Health Plans - FAQ
- What is the difference between UK-PPO and UK-EPO? What does this mean?
- Is the family combined credit (called "spousing") still available?
- What is the network for UK-PPO?
- Will I receive a health and prescription ID card each year?
- Will I receive a dental ID card each year?
- Will I receive a vision ID each year?
- Can UK-HMO Regional participants utilize both the UK Medical Center physicians in Lexington and the physicians in the county where they reside?
- Is the live or work option only available to persons who have the UK Indemnity plan option?
- What is an Indemnity plan?
- When are enrollment forms due?
- When can I change my health insurance elections?
- What is a qualified change in family status?
- What is the difference between UK-PPO and UK-EPO? What does this mean?
UK-PPO is a 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-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.
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- Is the family combined credit (called "spousing") still available?
Yes. 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 UK-HMO, 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.
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- What is the network for UK-PPO?
There are actually two networks available when participating in the UK-PPO and UK-EPO plan. They are Humana/ChoiceCare. Both networks may be accessed on Humana's website: www.humana.com.
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- Will I receive a health and prescription ID card each year?
UK-HMO members will receive a new ID card. UK-PPO and UK-EPO members will typically NOT receive a new ID card unless you are enrolling in one of these plans from a different plan. Prescription plan cards will not be reissued each year. Members will use the same ID card year to year.
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- Will I receive a dental ID card each year?
UK Dental members will NOT receive an ID card. UK Dental verifies member eligibility electronically. Delta Dental does send ID cards to new members, but not to existing members each year.
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- Will I receive a vision ID each year?
EyeMed members will receive a new ID card each year.
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- 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, if you have the UK-HMO Regional plan you have access to the network hospitals and physicians in the county where you live and contiguous counties. You may also use the UK Medical Center and UK physicians.
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- 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.
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- What is an Indemnity plan?
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/Choice Care network providers, a discount is provided.
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- When are enrollment forms due?
Return your completed form(s) to the Employee Benefits Office at 112 Scovell Hall. If you are a new employee, you have 30 days from your hire date to submit your forms. Otherwise, you must wait to enroll at next year's Open Enrollment period.
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- When can I change my health insurance elections?
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, 2012 through June 30, 2013.
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- What is a qualified change in family status?
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.
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