The University’s self-funded medical plan is available to all eligible employees. Claims are processed and paid by a third party administrator, Med-Pay Inc. The University pays over 90% of the employee’s monthly premium. In addition, your portion can be waived with participation in annual wellness activities making this benefit even more valuable to you. If you are hired after September 1st, you will initially have your employee premium waived until the next available opportunity to participate in wellness activities.
Medical coverage is available for both your spouse and/or your eligible dependents. If you elect spouse and/or dependent medical coverage, you pay the full cost for that coverage and the premium is paid through payroll deduction.
Your medical plan utilizes a Preferred Provider Organization (PPO) network. This Plan has entered into an agreement with certain Hospitals, Physicians and other health care providers, which are called Participating Providers. Because these Participating Providers have agreed to charge reduced fees to persons covered under the Plan, the Plan can afford to reimburse a higher percentage of their fees. Therefore, when a Covered Person uses a Participating Provider, that Covered Person will receive better benefits from the Plan than when a Non-Participating Provider is used. It is the Covered Person's choice as to which Provider to use.
The University has an on-site healthcare facility, Taylor Health and Wellness Center, that is convenient and affordable. In addition, many other facilities are available for your use. The in-network $800 deductible is waived if you or your insured family member uses an on-campus health care facility. Additional information regarding deductibles, co-insurance, and out-of-pocket costs is available at www.MissouriState.edu
You have the option to decline the University’s medical insurance coverage by completing a “Declination of Coverage” form. If you decline the University’s medical coverage for yourself, you are also declining coverage for your family members. Also, if you decline the medical coverage, you will not receive any payment or increase in salary in lieu of the coverage.
The University provides a preventive (routine care) benefit, e.g., annual physical, capped at $400 per covered person.
- If the office visit is performed at an onsite campus location, the deductible is waived and the insurance pays 100% of the cost up to the allowed $400.
- If the office visit is performed at a Participating Provider, the deductible is waived and your responsibility is 20% coinsurance up to the allowed $400.
- If the office visit is performed at a Non-Participating Provider, the deductible must be paid and the patient’s responsibility is 40% coinsurance up to the allowed $400.
- For employees on the West Plains campus, the deductible is waived and the insurance pays 100% of the cost up to the allowed $400 when you receive care from a network provider in the West Plains area.
The University’s medical insurance plan includes coverage for prescription medications. The medical/dental identification card issued also serves as a prescription drug discount card and should be shown to the pharmacist when filling a prescription. The University’s Pharmacy Benefits Manager is MedTrak Pharmacy Services, who offers both retail and mail-order pharmacy services at reduced costs. A list of pharmacies honoring the MedTrak prescription drug card is included with the orientation packet and available on the human resources page of the Missouri State University website. Note: the University’s on-campus pharmacy at Taylor Health & Wellness Center in Springfield is included on the list of MedTrak acceptable pharmacies.
Those who use Taylor’s pharmacy will be able to take advantage of a reduced coinsurance of 20%. For employees not using Taylor’s pharmacy, the prescription drug benefit requires a 30% coinsurance at the time the prescription is filled. The 30% coinsurance is paid each time a prescription is filled throughout the year until the total amount of the coinsurance paid for the year is $1,500. Once the person has paid the $1,500, all prescriptions filled for the remainder of the year are paid at 100% by the insurance plan. The annual coinsurance amount for families is capped at $3,000.