VCU Postdoc Association - Health Insurance

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Application forms and brochures for the three health insurance plans offered to VCU’s Postdoc’s through MAMSI Life and Health Insurance Company, A UnitedHealthcare Company, can be found here.   Dental coverage is included with all three plans, and administered through United Concordia. Enclosed are the medical and dental packages with applications to be filled out and returned for submission.

• Choose one of the three insurance plans offered, PPO – MAMSI, High Option HMO – Optimum Choice, or Primary HMO – Optimum Choice

• Dental insurance is included with all three plans, see separate information and application packet

• After choosing preferred plan, fill out the appropriate application form (please note separate applications for PPO and HMO plans) Group Name – Postdoctoral Association - Group Numbers:  PPO = M56542, High Option HMO = M56541*20, Primary HMO = M56541

• Department Administrator must fill out Postdoctoral Association Departmental Information Form

• Return the 3 completed forms (medical, dental, and department information form to Cathleen Finnerty (Group Administrator) for processing - Campus mail (Box 980568) or fax (828-2051). 

MAMSI  PPO  (Group # M56542)
The MAMSI Life and Health Insurance Company (MLH) PPO plan provides you with medical coverage through a network of preferred physicians and other health care practitioners. No referrals are needed. You may also access services from non-preferred physicians and other health care practitioners; however, your Out-Of-Pocket cost may be higher if you do so. The PPO plan has a $10 co-payment for regular office visits.  Please visit www.mamsi.com for more information, including the participating physician directory under “Find a Doctor”.

Optimum Choice - High Option HMO  (Group # M56541*20)  &  Optimum Choice - Primary HMO  (Group # M56541)
The Optimum Choice, Inc. HMO plan provides you with medical coverage through a network of participating physicians and other health care practitioners. To access specialty services, you will need a referral from you Primary Care Physician (PCP). PCP's usually specialize in family or general practice, internal medicine, obstetrics/gynecology (OB/GYN) or pediatrics. Each of your family members may choose a different PCP, and you can change your PCP as often as monthly.

Most of your medical care must be arranged and coordinated by your PCP. Your PCP will provide:

• Office visits when you are ill

• Preventive health care

• Immunizations for children and adults

• Health care education

Your PCP is also responsible for:

• Writing referrals for specialty care

• Arranging for hospitalizations

• Approving urgent care

• Arranging for behavioral health and substance abuse care

• Arranging for laboratory and X-ray services

• Arranging for outpatient services and surgery

There are usually no claim forms to fill out when you receive services from participating providers in our network. In some cases, you may incur out-of-pocket expenses for a Covered Service, such as in a medical emergency. If this happens, contact our Member Services Department for further assistance.

Eligible HMO doctors are listed in the MAMSI Optimum Choice Directory and on the MAMSI website, www.mamsi.com under “Find a Doctor”.   The High Option HMO plan has a $15 co-payment for regular office visits and a $25 co-payment for visits to a specialist.  The Low Option HMO plan has a $20 co-payment for regular office visits and a $30 co-payment for visits to a specialist.  If you need to see a specialist, you must consult with your PCP to get a referral prior to making the appointment with the specialist. 

Dental Coverage
Your dental plan is through United Concordia (Group # 842920000) and the dental booklet provided lists the benefits you will receive.  Please visit www.ucci.com for more information and a list of participating dentists. 

Other Important Information
It is VERY important that you choose doctors that participate in the plan you select.  You take the risk of being responsible for a large portion of the medical bill, or possibly the entire bill, if you visit a doctor that does not participate in your chosen plan.  You have been given the group numbers for each of our plans, which is very helpful when visiting the MAMSI website.  When adding dependents, (i.e. spouse, child and newborns, you have 31 days from qualifying event to enroll.  After the 31 day period, you will have to wait until Open Enrollment (October of each year) to add dependents or change plans. 

Please be sure to read all the information on the Benefit Summary sheets for all three plans (colored pages in packet).  There is very important information pertinent to each plan on these sheets.

Please review the attached MAMSI informational packets, FAQs, Glossary and MAMSI Meds.  There is valuable information in each of these packets.  All this information can be found on the www.mamsi.com website under MEMBERS. 

If there is an emergency and you need immediate medical attention, visit the nearest hospital.  If you are enrolled in an HMO Plan, and you experience such an emergency, you need to notify your PCP as soon as possible. Someone from the practice is “on call” 24 hrs a day, 365 days a year and will call you back. It is good practice to be aware of participating medical facilities near your home and job. There is a list of facilities on the website for each plan.   

Please read the information given to you carefully so that you understand what each plan offers.  If you have questions, contact:

Cathleen Finnerty
Administrative Assistant
Vice President for Research Office
Phone number: 828-3536
Fax number: 828-2051
E-mail: finnerty@vcu.edu
BioTech I Research Park Building
800 East Leigh Street
Suite 115
or visit the MAMSI website at www.mamsi.com, and United Concordia at www.ucci.com