Medical Insurance

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, a portion ($360 annually) can be waived with participation in annual biometric screenings making this benefit even more valuable to you. Refer to the tables below for details.


2019 plan year

Cost and coverage

Base Plan 

Coverage University pays for employees Employee pays for self* Employee pays for dependents Total premium

Employee only

$440.51

$40.00

$0.00

$480.51

Employee + spouse

$647.79

$40.00

$340.00

$1027.79

Employee + child(ren)

$603.36

$40.00

$240.00

$883.36

Employee + family

$995.64

$40.00

$395.00

$1430.64

*This monthly premium will be waived $30 for employees who participate in the wellness activities.  

Buy Up Plan

Coverage University pays for employees Employee pays for self* Employee pays for dependents Total premium

Employee only

$431.49

$76.00

$0.00

$507.49

Employee + spouse

$669.80

$76.00

$340.00

$1085.80

Employee + child(ren)

$617.00

$76.00

$240.00

$993.00

Employee + family

$1040.31

$76.00

$395.00

$1511.31

*This monthly premium will be waived $30 for employees who participate in the wellness activities.

Services covered

Preventive - Services at Magers Health and Wellness Center and Network Providers will be paid 100% by the plan. 

Prescription coverage

  • MedTrak will still be our Pharmacy Benefit Manager (PBM) in 2019.
  • The Base Plan maximum out of pocket for prescriptions will be $2000. 
  • The Buy-Up plan maximum out of pocket for prescriptions will be $1500. 

2019 forms and publications

Forms

Publications


All plan years

Limits and exclusions

If you are hired after Sept. 1, you will initially have your employee premium waived until the next available opportunity to participate in wellness activities.

How to use the benefit

Your medical plan utilizes a Preferred Provider Organization (PPO) network, which outlines participating providers. However, it is your choice as to which provider to use.

The university also has an on-site healthcare facility, Magers Health and Wellness Center, that is convenient and affordable. The in-network $800 deductible is waived if you or your insured family member uses this facility.

To begin taking advantage of the prescription medicine insurance, simply notify your pharmacy. Check out a list of MedTrak acceptable pharmacies.

Enrolling and making changes

You must enroll, and select dependent coverage options, within 30 days of your start date.

Each fall, the university participates in open enrollment when you can make changes to your plan.

Outside of the open enrollment period, changes can only be made due to qualifying life events (like marriage, divorce or having a child). For more information, contact human resources.

Declining coverage

You have the option to decline the medical insurance coverage. If you decline the university’s medical coverage for yourself, you are also declining coverage for your family members. Declining the coverage does not result in a payment or increase in your salary in lieu of coverage.

My Mercy

Through My Mercy, you have direct access to your medical records, including test results and immunizations. This resource also gives you a direct line to your physician’s office to schedule appointments, request medication refills or ask medical questions from Mercy providers.

Making claims

If you’re enrolled in the university’s cafeteria plan, follow the instructions on this form to submit a medical claim or to submit a pharmacy claim form.

Policy