you can afford.  Open enrollment in the Health Insurance Marketplace runs from October 1 through January 31 each year.  Click here for more information.