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This plan offers greater flexibility to choose providers from UK HealthCare, Anthem network or out-of-network. UK HealthCare facilities and physicians still offer excellent value with lower co-pays and co-insurance.

PPO Plan Booklet PDF
Summary of coverage and benefits PDF

​Service coverage and costs

All employee health insurance plans provide one annual preventive care visit with your primary care provider at $0 co-pay within specified networks. 

For other common visits, this is what you’ll pay with PPO.

$15
UK HEALTHCARE PRIMARY CARE CO-PAY
$25
ANTHEM PRIMARY CARE CO-PAY
$40
UK HEALTHCARE SPECIALIST CO-PAY
$50
ANTHEM SPECIALIST CO-PAY

Coverage highlights

Deductibles and out-of-pocket maximums vary based on who you see for care.
  PPO plan design UK HealthCare Anthem Out-of-network
Lifetime Maximum Benefit   Unlimited Unlimited Unlimited
Out-of-Pocket Amount Annual deductible $100/member; $200/family $500/member, $1,000/family $1,500/member; $3,000/family
  Medical out-of-pocket maximum $3,000/member; $6,000/family $3,000/member; $6,000/family N/A
  Prescription out-of-pocket maximum $4,900/member; $9,800/family $4,900/member, $9,800/family $4,900/member, $9,800/family

Employee monthly rates

2021-2022 HMO, PPO, SAVER PLAN, INDEMNITY
Coverage level Total monthly cost* UK pays You pay
Employee only $599 $564 $35
Employee + children $899 $752 $147
Employee + spouse $1,199 $927 $272
Employee + family $1,498 $1,098 $400
2022-2023 PPO AND INDEMNITY
Coverage level Total monthly cost* UK pays You pay
Employee only $616 $577 $39
Employee + children $926 $774 $152
Employee + spouse $1,235 $954 $281
Employee + family $1,543 $1,131 $412

* 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.

Coverage for common services

  PPO plan design UK HealthCare Anthem Out-of-network
Preventive Care (Coverage under preventive care category depends on age, symptoms and diagnosis) Routine mammogram and Pap smears $0 $0 50% after deductible
  Routine child care and immunizations (through age 18) $0 $0 50% after deductible
  Routine adult physical exam (19 years and above) $0 $0 50% after deductible
  Routine outpatient lab tests and X-rays $0 $0 50% after deductible
Physician Services Primary care office visits (excludes certain diagnostic lab and X-ray) $15 co-pay per visit $25 co-pay per visit 50% after deductible
  Specialist office visits (excludes certain diagnostic lab and X-ray) $40 co-pay per visit $50 co-pay per visit 50% after deductible
  Lab tests and X-rays Same as office visit co-pay Same as office visit co-pay 50% after deductible
  Allergy injections $10 co-pay per visit $10 co-pay per visit 50% after deductible
  Inpatient services $300 co-pay per visit 20% after deductible 50% after deductible
  Outpatient surgery $100 co-pay per visit 20% after deductible 50% after deductible
  Diagnostic tests (high costs - MRI, MRA, CT, and PET scans) $75 co-pay per visit 20% after deductible 50% after deductible
Hospital Services Inpatient care (semi-private room and board, nursing care, ICU) $300 co-pay per visit 20% after deductible 50% after deductible
  Outpatient surgery $100 co-pay per visit 20% after deductible 50% after deductible
  Diagnostic tests (high costs - MRI, MRA, CT, and PET scans) $75 co-pay per visit 20% after deductible 50% after deductible
  Outpatient nonsurgical care $100 co-pay per visit 20% after deductible 50% after deductible
  Outpatient tests, lab and X-ray $0 20% after deductible 50% after deductible
  Ancillary services $0 20% after deductible 50% after deductible
  Organ transplants $0 20% after deductible 50% after deductible
  Emergency room 20% after $100 co-pay per visit (waived if admitted) 20% after $100 co-pay per visit (waived if admitted) 20% after $100 co-pay per visit (waived if admitted)
Other Medical Services Urgent treatment center $50 co-pay per visit 100% after $50 co-pay per visit 50% after deductible
  Skilled nursing facility (up to 100 days/plan year) 20% after deductible 20% after deductible 50% after deductible
  Home health care (up to 100 visits/plan year) and hospice services 20% after deductible 20% after deductible 50% after deductible
  Durable medical equipment 20% after deductible 20% after deductible 50% after deductible
  Ambulance 20% after deductible 20% after deductible 50% after deductible
  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 50% after deductible
Mental Health and Substance Abuse Inpatient $300 co-pay per visit 20% after deductible 50% after deductible
  Outpatient $40 co-pay/visit $50 co-pay/visit 50% after deductible

UK HealthCare

HMO plan members have access to the expertise of UK HealthCare providers.

Eligibility and enrollment

Your first 30 days

Welcome to UK! You can sign up for benefits depending on your FTE. Enroll in your benefits quickly in myUK.

Qualifying events

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.

Benefits Open Enrollment

Our Benefits Open Enrollment happens every year so you can make changes. Changes can be made in myUK, or with paper forms.

Retirees

Please use the Retiree Benefits Enrollment form and return to Scovell Hall.

How to change your benefits

Signing up as a new employee or making changes during Benefits Open Enrollment can be done in myUK, or with paper forms.

Step-by-step tutorial

Making changes at other times of the year due to a qualifying event are completed using our Benefits Enrollment Form.

Paper forms can be emailed, faxed or brought to Scovell Hall.