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Human Resources > Benefits > High Deductible Plan with HSA

High Deductible Plan with HSA

Effective January 1, 2019 AUI's domestic medical plan will transition to Anthem/Blue Cross Blue Shield.

Provider directories are available below.  If you have questions regarding the change please contact your HR representative or the Benefits Office.

New Mexico Providers West Virginia Providers Virginia Providers

The High Deductible Plan has two levels of deductible: Single ($1,500) and Family ($3,000) for in-network services. Deductibles are annual and reset each January. Additional details of the plan are available below.

Plan Info


Use Anthem


Medical Plan Highlights

  • Active employees may participate in a high deductible plan with Health Savings Account (HSA) through PNC Bank.
  • Medical benefits are provided by Anthem
  • Enrollment is allowed only as a new hire, through qualifying events, or open enrollment
  • Coverage is continuous unless actively changed
  • Preventive medical care is covered at 100%

Preventive Services List

  • Preventive drugs covered outside of the deductible, at coinsurance level

Preventive Drug List

If you are traveling abroad and need services:

  • Cigna will cover your claim as in-network if it is considered a "true emergency" (heart attack, bone break, seizure, etc.).
  • You will have to pay at the time of service and submit the claim later. Claim forms are available on this page, or from MyCigna.com.
  • Assistance with claims payment may be available through our Cigna Travel Insurance.
  • Non-emergency services can be handled through Telemed (MDLive).


      2-Step Enrollment

      There are two steps to enroll in the High Deductible Plan with Health Savings Account:

      1. Complete the Medical/Dental/Vision enrollment form

      - HSA/HDHP option

      - HRA/HDHP option (if you have other insurance coverage, including Medicare, Medicaid, spouse plan, flexible spending, etc.)

      2. Complete the Salary Reduction Agreement form (optional)
      - if you intend to contribute your own money to your HSA.

      - HRA participants cannot contribute their own money.



      Anthem Member Services: Call Anthem if you have any issues regarding your coverage at: 833-820-8990


      Anthem Online:

      Website registration is required

      • Track HSA and claims
      • Download Explanations of Benefits
      • Pay bills out of your HSA
      • Verify coverage for prescription drugs
      • In-network provider look-up
      • Manage plan ID cards


      Anthem Portal Guide

      Specialty Pharmacy

      Mail Order


      Health Savings Account (HSA)


      Tax-exempt contributions to an HSA remain exempt if you use them (and their earnings) to pay for qualifying Medical expenses.

      Certain restrictions exist for participation in an HSA:

      • Must be enrolled in a high deductible health plan.
      • Must not have any other insurance coverage.
      • Dependents with other coverage may impact the amount you can save.

      AUI will make a $500/$1000 employer contribution to the HSA for participating HDHP employees. New Hires will receive a pro-rated contribution.

      Eligible HSA Expenses

      Accessing your HSA Bank Account without MyCigna


      Sample Anthem HSA/HRA Card




      How much does it cost?

      Link to NRAO WebpageCurrent Year Medical Premiums

      What is covered?

        Summary Plan Description (SPD)

        Click the SPD to see what your Cigna plan pays.

        Legal Plan Document

        AUI Comprehensive Medical Plan Document.

        Legal document outlining who can be covered and how the plan works.


        Enrollment Forms and Links

        Medical/Dental/Vision enrollment form

        Salary Reduction Agreement - HSA

        HSA contributions can be changed at any time during the year.

        You must manually assign your beneficiary for your HSA. If you do not do so, your HSA will be assigned to your estate.  See the document below for more information.

        HSA Beneficiary Assignment Instructions


        Claim and Pre-Authorization Forms

        Medical Claim Form
        Medical Claim Form for out-of network claims, not for use with prescriptions.


        Rx Drug Claim Form
        Cigna uses a 3-step plan for prescription drugs. Step-1 and Step-2 drugs don't require pre-authorization. Use this form to file claims.


        Rx Pre-Authorization Form
        Use this form to receive pre-authorization for Step-3 prescription drugs.

        Health Reimbursement Account (HRA)


        Individuals who are not eligible for an HSA due to other medical coverage (Medicare, Medicaid, spouse insurance, flexible spending accounts, etc.) may receive the employer contribution given to HSAs through an HRA.

        HRAs only have balances if an employer contribution is made to employee HSA accounts.  For 2019, there is a $500/$1000 AUI contribution to the HRA.

        "Summary of Coverage and Benefits" document

        The Patient Protection and Affordable Care Act (PPACA) requires the AUI Comprehensive Medical Insurance Plan to provide a “Summary of Coverage and Benefits” to plan participants prior to the close of annual open enrollment.


        These documents were produced by Anthem and follow specific federal guidelines. Please note that these are only summaries and do not outline the comprehensive details of your plan. For complete coverage details you should refer to the Summary Plan Description for your plan as posted on this site.

        The updated current year Summary Plan Descriptions will be available online and in hard copy form upon request in the first quarter of the current year.

        You have a right to receive a paper copy of the Summary of Coverage and Benefits upon request at no charge to you. If you would like to request a paper copy, or if you have any questions, please contact the benefits office.

        Anthem Provider Search

        Medical Benefits


        Cigna website Cigna Healthcare


        Cigna Claims Processing
        P.O. Box 182223
        Chattanooga, TN 37422-7223

        Group ID: 3213380

        Health Advocate
        M-F 8:00am - 7:00pm EST

        Medical Plan/HSA Forms