Health plan EPO
No-deductible health insurance with provider options
This plan offers greater flexibility of health care providers similar to the PPO plan. However, there are no deductibles or co-insurance. This excellent coverage is achieved in exchange for a higher monthly premium.
Employee monthly rates
|Coverage||Cost *||UK pays||You pay|
|Employee + children||$1,141||$719||$422|
|Employee + spouse||$1,537||$885||$652|
* Regular part-time and temporary employees (less than 0.75 FTE or work less than an average of 30 hours per week in a 12 month measurement period), who are not eligible for the UK credit toward the costs of coverage, pay this rate.
Deductibles and out-of-pocket maximums that vary based on who you see for care.
|EPO health plan||Maximums||UK HealthCare||Anthem|
|Lifetime Maximum Benefit||Unlimited||Unlimited|
|Out-of-Pocket Amount||Annual deductible||$0/member; $0/family||$0/member; $0/family|
|Medical out-of-pocket maximum||$3,000/member; $6,000/family||$3,000/member; $6,000/family|
|Prescription out-of-pocket maximum||$4,900/member; $9,800/family||$4,900/member; $9,800/family|
Costs for common services
|EPO health plan||Service||UK HealthCare||Anthem|
|Preventive Care (Coverage under preventive care category depends on age, symptoms and diagnosis)||Routine immunizations (through age 18)||$0||$0|
|Routine mammogram and Pap smears||$0||$0|
|Routine child care (through age 18)||$0||$0|
|Routine adult physical exam (19 years and above)||$0||$0|
|Physician Services||Primary care office visits (excludes certain diagnostic lab tests and X-ray)||$15 co-pay per visit||$25 co-pay per visit|
|Specialist office visits (excludes certain diagnostic lab tests and X-ray)||$40 co-pay per visit||$50 co-pay per visit|
|Lab tests and X-rays||Same as office visit co-pay||Same as office visit co-pay|
|Allergy injections||$10 co-pay per visit||$10 co-pay per visit|
|Outpatient surgery and diagnostic tests||$0||$0|
|Physician visits to emergency room||$0||$0|
|Hospital Services||Inpatient care (semi-private room and board, nursing care, ICU)||$300 co-pay per admission (limited to two co-pays per plan year)||$500 co-pay per admission (limited to two co-pays per plan year)|
|Outpatient surgery||$100 co-pay per procedure||$150 co-pay per procedure|
|Outpatient diagnostic testing (high costs - MRI, MRA, CT, PET scans)||$75 co-pay per test||$100 co-pay per test|
|Outpatient nonsurgical care||$0||$0|
|Outpatient tests, lab and X-ray||$0||$0|
|Emergent Medical Services||Emergency room||$100 co-pay (waved if admitted)||$100 co-pay (waived if admitted)|
|Urgent treatment center||N/A||$50 co-pay per primary care visit|
|Ambulance services||$100 co-pay||$100 co-pay|
|Other Medical Services||Skilled nursing facility (up to 100 days/plan year)||$0||$0|
|Home health care (up to 100 visits/plan year) and hospice services||$0||$0|
|Durable medical equipment||20% co-insurance up to $500 member cost per year||20% co-insurance up to $500 member cost per year|
|Chiropractic care*, physical, speech, music, hydrotherapy, occupational and acupuncture therapy (limited to 45 visits per plan year, combined) *Maximum 20 visits for chiropractic care||$20 co-pay/visit||$30 co-pay/visit|
|Mental Health and Substance Abuse||Inpatient||$300 co-pay per admission||$500 co-pay per admission|
|Outpatient||$40 co-pay per visit||$50 co-pay per visit|
Welcome to UK! You can sign up for benefits depending on your FTE. Enroll in your benefits quickly in myUK.
If you experience a major life change outside of open enrollment you can also make changes to your insurance. This is known as a qualifying event. You'll need to fill out and submit a form within 30 days.
Our Benefits Open Enrollment happens every year so that you can make changes. Changes can be made in myUK, or with paper forms.
Please use the Retiree Benefits Enrollment form and return to Scovell Hall.