Health
 

The Medical Association has you, your staff, and your family covered!  The Medical Association offers an exclusive health insurance opportunity through Blue Cross and Blue Shield of Alabama for our members.  *Qualified new members may sign up for insurance as soon as full regular member dues are paid.  Your membership dues alone could save you thousands in insurance premiums and out-of-pocket expenses.  

 


HSA Plan continues for the 4th year

PIPA is continuing to offer a third health insurance option, which is a High Deductible Plan that can be used in conjunction with a Health Savings Account (HSA).  Rates for the high-deductible plan and further information regarding how to set up an HSA account can be found below. Practices that elect to offer the HSA option will need to “opt in” to the plan by signing the HDHP agreement found below and returning it to Brenda Ellis at bellis@alamedical.org. Practices will be responsible for the administration of the HSA for their employees as this will be a separate function from the services provided by the Medical Association. The Association will enroll individuals in the Blue Cross high-deductible plan as is currently done with the other plans, and the practice will be responsible for setting up the HSA administration.  The HDHP agreement MUST be signed and returned with any HSA applications.

2022 HDHP Agreement

PIPA Eligibility requirements: 

    • Be a Regular member of the Medical Association, which includes paying regular annual medical association dues as well as your local county membership dues.
    • If self‐employed (e.g., sole proprietorship, partnership, LLC, P.A. or certain S‐Corporations), have at least one employee other than the physician and his/her spouse eligible to be in the plan. 
    • In order for an employee to be eligible, he/she must be considered a full time employee working at least 30 hours per week.     
    • If the corporate structure of the physicians’ practice is a professional corporation (P.C.), there is no requirement that additional employees be eligible for the plan, but those employees are welcome to participate.
    * Physicians who are retired and otherwise Dues Exempt, are only required to pay State Dues.
Not sure if you are eligible? Use the Eligibility Decision Tree (document on the right hand side) to find out. In order for an employee to participate, the physician member MUST participate in the insurance plan.

Enrollees in the group practice DO NOT have to all be on the same plan.

OPEN ENROLLMENT- OCTOBER 1 THRU NOVEMBER 16, 2021

To apply, submit the following to the Medical Association: 

NOTE: In order to apply for insurance, the physician member must be current on 2022 Medical Association membership dues, and their local county membership dues.

  1. Completed Application
  2. Employer Participation Agreement (only one necessary per group)
  3. Cover Page indicating type of coverage (High, Basic, or Dental options for each application) 
  4. $10 application fee (per application)
  5. Premium for the first quarter - Use the rates below to determine the quarterly rate for each application. (Quarterly premiums are due at this time for each application submitted.)
  6. HDHP Agreement MUST be mailed with any HSA/HDHP Applications

All applications for each group (physician and employees) must be sent at one time with one check (payment in full as described above). After the initial application is complete, The Medical Association will bill each entity quarterly for premiums due.

 The Medical Association will not process any applications until all of the above information (items 1-5) is received, 2022 dues requirements met by all physicians applying, and all monies paid.

Make checks payable to The Physicians Insurance Plan of Alabama and mail to:
Medical Association of the State of Alabama
P.O. Box 1900
Montgomery, AL 36102
 

PIPA changes for 2022

For 2022, The Medical Association worked with Blue Cross to keep the rate increase to a minimum.  While many groups are experiencing double digit increases, our increase is only between 2% -6.5%. 
See changes as follows:
  1.  The high option out of pocket deductible has been increased to $1500/$4500 per year

  2.  We now have the Source Rx 1.0 formulary for prescriptions.    Effective January 1, 2022, PIPA will now be under the Source Rx 1.0 formulary.  Since it’s inception in December 2014, PIPA has been under the Standard formulary for prescriptions, (where it covered the broadest list of drugs, including high cost outliers, non-essential drugs and prescription drugs with over the counter alternatives).  The Source Rx formulary excludes select non-preferred drugs, non-essential drugs and prescription drugs with over the counter equivalents, however, exceptions can be made for those with prior authorization.  This change keeps PIPA more in line with other large group plans and will help to keep premiums lower in the future for all participants.  (These changes will be shown in the Matrices once available.)

    Please contact BCBS customer service at 800-292-8868 for specific questions regarding the Source Rx 1.0 formulary.

  3. All options now have a 10% coinsurance for in-network, which includes:  Inpatient Physician Visits and Consultations (except Mental Health/SUBA), Outpatient Diagnostic Lab, X-Ray (including MRI, CAT Scan, PET/SPECT), Pathology, Dialysis, IV Therapy, Chemotherapy & Radiation Therapy, Physician Second Surgical Opinions, Physician Diagnostic Lab, X-Ray (including MRI, CAT Scan, PET/SPECT), Pathology, Dialysis IV Therapy, Chemotherapy & Radiation Therapy, Physician Surgery & Anesthesia, Physician Maternity Care and Home Health and Hospice.
 

*This Blue Cross and Blue Shield group rated health insurance plan continues to be a valuable membership benefit to physician members and their staff.

 

2022 Rates 
effective January 1-December 31, 2022

Rates shown are MONTHLY amounts. Premiums will be billed QUARTERLY.

  High Option   Basic Option    HDHP       Dental*
Single $680 $591 $518
   $41
2 Person     $1374 $1190 $1042
    n/a
Family $2010 $1742 $1523
   $107

*Dental coverage is optional.

2021 Rates 
effective January 1-December 31, 2021

Rates shown are MONTHLY amounts. Premiums will be billed QUARTERLY.

  High Option   Basic Option    HDHP       Dental*
Single $667 $568 $486
   $39 
2 Person     $1,320 $1,142 $981
    n/a
Family $1,936 $1,668 $1,427
   $103

*Dental coverage is optional.

 

 

RX Claim Form (CL-94)
(Adobe PDF File)
Eligibility Decision Tree
(Adobe PDF File)
For information on joining The Medical Association contact Meghan Martin at (334) 954-2500 or click here for our Membership application. If joining online, you must pay full dues of $450 for the Medical Association and your Full County Dues before submitting your application. 

If you have any questions please feel free to contact Mark Jackson or Brenda Ellis at (800) 239‐6272 or (334) 954‐2500.

To be eligible to enroll outside of the open enrollment period, you must be:
    • A new Medical Association member (Members who join within three years of terminating their membership are considered "reinstated" members and must wait until open enrollment to apply for insurance.)
    • A new licensee
    • New to Alabama
    • A newly hired employee of a group already participating in PIPA
    • A previously ineligible individual whose practice status has changed and are now eligible 
Point of Sale Prescriptions:

To set up your point of sale prescription reimbursements, go to www.bcbsal.org  and register your member plan and set up your direct deposit for your point of sale prescription reimbursements.  To file a drug claim logon to www.bcbsal.org  and click on myBlueCross and then click on File a Drug Claim.  Once you file your point of sale prescriptions, you should receive your reimbursement electronically within 10 days.  Please note the annual deductible for your plan must be met first in order to receive reimbursement for your prescriptions.

Retiree Rates and Eligibility


RETIREES: Click here to learn if you are eligible.