Medical

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Wake Forest University offers two medical plan options:

  • Low Plan: Lower premiums, larger deductible and out-of-pocket maximum.
  • High Plan: Higher premiums, lower deductible and out-of pocket maximum.

Both plans offer Prescription and Behavioral health coverage.


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Provider

Aetna

Aetna’s Health Concierge Team: 855-586-6961 

Wake Forest University’s Dedicated Inbox: WFU@nullaetna.com

*Members enrolled in the Aetna Whole Health Network are eligible to take advantage of Maximum Savings Tier when using Atrium Providers

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Low / High Plan Deductible

Maximum Savings*

Individual: $600 / $250

Family: $1,500 / $625

Standard Savings

Individual: $1,250 / $750

Family: $3,125 / $1,875

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Low / High Plan

Out-of-Pocket Maximum

Maximum Savings*

Individual: $2,500 / $1,200

Family: $6,250 /$3,000

Standard Savings

Individual: $4,000 / $3000

Family: $10,000 / $7,500


Telehealth Services

Wake Forest University offers a telehealth option with Teladoc through Aetna for both medical plans. These secure video consults are available at a $10 copay for plan members and are a good option for minor health issues when you cannot see your regular doctor. An additional Teladoc Caregiver option is now available for $49 per visit. You can add a loved one you care for to your Teladoc account and have two or three-way visits with a doctor. You can register online or call 1-800-Teladoc, (1-800-835-2362). Learn more about Teledoc by reviewing this flyer.


Enrolling or Making Changes

New Hires

  1. Enrollment is completed in Workday during the onboarding process.
  2. If adding a spouse and/or dependent child, submit the required dependent verification documentation.
  3. You will receive an ID card from Aetna.

Throughout the Year

  1. Log into Workday to elect coverage throughout the year following a qualifying event.
  2. Provide supplemental documentation for the event.
  3. If adding a spouse and/or dependent child, submit the required dependent verification documentation via Workday within 30 days of the event or by the Annual Benefits Enrollment deadline.
  4. If you need a replacement ID card, call Aetna at (855) 586-6961.

Prescription

If you have elected medical coverage through Wake Forest, you are automatically enrolled in the prescription drug plan. The Low and High Plans offer the following in-network copayments for prescription drugs:

  • Generic brand: $15
  • Preferred brand: $30
  • Non-preferred brand: $60
  • Specialty: 10%, minimum of $50, maximum of $100

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Provider

Aetna / CVS Caremark®
(855) 586-6961

Specialty Medications (CVS Specialty® Pharmacy; 800.237.2767)

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Mail Order

  • Cost savings
  • Convenient ordering
  • Expedited shipping
  • Delivery tracking
  • Flexible payment options
  • Refill reminders
  • Mobile app

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Preferred Network

Maintenance Medications

Beginning January 1, 2023, members must transition to a 90-day supply with CVS Caremark® Mail Service Pharmacy or a 90-day supply at a CVS Pharmacy®. However, members will be permitted two 30-day grace refills of maintenance medications at any covered retail pharmacy.


Enrolling

  1. If you have elected Wake Forest medical coverage, you are automatically enrolled in the prescription drug plan at no additional cost.

Behavioral

If you have elected medical coverage through Wake Forest, you are automatically enrolled in the behavioral health plan. Licensed clinical case managers will connect you or your covered family members with in-network providers, specializing in mental health and substance abuse issues. The behavioral health plan includes coverage for Adaptive Behavioral Treatment (ABT). There is a separate $1,000 out-of-pocket maximum for both in- and out-of-network providers, which includes office visit copays and coinsurance amounts associated with mental health and substance abuse services coordinate through CBHA.

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Provider

Carolina Behavioral Health Alliance (CBHA)

Contact CBHA at 1 (800) 475-7900 (located on the back of your medical ID card) for a confidential assessment and service.

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Inpatient Care

Low Plan:

100% covered in-network, 60% covered out-of-network

High Plan:

100% covered in-network, 70% covered out-of-network

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Outpatient Care

Low Plan:

$30 copayment in-network, 60% covered out-of-network

High Plan:

$30 copayment in-network, 70% covered out-of-network


Enrolling

  1. If you have elected Wake Forest University medical coverage, you are automatically enrolled in the behavioral health plan at no additional cost.
  2. You will not receive a separate ID card.
  3. You can access Adaptive Behavioral Treatment services by calling CBHA at (800) 475-7900. A clinician will help determine the services needed, the diagnosis, treatment planning, or therapy, and will direct you to an in-network provider.

Resources

  • CBHA Website (Provider Search, Disease Management Program, Alcohol Assessment, Opiates Assessment, Depression Assessment, Information on support groups and community resources, Articles and e-Books about alcohol, depression, and drug abuse)
  • Summary Plan Description

2023 Benefits Guidebook Cover

2023 Benefits Guidebook

The 2023 Benefits Guidebook for Faculty and Staff outlines benefits specific to the Jan. 1 through Dec. 31, 2023 plan year. The information included in the guidebook is intended as a benefit summary only.

View the benefits guidebook »


The above information is intended as a benefit summary only. It does not include all of the benefit provisions, limitations, and qualifications. If this information conflicts in any way with the contract, the contract will prevail. Any services rendered under the CBHA benefit do not apply towards the BCBS annual deductible or co-insurance.

Wake Forest University Human Resources

P.O. Box 7424, Winston-Salem, NC 27109 
askHR@nullwfu.edu |  P 336.758.4700 |  F 336.758.6127