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Open Enrollment Information for Indiana School Corporations

The state will continue offering three statewide medical plans for 2026: Consumer-Driven Health Plan 1 (CDHP 1), Consumer-Driven Health Plan 2 (CDHP 2) and Traditional Plan. All three available plans are in the National (BlueCard) PPO network with Anthem and have a prescription drug plan through CVS Caremark. Each plan has differences in premium costs, deductibles, and out-of-pocket maximums. Your money goes further with Tier 1 providers.

Within each plan, employees may choose providers from any of the network options. Each network has a diverse group of providers that provide all types of services including preventive care, acute care for illnesses, and chronic care. The big difference between the networks is the cost to you.

  • Tier 1 - HealthSync: Lowest Cost Option: To save the most money, use providers within the Tier 1 - HealthSync network. This tier has lower costs plus the lowest deductible, out-of-pocket maximum, and co-insurance rates. All in-network pharmacies through the prescription drug coverage are Tier 1 providers.
  • Tier 2 - In-Network: Tier 2 is your next best option. This tier includes all other in-network providers. In-network providers have a contract with Anthem to provide services at a discount. They cannot bill members above that discounted rate.
  • Out-of-Network: Highest Cost Option: Out-of-network providers do not have an agreement with Anthem. Providers can charge you any amount for their services. The health plan will only cover the same cost as an in-network provider, and you will be balanced billed for any cost exceeding that amount.

You can use providers from all tiers any time during the plan year. The amount you pay for each visit depends on the provider you choose for that visit. Each claim is applied to the deductible and out-of-pocket maximums of all tiers.

Plan Rates

Plan Summaries

CDHP 1

CDHP 2

Traditional Plan

Compare the Plans

  • 2026 School Corps Plan Comparison - This document includes information related to office visits, inpatient, ER, urgent care, wellness and prevention and medicine as they relate to each plan.

Prescription coverage

Spousal Surcharge

Beginning in January 2026, employees covering a spouse on their medical plan may be required to pay a spousal surcharge. If your spouse has access to medical coverage through their employer and does not elect it for 2026 and you enroll them as a dependent under the State’s medical plan, you will be charged the spousal surcharge. If you do not fall in the above scenario but are covering a spouse on your medical plan in 2026, you will want to provide verification to have the spousal surcharge waived.

This change will apply only in the situation that:

  • You cover your spouse under a State Employee Health Plan, and
  • Your spouse’s employer offers them health insurance.
  • Your spouse is not enrolled in their employer’s health plan.

It will not apply if your spouse:

  • Is not employed.
  • Does not have access to coverage through their employer.
  • Also works for the State of Indiana or a school participating in the State’s health insurance (Canaan, Cannelton City, Charles A. Beard, Freemont, MSD of Shakamak, or Springville Community Academy).

During Open Enrollment, you will need to complete a spousal surcharge certification, and you may be required to submit documentation from your spouse’s employer. The surcharge will apply if you cover a spouse but do not complete these steps. Health care costs continue to rise, and the State must ensure that the State Employee Health Plan (SEHP) remains viable long-term for employees and their dependents.

School Spousal Surcharge Form

Federal Notices

Questions

If you have questions about your medical plans, contact the Benefits Hotline Monday through Friday, 7:30 a.m. to 5 p.m. ET.

  • 317-232-1167 within Indianapolis area
  • 1-877-248-0007 toll-free outside Indianapolis

Email: benefitingschools@spd.in.gov