Where may I access tools or information that allow me to compare health plans side by side?
Information will be posted on this site as it becomes available. You may also use the Decision Support Tool for a side by side comparison. Click here for details.
Are there any benefit offerings that have changed for the 2008-2009 plan year?
Yes. The UK Health First Plan will not be offered as of 7/1/08. Current UK Health First members who wish to continue coverage must select another plan.
Will the family combined credit (called "spousing") still be available in the 2008-2009 plan year?
Yes, the spousing credit will apply. When both husband and wife are regular full-time UK employees, the single coverage tier credit is combined with the employee plus children coverage tier credit, and both credits are applied toward the cost of the family premium. The out of pocket cost is exactly the same as one employee being on a single plan and the other employee being on an employee plus children plan. There is no benefit in combining credits if you are in the UKHMO or UK EPO plan. However, there is an advantage of combining credits in the PPO plans that have a family maximum on deductibles. Employees may have a lower deductible amount to meet in one family plan versus in two separate plans.
Will I receive a new pharmacy ID or health plan ID card this year?
Express Scripts will NOT send a new pharmacy benefit ID card if you are currently participating in a UK health plan and do not change your UK health plan coverage.
UK-HMO health plan members will receive a new ID card. UK-PPO, UK-PPO High, UK-EPO, UK Retiree Carveout and UK Indemnity health plan members will NOT receive a new ID card unless you are enrolling in one of these plans from a different plan. UK Dental and MetLife will not send ID cards. EyeMed members will receive a new ID card.
Are there any changes in the health plan affecting retirees?
Out-of-pocket premiums for retirees who receive the UK health credit on the Medicare Carveout plan has increased by $2 per month for FY 2006-07. Retirees on the Medicare Carveout plan who are eligible for the health credit will receive a $222 credit toward the cost of their plans. Retirees, who are eligible for the health credit but not eligible for Medicare, will receive a $222 credit toward the cost of their plans, regardless of the level of coverage you choose. Retirees and their spouses living in Kentucky who are not eligible for Medicare will have the same choices as active employees, based on the county in which they live. If the retiree lives outside of Kentucky or is eligible for Medicare, the choices will remain the same. For retirees over the age of 65 who are on the Medicare Carveout plan, the prescription drug benefit will remain the same for FY 2006-07. A surviving spouse of a retiree will continue to be eligible for a health credit equal to one-half that of the retiree health credit for the Medicare Carveout plan ($111).
What is the difference between UK-PPO, UK-PPO High and UK-EPO? What does this mean?
UK-PPO and UK-PPO "High" are both preferred provider organization health plans (PPO). The differences between the plans are the premiums, deductibles, copayments and coinsurances that apply for each plan. The UK-PPO High will have a higher premium and higher benefits, such as a lower copayment for physician office visits, a lower deductible and lower coinsurance when compared to the UK-PPO. PPO plans offer coverage for both in-network and out-of-network providers. There is a higher coverage level for benefits provided by a network provider. The UK-EPO (Exclusive Provider Organization) plan is the same as an HMO (Health Maintenance Organization). A network provider must be used in order to receive a benefit unless benefits are received for a life or limb threatening medical emergency.
There are actually two networks available when participating in the UK-PPO, UK-PPO High, or UK-EPO plan. They are Humana and ChoiceCare. Both networks may be accessed on Humana's website: www.humana.com.
The Indemnity plan is a traditional health plan with a deductible and coinsurance. It does not have a network requirement and is only offered to participants who live outside of Kentucky. When participants use one of the Humana or Choice Care network providers, a discount is provided.
Is there full coverage for emergencies under the UK-EPO plan or is only a percentage of an emergency visit or hospitalization covered?
Under the UK-EPO plan, there is full coverage for emergencies or "urgent care" services received from an in- or out-of-network facility. For example, if you have the UK-EPO plan and break your leg while on vacation, the emergency room visit and any immediately necessary treatment would be covered at the "in-network" level. However, if the doctor tells you to come back in three days for a follow-up visit, that follow-up visit would not be considered emergency or urgent care. You would have to come home for follow-up treatment (or find a participating network physician and facility).
Can UK-HMO Regional participants utilize both the UK Medical Center physicians in Lexington and the physicians in the county in which they reside?
Yes, the UK-HMO Regional plan network includes the UK HealthCare facilities, UK HealthCare physicians, and certain Humana/ChoiceCare providers. Providers can be found at www.mc.uky.edu/ukhmo and using the UKHMO RSA provider link at www.humana.com.
Is the live or work option only available to persons who have the UK Indemnity Plan option?
Yes, it is. The UK Indemnity Plan will be offered to the areas out of state. So if you live in Indiana, but work in Louisville, you may choose the plans that are available in Jefferson County where you work or in Indiana where you live.
Did the costs of health care benefit premiums for employees change this plan year?
The vast majority of the UK health plan members will pay the same or lower out-of-pocket premiums. UK-HMO rates remain unchanged, while UK-PPO and UK-EPO rates decrease! UK-PPO High rates increase slightly. More good news: UK-EPO, UK-PPO, and UK-PPO High members may now save money when seeing UK HealthCare providers.
Because the University of Kentucky deducts premiums for health, dental and vision insurance as well as flexible spending benefit plans on a pre-tax basis, the benefit choices you make now may not be changed unless you have a qualified change in family status, as defined by Internal Revenue Code, Section 125. The choices you make during Open Enrollment will be in effect from July 1 through June 30.
A qualified change in family status is defined as: marriage, divorce, birth or adoption of a child, death of a spouse or child, dependent child reaches the age limit or gets married, change in employment status of you or your spouse from full-time to part-time and vice versa, termination of employment by you or your spouse and open enrollment of a spouse.
