Benefit Options

IDA Insurance Trust: Working For You

In 2013, The Indiana Dental Association rolled out their answer to the Affordable Care Act and mandates that would limit options for the IDA Members’ insurance needs, thus forming The IDA Insurance Trust. The IDA Insurance Trust is a self-funded MEWA (Multiple Employer Welfare Arrangement), allowing the IDA to present a medically underwritten health insurance plan, a variety of deductible options and a more board network of covered doctors and medical facilities, to dentists to enhance their membership benefits.

NEW VISION BENEFIT OFFERING EFFECTIVE 2021**


DOWNLOAD NEW VISION PLANS COMPARISON

Check out our 2021 Benefits Offerings

PPO $500

Single

Family

Single

Deductible
$500 network / $1,000 non-network

Family

Deductible
$1,500 network / $3,000 non-network

Single

Out of Pocket Maximum
$2,000 network / $4,000 non-network

Family

Out of Pocket Maximum
$4,000 network / $8,000 non-network

Single

Coinsurance*
20% network | 40% non-network

Family

Coinsurance*
20% network | 40% non-network

Single

Hospital Services
20% network | 40% non-network

Family

Hospital Services
20% network | 40% non-network

Single

Office Visit
$25 co-pay network | 40% non-network

Family

Office Visit
$25 co-pay network | 40% non-network

Single

Urgent Care Facility
$75 Co-pay

Family

Urgent Care Facility
$75 Co-pay

Single

Outpatient Facility
20% network | 40% non-network

Family

Outpatient Facility
20% network | 40% non-network

Single

Prescription Drug Co-pay applies at all Anthem participating network pharmacies (30 day supply max.)
$200 Deductible** $15 Tier 1 | $40 Tier 2 | $60 Tier 3

Family

Prescription Drug Co-pay applies at all Anthem participating network pharmacies (30 day supply max.)
$200 Deductible** $15 Tier 1 | $40 Tier 2 | $60 Tier 3

Single

Anthem Mail Order Prescription Drug (up to 90 day supply)
$15 Tier 1 | $100 Tier 2 | $180 Tier 3

Family

Anthem Mail Order Prescription Drug (up to 90 day supply)
$15 Tier 1 | $100 Tier 2 | $180 Tier 3

Single

Emergency Room
$200 Co-pay

Family

Emergency Room
$200 Co-pay

Single

Human Organ Transplant
0% in network | 50% out-of-network

Family

Human Organ Transplant
0% in network | 50% out-of-network

Single

Ambulance
20%

Family

Ambulance
20%

Single

Outpatient Therapy Services
20 visits per calendar year, 36 visits for Cardiac Rehab

Family

Outpatient Therapy Services
20 visits per calendar year, 36 visits for Cardiac Rehab

Single

Behavioral Health | In-patient (Admin. by Anthem Behavior Health and network providers)
20% network | 40% non-network

Family

Behavioral Health | In-patient (Admin. by Anthem Behavior Health and network providers)
20% network | 40% non-network

Single

Behavioral Health | Physician Office (Admin. by Anthem Behavior Health and network providers)
$25 co-pay network | 40% non-network

Family

Behavioral Health | Physician Office (Admin. by Anthem Behavior Health and network providers)
$25 co-pay network | 40% non-network

*Coinsurance percentages indicate your share of billed services after you have met your deductible.

**Prescription deductible does not apply to Generic prescriptions.

***Maternity coverage is included on all IDA Group Health Plans.

PPO $1000

Single

Family

Single

Deductible
$1,00 network / $2,000 non-network

Family

Deductible
$3,000 network / $6,000 non-network

Single

Out of Pocket Maximum
$3,000 network / $6,000 non-network

Family

Out of Pocket Maximum
$6,000 network / $12,000 non-network

Single

Coinsurance*
20% network | 40% non-network

Family

Coinsurance*
20% network | 40% non-network

Single

Hospital Services
20% network | 40% non-network

Family

Hospital Services
20% network | 40% non-network

Single

Office Visit
$25 co-pay network | 40% non-network

Family

Office Visit
$25 co-pay network | 40% non-network

Single

Urgent Care Facility
$75 Co-pay

Family

Urgent Care Facility
$75 Co-pay

Single

Outpatient Facility
20% network | 40% non-network

Family

Outpatient Facility
20% network | 40% non-network

Single

Prescription Drug Co-pay applies at all Anthem participating network pharmacies (30 day supply max.)
$200 Deductible** $15 Tier 1 | $40 Tier 2 | $60 Tier 3

Family

Prescription Drug Co-pay applies at all Anthem participating network pharmacies (30 day supply max.)
$200 Deductible** $15 Tier 1 | $40 Tier 2 | $60 Tier 3

Single

Anthem Mail Order Prescription Drug (up to 90 day supply)
$15 Tier 1 | $100 Tier 2 | $180 Tier 3

Family

Anthem Mail Order Prescription Drug (up to 90 day supply)
$15 Tier 1 | $100 Tier 2 | $180 Tier 3

Single

Emergency Room
$200 Co-pay

Family

Emergency Room
$200 Co-pay

Single

Human Organ Transplant
0% in network | 50% out-of-network

Family

Human Organ Transplant
0% in network | 50% out-of-network

Single

Ambulance
20%

Family

Ambulance
20%

Single

Outpatient Therapy Services | Spinal Manipulations
20 visits per calendar year, 36 visits for Cardiac Rehab

Family

Outpatient Therapy Services | Spinal Manipulations
20 visits per calendar year, 36 visits for Cardiac Rehab

Single

Behavioral Health | In-patient (Admin. by Anthem Behavior Health and network providers)
20% network | 40% non-network

Family

Behavioral Health | In-patient (Admin. by Anthem Behavior Health and network providers)
20% network | 40% non-network

Single

Behavioral Health | Physician Office (Admin. by Anthem Behavior Health and network providers)
$25 co-pay network | 40% non-network

Family

Behavioral Health | Physician Office (Admin. by Anthem Behavior Health and network providers)
$25 co-pay network | 40% non-network

*Coinsurance percentages indicate your share of billed services after you have met your deductible.

**Prescription deductible does not apply to Generic prescriptions.

***Maternity coverage is included on all IDA Group Health Plans.

PPO $2,500

Single

Family

Single

Deductible
$2,500 network / $5,000 non-network

Family

Deductible
$7,000 network / $15,000 non-network

Single

Out of Pocket Maximum
$6,000 network / $12,000 non-network

Family

Out of Pocket Maximum
$12,000 network / $24,000 non-network

Single

Coinsurance*
20% network | 40% non-network

Family

Coinsurance*
20% network | 40% non-network

Single

Hospital Services
20% network | 40% non-network

Family

Hospital Services
20% network | 40% non-network

Single

Office Visit
$30 co-pay network | 40% non-network

Family

Office Visit
$30 co-pay network | 40% non-network

Single

Urgent Care Facility
$75 Co-pay

Family

Urgent Care Facility
$75 Co-pay

Single

Outpatient Facility
20% network | 40% non-network

Family

Outpatient Facility
20% network | 40% non-network

Single

Prescription Drug Co-pay applies at all Anthem participating network pharmacies (30 day supply max.)
$200 Deductible** $15 Tier 1 | $40 Tier 2 | $60 Tier 3

Family

Prescription Drug Co-pay applies at all Anthem participating network pharmacies (30 day supply max.)
$200 Deductible** $15 Tier 1 | $40 Tier 2 | $60 Tier 3

Single

Anthem Mail Order Prescription Drug (up to 90 day supply)
$15 Tier 1 | $100 Tier 2 | $180 Tier 3

Family

Anthem Mail Order Prescription Drug (up to 90 day supply)
$15 Tier 1 | $100 Tier 2 | $180 Tier 3

Single

Emergency Room
$200 Co-pay + 20%

Family

Emergency Room
$200 Co-pay + 20%

Single

Human Organ Transplant
0% in network | 50% out-of-network

Family

Human Organ Transplant
0% in network | 50% out-of-network

Single

Ambulance
20%

Family

Ambulance
20%

Single

Outpatient Therapy Services | Spinal Manipulations
20 visits per calendar year, 36 visits for Cardiac Rehab

Family

Outpatient Therapy Services | Spinal Manipulations
20 visits per calendar year, 36 visits for Cardiac Rehab

Single

Behavioral Health | In-patient (Admin. by Anthem Behavior Health and network providers)
20% network | 40% non-network

Family

Behavioral Health | In-patient (Admin. by Anthem Behavior Health and network providers)
20% network | 40% non-network

Single

Behavioral Health | Physician Office (Admin. by Anthem Behavior Health and network providers)
$25 co-pay network | 40% non-network

Family

Behavioral Health | Physician Office (Admin. by Anthem Behavior Health and network providers)
$25 co-pay network | 40% non-network

*Coinsurance percentages indicate your share of billed services after you have met your deductible.

**Prescription deductible does not apply to Generic prescriptions.

***Maternity coverage is included on all IDA Group Health Plans.

HSA $4,000/$8,000

Single

Family

Single

Deductible
$4,000 network / $8,000 non-network

Family

Deductible
$8,000 network / $16,000 non-network

Single

Out of Pocket Maximum
$4,000 network / $8,000 non-network

Family

Out of Pocket Maximum
$8,000 network / $16,000 non-network

Single

Coinsurance*
0%

Family

Coinsurance*
30%

Single

Hospital Services
0%

Family

Hospital Services
30%

Single

Office Visit
0%

Family

Office Visit
30%

Single

Urgent Care Facility
0%

Family

Urgent Care Facility
30%

Single

Outpatient Facility
0%

Family

Outpatient Facility
30%

Single

Prescription Drug Co-pay applies at all Anthem participating network pharmacies (30 day supply max.)
0%

Family

Prescription Drug Co-pay applies at all Anthem participating network pharmacies (30 day supply max.)
30%

Single

Anthem Mail Order Prescription Drug (up to 90 day supply)
0%

Family

Anthem Mail Order Prescription Drug (up to 90 day supply)
30%

Single

Emergency Room
0%

Family

Emergency Room
30%

Single

Human Organ Transplant
0%

Family

Human Organ Transplant
30%

Single

Ambulance
0%

Family

Ambulance
0%

Single

Outpatient Therapy Services
20 visits per calendar year, 36 visits for Cardiac Rehab

Family

Outpatient Therapy Services
20 visits per calendar year, 36 visits for Cardiac Rehab

Single

Behavioral Health | In-patient (Admin. by Anthem Behavior Health and network providers)
0%

Family

Behavioral Health | In-patient (Admin. by Anthem Behavior Health and network providers)
30%

Single

Behavioral Health | Physician Office (Admin. by Anthem Behavior Health and network providers)
0%

Family

Behavioral Health | Physician Office (Admin. by Anthem Behavior Health and network providers)
30%

*Coinsurance percentages indicate your share of billed services after you have met your deductible.

**Prescription deductible does not apply to Generic prescriptions.

***Maternity coverage is included on all IDA Group Health Plans.

HSA $6,450/$12,900

Single

Family

Single

Deductible
$6,450 network / $12,900 non-network

Family

Deductible
$12,900 network / $25,800 non-network

Single

Out of Pocket Maximum
$6,450 network / $12,900 non-network

Family

Out of Pocket Maximum
$12,900 network / $25,800 non-network

Single

Coinsurance*
0%

Family

Coinsurance*
30%

Single

Hospital Services
0%

Family

Hospital Services
30%

Single

Office Visit
0%

Family

Office Visit
30%

Single

Urgent Care Facility
0%

Family

Urgent Care Facility
30%

Single

Outpatient Facility
0%

Family

Outpatient Facility
30%

Single

Prescription Drug Co-pay applies at all Anthem participating network pharmacies (30 day supply max.)
0%

Family

Prescription Drug Co-pay applies at all Anthem participating network pharmacies (30 day supply max.)
30%

Single

Anthem Mail Order Prescription Drug (up to 90 day supply)
0%

Family

Anthem Mail Order Prescription Drug (up to 90 day supply)
30%

Single

Emergency Room
0%

Family

Emergency Room
30%

Single

Human Organ Transplant
0%

Family

Human Organ Transplant
30%

Single

Ambulance
0%

Family

Ambulance
0%

Single

Outpatient Therapy Services
20 visits per calendar year, 36 visits for Cardiac Rehab

Family

Outpatient Therapy Services
20 visits per calendar year, 36 visits for Cardiac Rehab0%

Single

Behavioral Health | In-patient (Admin. by Anthem Behavior Health and network providers)
0%

Family

Behavioral Health | In-patient (Admin. by Anthem Behavior Health and network providers)
30%

Single

Behavioral Health | Physician Office (Admin. by Anthem Behavior Health and network providers)
0%

Family

Behavioral Health | Physician Office (Admin. by Anthem Behavior Health and network providers)
30%

*Coinsurance percentages indicate your share of billed services after you have met your deductible.

**Prescription deductible does not apply to Generic prescriptions.

***Maternity coverage is included on all IDA Group Health Plans.

2021 Blue View Vision Benefit Summary

2021 Blue View Vision Benefit Summary

Benefits

Low Plan

High Plan

Frequency

Benefits

Routine Eye Exam: Comprehensive Eye Exam

Low Plan

Deductible
$10/copay network | Up to $42 non-network

High Plan

Deductible
$10/copay network | Up to $42 non-network

Frequency

Frequency
Once every calendar year

Benefits

Eyeglass Frames

Low Plan

Deductible
$130 allowance, then 20% off any balance | Up to $45 non-network

High Plan

Deductible
$150 allowance, then 20% off any balance | Up to $45 non-network

Frequency

Frequency
Low Plan: Once every 2 years | High Plan: Once every year

Benefits

Single Vision Eyeglass Lenses

Low Plan

Deductible
$25 Copay network | Up to $40 non-network

High Plan

Deductible
$10 copay network | Up to $40 non-network

Frequency

Frequency
Once every calendar year

Benefits

Bifocal Vision Eyeglass Lenses

Low Plan

Deductible
$25 Copay network | Up to $60 non-network

High Plan

Deductible
$10 copay network | Up to $60 non-network

Frequency

Frequency
Once every calendar year

Benefits

Trifocal Vision Eyeglass Lenses

Low Plan

Deductible
$25 Copay network | Up to $80 non-network

High Plan

Deductible
$10 copay network | Up to $80 non-network

Frequency

Frequency
Once every calendar year

Benefits

Eyeglass Lense Enhancements:
Transition Lenses

Low Plan

Deductible
$0 Copay network | No allowance when obtained out-of-network

High Plan

Deductible
$0 copay network | No allowance when obtained out-of-network

Frequency

Frequency
Once every calendar year

Benefits

Eyeglass Lense Enhancements:
Standard polycarbonate

Low Plan

Deductible
$0 Copay network | No allowance when obtained out-of-network

High Plan

Deductible
$0 copay network | No allowance when obtained out-of-network

Frequency

Frequency
Once every calendar year

Benefits

Eyeglass Lense Enhancements:
Factory scratch coating

Low Plan

Deductible
$0 Copay network | No allowance when obtained out-of-network

High Plan

Deductible
$0 copay network | No allowance when obtained out-of-network

Frequency

Frequency
Once every calendar year

Benefits

Contact Lenses
Elective conventional (non-disposable: OR

Low Plan

Deductible
$130 allowance, then 15% off any balance in network | Up to $105 allowance out-of-network

High Plan

Deductible
$150 allowance, then 15% off any balance in network | Up to $105 allowance out-of-network

Frequency

Frequency
Once every calendar year

Benefits

Contact Lenses
Elective disposable: OR

Low Plan

Deductible
$130 allowance | Up to $105 allowance out-of-network

High Plan

Deductible
$150 allowance | Up to $105 allowance out-of-network

Frequency

Frequency
Once every calendar year

Benefits

Contact Lenses
Non-Elective (medically necessary)

Low Plan

Deductible
Covered in Full in-network | Up to $210 allowance out-of-network

High Plan

Deductible
Covered in Full in-network | Up to $210 allowance out-of-network

Frequency

Frequency
Once every calendar year
Apply for Coverage Now
medical_insurance_icon
3,304

lives covered

1,083

active groups

I have been with the IDA insurance trust since its inception in 2013. Since joining the trust we have seen our premiums remain remarkably stable, and the customer service Ashley and Wanda provide is outstanding. The insurance product provided by Anthem is top rate and the personalized attention the IDA insurance staff provides is wonderful. Whether I or a staff member would like to review health insurance options, make changes to a policy, or add a dependent the staff at IDA insurance is easy to get in contact with and quick to answer any questions. I highly recommend the IDA insurance trust for you and your staff.

Jason Glassley, DDS

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