Benefits -> Benefit Plans (Group Coverage) -> Medical Plans
Medical Plans
All medical plans are made available to KSU employees through the University System of Georgia. Enrollment is subject to the standard requirements. Coverage is available for the employee, spouse and dependents, including full time students up to age 26. The information outlined here only highlights a portion of the benefits available. Please refer to plan handbooks for exact coverage limits and specific details of each plan. In the event of a discrepancy between this summary and the plan handbook, the plan handbook will take precedence.
Notice regarding "Georgia PeachCare for Kids": State legislation prohibits dependents of state employees from obtaining and/or continuing coverage under the PeachCare program. Required, regular employment reports submitted to State entities will result in the loss of dependent coverage under this program. Please keep this information in mind when making your initial and annual enrollment elections as some plans may not be available after the first 31 days of employment.
Health Maintenance Organizations (HMOs)
HMOs aim to provide lower costs to employees, both in terms of premiums and out-of-pocket expenses. In return, participants are required to:
- Seek care within the established service network of medical providers
- Designate a Primary Care Physician (PCP)
- Have a referral from the PCP to see most specialists (Participants may self refer within the network to Gynecologists, Dermatologists, Ophthalmologists and Chiropractors.)
HMO Provider Listings
Preferred Provider Option (PPO)
PPOs aim to provide a middle ground between the more expensive, less restrictive traditional indemnity plans and the less expensive, more restrictive HMOs, both in terms of premiums and out-of-pocket expenses. In return, for seeking care within the established service network of providers, benefit coverage levels are higher and reasonable and customary amounts are honored by providers, therefore reducing the member's out-of-pocket liability. No primary care designations or referrals are required. Members can exercise the option to see a non-network physician for acute care services, thereby choosing to bear more out-of-pocket cost.
Indemnity plans generally offer the most freedom and flexibility and in return members pay higher premiums and out-of-pocket costs. No primary care physician designation or referrals are required. While a network of doctors is available to help reduce the members overall cost liability, benefit levels are consistent regardless of network participation.
The information outlined here only highlights a portion of the benefits available. Please refer to the plan handbook for exact coverage limits and specific details of each plan. In the event of a discrepancy between this summary and the plan handbook, the plan handbook will take precedence. If you have a question about your benefits that cannot be answered on the links above, you may contact your HR Partner in the KSU HR department for further assistance.
