Medical Benefits

SummaCare (officially known as Apex Benefits Services) is the administrator of the University’s medical insurance program.   By registering on SummaCare’s Plan Central website, employees can:

• Review benefits information
• Check the status of claims
• Deductible information
• Prior Authorization Status
• Other plan documents

Employee may contact SummaCare Customer Service by calling 800-753-8429.

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2012 Medical Plan Information, including Dental, Vision and other components

1.  Member Handbook

• Active Employee PPO Plans
• Retiree Dependent PPO Plan
• Retiree Dependent Medicare Supplement Plan

2.  Preventive Care List

The University follows the Affordable Care Act’s “U.S. Preventive Services Task Force” guideline for 100 percent University-paid preventive care.

3.  Immunization and Vaccination List

The University follows the Center for Disease Control and Prevention’s (CDC) “Vaccines and Immunization Schedules” recommended guidelines for 100 percent University-paid immunization and vaccination.

4.  Pediatric Health Care List

The University follows the American Academy of Pediatrics “Recommendations for Preventive Pediatric Health Care” guidelines for 100 percent University-paid pediatric health care.

5.  Diabetes Supplies and Durable Medical Equipment Information (DME)

SummaCare members have access to certain diabetes testing supplies at low or no cost from Cornerstone Medical Services.  Cornerstone Medical Services is also the vendor for durable medical equipment (i.e.: wheelchairs, nebulizers, crutches, etc.)

6. Preferred Provider Network Access

• Within Ohio: SC Plus
• Outside of Ohio: PHCS MultiPlan

In an emergency, go to the nearest hospital.

7.  SummaCare Prior Authorization List

Certain services require pre-authorization by SummaCare. If the patient is using an in-network provider, it is the physician's responsibility to obtain a pre-authorization. If the patient is using an out-of-network provider, it is the patent's responsibility to obtain prior authorization. Prior authorization can be waived in emergency situations. If the University's medical insurance is being used as secondary coverage, prior authorization is not required.

8. SummaCare Claim Form

9.  Weight Watchers

SummaCare has partnered with The University of Akron to help members reach their personal health and weight management goals. As an incentive to joining and completing a Weight Watchers program, SummaCare will reimburse part of your Weight Watchers enrollment fee.

• Program Information
• Reimbursement Form

10.  General Information about HIPAA

The HIPAA Privacy Regulations place limitations upon covered entities' use of "protected health information" (PHI). Protected health information is information that is individually identifiable and that relates to an individual's past, present, or future medical condition or treatment. The Privacy Regulations also create or formalize several rights members in a health plan have regarding their health information.