Temple University cherry "T" logo

Human Resources
Search Keywords
20170509_flags_002_0.jpg

Full-time Employee Health Insurance Plan

Health insurance is available to all full-time employees, faculty members and their eligible dependents. Eligible dependents include the employee’s spouse and biological, adopted and/or step children under the age of 26. Coverage of dependent children is through the end of the month in which they reach the age of 26 under the medical and prescription coverages. For dental and vision coverages, they are covered through the end of the year in which they reach age 23.

Plan copayments are based on the employee’s job classification and collective bargaining agreements. For specific plan details, refer to detailed summaries and additional information in TUportal.

Plan changes are allowed during the annual open enrollment period in June, or as a result of an approved qualifying status change.

contents

Medical Insurance Coverage

Medical insurance covers all full-time employees, faculty members and their eligible dependents. The plan may vary by job classification and whether the position is represented and covered by a collective bargaining agreement.

As a benefit to Temple University employees, Temple Health, Temple University Physicians and Temple Physicians Inc. will waive applicable copayments for current employees and their dependents with medical insurance coverage under the Temple University benefit program.

Medical Plan Types

Personal Choice Medical Plan

This is a preferred provider organization (PPO) that allows you the freedom of choice to choose in network providers anywhere in the United States through the BlueCard PPO Network. You can also access doctors and hospital around the world through the Blue Cross Blue Shield Global Core program.

Keystone Health Plan East Medical Plan

This is a health maintenance organization (HMO), which requires employees to choose a primary care physician. All medical services must be performed or authorized by the primary care physician with a written referral.

Personal Choice $2000/$30 Medical Plan

This is a preferred provider organization (PPO) that allows you the freedom of choice to choose in-network providers anywhere in the United States through the BlueCard PPO Network. You can also access doctors and hospital around the world through the Blue Cross Blue Shield Global Core program. Some services have copays, while others are subject to a yearly deductible.

Temple Providers

As a convenience to our employees, Temple also provides the following services irrespective of medical plan type.

Physician Services

Physician services is a network of Temple affiliated doctors. Copays for employees and their dependents are waived during office visits.

The network is an in-network provider. Find a physician.

Temple University Hospitals

For specialized services, employees and their dependents can also visit any of Temple’s hospitals for inpatient service. Services provided at the following Temple hospitals are considered in-network.

Out Patient Sites—Temple Health

If preferred, employees and their dependents can utilize Temple’s outpatient service. Copays maybe waived during visits. Services provided at the following Temple outpatient locations are considered in-network.

Urgent Care Sites (Temple ReadyCare)

Cannot get an appointment with your doctor? Visit Temple ReadyCare for access to physicians and a care team for treatment of bumps and minor cuts. Instead of sitting in a crowded ER, walk in to our ReadyCare to quickly receive treatment.

Learn more about the services provided, and the locations of our ReadyCare centers.

Prescription Coverage

Full-time employees and faculty who are enrolled in one of the university’s medical insurance plans are also enrolled in prescription drug coverage with CVS Caremark. Although there is one plan, employee and faculty copayments can vary by employee type and bargaining agreement.

If you have specific questions about your prescription, call CVS customer service at 1-800-966-5772 or visit caremark.com. You may create your own user account by registering on Caremark’s site.

Some or all of these provisions may not apply to select bargaining groups.

Prescription Coverage Provisions

Mandatory Mail Order

Long-term maintenance drugs that are used on a regular basis and listed on CVS Caremark’s maintenance drug list must be filled either through mail order or at a CVS pharmacy. Members will receive the discounted pricing of a three months’ supply for the price of two months’ copay.

Generic Step Therapy

Generic alternatives within the same therapeutic class must be used as first-line therapy before certain targeted brand drugs are covered. If you are using a brand drug, discuss this new requirement with your physician to ensure that your drug is covered.

Dispense As Written (DAW) 1

If your health provider requires a brand drug when a generic substitution is available, you will be charged a penalty in the amount of the difference in cost between the generic and the brand drug, plus your copay. This only applies when a multisource brand medication is dispensed by a physician or by customer request over available generic equivalents. If you are using a brand drug, discuss this requirement with your physician to ensure that your drug is covered.

Exclusive Specialty

Employees taking specialty drugs may fill their prescriptions only at a local CVS or have a physician send prescriptions directly to a CVS Caremark specialty pharmacy for home delivery.

Prescription Prior Authorization

For prescription prior authorization, contact CVS Caremark.

  • Nonspecialty medications—Call the authorization line at 1-800-294-5979
  • Specialty medication—Call the authorization line at 1-866-814-5506

Dental Insurance Coverage

Dental insurance is available to eligible full-time employees, faculty members and their eligible dependents. The plan may vary by job classification and whether the position is represented and covered by a collective bargaining agreement.

Dental Plans

For specific plan details, refer to detailed summaries and additional information in TUportal.

Temple University Kornberg School of Dentistry

Temple University Kornberg School of Dentistry extends an invitation to the Temple community of faculty, staff and students to receive dental care at their community clinic. The goal is to provide fast, efficient care in a friendly and convenient environment.

Vision Care Coverage

Vision care covers all full-time employees, faculty members and their eligible dependents. The plan may vary by job classification and whether the position is represented and covered by a collective bargaining agreement.

The plan provides vision evaluation and provision of eyeglasses once every two years. Employees and their eligible dependents must have their eye exam performed by the Temple University Department of Ophthalmology in order to receive benefit coverage for the exam. Employees then have the option to choose a standard pair of frames and lenses for free, or different frames and specialty lenses and pay the additional cost. In lieu of eyeglasses, some employees may elect to receive a $25 allowance for the purchase of contact lenses.

Employee Contribution

None.

Exam

A vision care exam consists of an evaluation of refractive error (glasses) and an exam of the eye that includes an exam of the anterior part of the eye, the optic nerve and the central retina. Such an exam is designed to detect cornea problems, cataracts, glaucoma and macular degeneration. Advances in examination techniques often permit these exams to be done without dilating the pupil. If necessary, a dilated exam for a peripheral retinal exam or for diabetes may be done during the vision care appointment, but a follow-up medical exam may be required.

Contact Lenses

If you wish to have an exam for contact lenses, there is an additional charge for this type of exam.

Exam Locations

The university Department of Ophthalmology provides eye exams and eyeglasses at the following locations.

Summary of Temple Ophthalmology locations.

Health Sciences Center

Jeanes Hospital

Fort Washington

Temple Hospital, Parkinson Pavilion
6th floor, Suite 630
3401 N. Broad St.
Philadelphia, PA 19140
Ph. 215-707-5300

Physicians’ Office Building
Suite 201
7500 Central Ave.
Philadelphia, PA 19111
Ph. 215-707-3185

Temple Health Ft. Washington
515 Pennsylvania Ave.
Fort Washington, PA 19034
Ph. 215-540-0120

Employees calling to make an appointment for themselves or a dependent will need the employee’s TUid number for verification of eligibility. Contact Temple Ophthamology.

Detailed Plan Summaries and Additional Information

Contact Us

For questions regarding our health insurance plans, call 215-926-2270 or email .