Medical Plans

Medical Plan Choices

Cleveland State University offers eligible faculty and staff four medical plan options during the plan year.

MetroHealth Select (Skyway) Exclusive Provider Organization (EPO)
Medical Mutual Value Plan SuperMed Preferred Provider (PPO) Network
Medical Mutual Traditional Plan SuperMed Preferred Provider (PPO) Network
Taxable Cash Option (Waiving medical coverage)—Must be covered by another medical plan not sponsored by Cleveland State University

Selecting a Medical Plan

When selecting a medical plan, consider more than the lowest premium cost. Determine which plan will provide the highest level of benefits at the lowest out-of-pocket expense to meet you and your family’s medical needs, and the network of medical providers including doctors, hospitals and other ancillary services.

Note: The benefit period for all CSU medical plans is a calendar year (January 1 through December 31). Deductibles and maximum out of pocket accumulators start over January 1.

MetroHealth Select (Skyway) Exclusive Provider Organization (EPO) — In-Network Coverage Only

The MetroHealth Select (Skyway) Plan Exclusive Provider Organization (EPO) through the MetroHealth Hospital System provides health centers located throughout Cuyahoga, Lake, and Medina counties. Covered services must be provided by MetroHealth Select (Skyway) network providers at health center locations. A listing of common services covered under the plan is included in the Medical and Prescription Drug Plans Comparison Chart.

Prescription drug coverage is included as part of the MetroHealth Select (Skyway) Plan. Refer to the Prescription Drug Coverage section of this website for more details. Medical Mutual is the claims administrator for the MetroHealth Select (Skyway) Plan. Medical Mutual reviews and pays claims for covered services provided by MetroHealth Select (Skyway) Network Providers. Direct questions regarding covered services, claims and requests for identification cards to Customer Service at Medical Mutual at 800.774.5284. Call the MetroHealth concierge line at 216.778.8818 to schedule appointments, locate network doctors and get information on the services provided at health center locations or visit metrohealth.org.

MetroHealth Select (Skyway) Summary of Benefits and Coverage (SBC)

This plan is available to Full-Time, Part-Time (30-39 hours), Part-Time (20-29) and ACA eligible employees.

Medical Mutual Value and Traditional Plan

The Medical Mutual Value and Traditional Plans are a Preferred Provider Organization (PPO) through Medical Mutual, which provides three “tiers” or levels of benefit coverage based on medical services and the providers of care:

TIER 1 CSU On-Campus Health and Wellness Services Provider
For limited covered services received from CSU Health and Wellness Services Clinic. Limited services are available with no deductible, coinsurance or copayment. A claim will be filed with Medical Mutual for payment of services for faculty and staff only. Dependents of faculty and staff are not eligible for care from CSU Health and Wellness Services.
TIER 2 SuperMed Preferred Provider (PPO) Network (Contracting Provider)
For covered services received from a SuperMed PPO Network Provider, services are subject to deductible, copayments and coinsurance.
TIER 3 Non-Network Provider (Non-Contracting Provider)
For covered services received from a Non-SuperMed PPO Network or Non-Contracting Provider, services are subject to higher deductibles, copayments, and coinsurance.

Medical Mutual serves as the claims administrator paying benefits for services provided by CSU’s On-Campus Health and Wellness Services Clinic, SuperMed PPO network providers, and non-network providers. Refer to the Medical and Prescription Drug Plans Comparison Chart.

To receive the highest level of benefits at the lowest out-of-pocket expense, use the Tier 1 On-Campus Health and Wellness Services Provider (if/when available) and/or Tier 2 SuperMed PPO Network Provider. To locate a Tier 2 SuperMed PPO network provider, search online at medmutual.com or call Medical Mutual Customer Service at 800.774.5284 for assistance.

Medical Mutual Value Plan Summary of Benefits and Coverage (SBC)

Medical Mutual Traditional Plan Summary of Benefits and Coverage (SBC)

These plans are only available to Full-Time, Part-Time (30-39 hours) eligible employees.

Taxable Cash Option

The Taxable Cash Option is available when enrollment in a medical plan is “waived” and you are covered by a medical plan not sponsored by Cleveland State University.

Full-time employees can receive, as taxable earnings, a lump sum payment up to $1,200 a year; part-time employees (30 to 39 hours) up to $900 per year. The amount of the payment is based on the period of time the employee is enrolled in this option during the benefit plan year. The plan year for benefit enrollment is July 1 to June 30. Full-time employees can earn $100 per month and part-time employees can earn $75 per month. The payment is paid annually generally the second pay in July if enrolled in the “Cash Option” during the current plan year ending June 30. A pro-rated payment is disbursed for partial year enrollment.

To receive the payment in their taxable gross earnings at the end of the plan year, the employee must select the Cash Option as their medical plan enrollment, and they must not be covered under a medical plan sponsored by Cleveland State University through a family member who is also an employee.

CSU Health and Wellness Services — On-Campus Clinic

The convenience of low/no-cost on-campus health care for faculty and staff is available at CSU Health and Wellness Services, located in the Center for Innovation and Medical Professions (IM), Room 205. Call 216.687.3649 for an appointment. Faculty and staff enrolled in the MetroHealth Select, Medical Mutual Value or Medical Mutual Traditional plans can receive office visit care with coverage as shown on the Medical and Prescription Drug Comparison chart.