Medical Insurance
Cost and coverage
2026 Base Plan
| Coverage | University pays for employees | Employee pays for self* | Employee pays for dependents | Total premium |
|---|---|---|---|---|
| Employee only | $676.05 + | 48.00 + | $0.00 = | $724.05 |
| Employee + spouse | $1090.74 + | $48.00 + | $410.00 = | $1548.74 |
| Employee + child(ren) | $993.08+ | $48.00 + | $290.00 = | $1331.08 |
| Employee + family | $1631.75+ | $48.00 + | $476.00 = | $2155.75 |
2027 Base Plan
| Coverage | University pays for employees | Employee pays for self* | Employee pays for dependents | Total premium |
|---|---|---|---|---|
| Employee only | $753.47 + |
54.00 + |
$0.00 = | $807.47 |
| Employee + spouse | $1215.18 + | $54.00 + | $458.00 = | $1727.18 |
| Employee + child(ren) | $1106.44 + | $54.00 + | $324.00 = | $1484.44 |
| Employee + family | $1819.12 + | $54.00 + | $531.00 = | $2404.12 |
**Monthly premium will be reduced up to $30 for employee who qualify by participating in the designated wellness activities.
*Domestic Partner coverage requires completed affidavit.
2026 Buy-up Plan
| Coverage | University pays for employees | Employee pays for self* | Employee pays for dependents | Total premium |
|---|---|---|---|---|
| Employee only | $730.67+ | $107.00 + | $0.00 = | $837.67 |
| Employee + spouse (Domestic Partner*) | $1203.23 + | $107.00 + | $482.00 = | $1792.23 |
| Employee + child(ren) | $1093.02 + | $107.00 + | $340.00 = | $1540.02 |
| Employee + family | $1830.60+ | $107.00 + | $557.00 = | $2494.60 |
2027 Buy-up Plan
| Coverage | University pays for employees | Employee pays for self* | Employee pays for dependents | Total premium |
|---|---|---|---|---|
| Employee only | $816.02+ | $119.00 + | $0.00 = | $935.02 |
| Employee + spouse (Domestic Partner*) | $1346.52 + | $119.00 + | $535.00 = | $2000.52 |
| Employee + child(ren) | $1222.00 + | $119.00 + | $378.00 = | $1719.00 |
| Employee + family | $2046.51+ | $119.00 + | $619.00 = | $2784.51 |
**Monthly premium will be reduced up to $30 for employee who qualify by participating in the designated wellness activities.
*Domestic Partner coverage requires completed affidavit.
Covered Services 🏥
- Comprehensive medical and prescription coverage, including mental health
- Preventive services at Magers Health & Wellness Center or In-Network providers are 100% covered
- Non-network or wrap providers: Referral required if services are available in-network; must be approved by Utilization Review Coordinator
- Mercy Tertiary Network (outside SW Missouri): Referral required for Network benefit approval
- See plan document for full details, limitations, and exceptions
Prescription Coverage 💊
Pharmacy Benefit Manager: Med-Impact
Out-of-pocket maximums:
- Base Plan: $2,000 individual / $4,000 family
- Buy-Up Plan: $1,500 individual / $3,000 family
Programs & Rules:
- Generic Incentive: Use generics when available; pay the difference if choosing a multi-source brand. FAQ's
- Brand Drugs with Generic Equivalent: 50% coinsurance at retail or Magers Pharmacy
- Other Drugs at Magers Pharmacy: 20% coinsurance
- Other Drugs at Med-impact Pharmacy: 30% coinsurance
- Step Therapy: Must try a lower-cost drug first unless your doctor documents prior attempt without benefit
- Extra Savings: 10% discount at Magers Pharmacy + mail-order options
- Speciality Medications
- Med-impact portal & App Flyer
Enroll & Make Changes ✅
- Deadline: Within 31 days of your start date
- Premiums: Paid in advance (e.g., coverage starts July 1 → deducted from June paycheck)
- Making Changes:
- During Open Enrollment, or
- Within 31 days of a qualifying life event (marriage, divorce, birth, coverage change)
- Most changes take effect the first of the month after documentation (except births)
- Qualifying Life Event Change Form
📞 Questions? Contact Human Resources
Declining Coverage ❌
- You may waive MSU coverage and use the Health Insurance Marketplace
- Re-enroll only during Open Enrollment or within 31 days of a qualifying life event
- Important: Waiving coverage does not increase your salary
Access Your Info 💻
- View medical records
- Schedule appointments
- Request prescription refills
- Contact your Mercy physician
- Track claims & deductibles
- View/reprint EOBs
- Request duplicate or dependent ID cards
- Download claims summaries
- Member Portal Quick Start Guide
Group #: 090188MSU
Policy
Forms and publications
Forms
Publications
- 2026 Base Plan
- 2027 Base Plan
- 2026 Buy-up Plan
- 2027 Buy-up Plan
- Base and Buy-Up Comparison Tables and Buckets
- 2027 Summary of Benefits and Coverage (Base Plan)
- 2026 Summary of Benefits and Coverage (Base Plan)
- 2027 Summary of Benefits and Coverage (Buy-up Plan)
- 2026 Summary of Benefits and Coverage (Buy-up Plan)
- Medical plan SPD
- SPD amendments
- No Surprises Act
- Prescription drug plan and list of pharmacies
- Medimpact Formulary effective 01/01/2026
- Legal notices
- CHIP notice
- Medicare Part D Creditable Coverage Notice
- Glossary of health coverage and medical terms
- MSU Notice of Privacy Practices
- Exhange notice 2026 plan year
- Exchange notice 2027 plan year
- 2026 Premium rates
- 2027 Premium Rates
- New Medical Claims System Member FAQ
- How To Read Your EOB
Flyers:
Contact information
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