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Division of Human Resources


Health Insurance

There are three health insurance plans from which to choose. State Health Plans include the Standard Plan or the Savings Plan. The third plan, Tricare Supplement Plan, is only extended to active and retired service members. A comparison chart [pdf] in your UofSC Insurance Benefits Summary [pdf] provides a more detailed description of plan summaries and cost for the Standard Plan and Savings Plan. More information about the Tricare Supplement Plan may be found in the PEBA Insurance Benefits Guide [pdf]

State Health Plans

Both the Standard Plan and Savings Plan are self-insured and funded by premiums paid to the plan. Claims are processed by BlueCross BlueShield of South Carolina. Both plans have an annual deductible that must be met before the co-insurance benefits are paid. After the deductible is met, you will pay part of the expenses until you meet an annual out-of-pocket maximum. After the out-of-pocket maximum is met, you are covered for 100% of eligible charges for the remainder of the year (according to plan provisions and guidelines).

Some covered services require preauthorization before you receive them. Your health care provider may make the call for you, but it is your responsibility to see that the call is made. For more detailed information, including  what types of services require preauthorization and the penalty you pay for not calling, please refer to the PEBA Insurance Benefits Guide [pdf]. 

Standard Plan

Annual Deductible: $445 (single); $890 (family)

Coinsurance:

  • In-Network: Plan pays 80%, You pay 20%
  • Out-of-Network: Plan pays 60%; You pay 40%

Coinsurance Maximum: Excludes deductible and copayments.

  • In-Network: $2,540 (single); $5,080 (family). 
  • Out-of-Network: $5,080 (single); $10,160 (family). 

Physician's Office:

  • Chiropractic payments limited to $2,000 a year, per person
  • $12 copayment
  • In-Network: Plan pays 80%, You pay 20%
  • Out-of-Network: Plan pays 60%; You pay 40%

Hospitalization/Emergency Care:

  • Outpatient facility services: $95 copayment
  • Emergency care: $159 copayment
  • In-Network: Plan pays 80%, You pay 20%
  • Out-of-Network: Plan pays 60%; You pay 40%

Prescription Drugs: Express Scripts is the State Health Plan pharmacy benefits manager. Benefits under the Standard plan are not payable if you use a non-participating pharmacy.

  • For participating pharmacies only (up to 31 day supply) - $9 Tier 1; $38 Tier 2; $63 Tier 3
  • For mail order and retail maintenance network pharmacies (up to 90-day supply) - $22 Tier 1; $95 Tier 2; $158 Tier 3
  • Copay maximum of $2,500

Savings Plan

Annual Deductible: (No copayments); $3,600 (single); $7,200 (family)

Coinsurance:

  • In-Network: Plan pays 80%, You pay 20%
  • Out-of-Network: Plan pays 60%; You pay 40%

Coinsurance Maximum: Excludes deductible

  • In-Network: $2,400 (single); $4,800 (family). 
  • Out-of-Network: $4,800 (single); $9,600 (family). 

Physician's Office:

  • Chiropractic payments limited to $500 a year, per person
  • No copayment
  • In-Network: Plan pays 80%, You pay 20%
  • Out-of-Network: Plan pays 60%; You pay 40%

Hospitalization/Emergency Care: No copayments

Prescription Drugs: Participating pharmacies and mail order only: You pay the State Health Plan's allowed amount until the annual deductible is met. Afterward, the Plan will reimburse 80% of the allowed amount; you pay 20% coinsurance. When the coinsurance maximum is reached, the Plan will reimburse 100% of the allowed amount.

GEA Tricare Supplement Plan

The Tricare Supplement Plan coverage is extended only to active and retired service members and their spouses who are under the age of 65 years old, not eligible for Medicare, and registered with Defense Enrollment Eligibility Reporting System (DEERS). Dependent children are also eligible based on Tricare eligibility guidelines. This plan is underwritten by Transamerica Premier Life Insurance Company and is administered by Selman & Company. Upon termination of coverage, COBRA rights are not extended. Please see the PEBA Insurance Benefits Guide [pdf] for more information regarding coverage details.