Full-time employees have the opportunity to enroll in a University-sponsored medical insurance plan within 30 days of hire or qualifying event (marriage, birth, adoption, loss of other coverage, etc.) or during the annual open enrollment period.  These group plans are comprehensive medical plans that cover all in and out-patient hospital services, laboratory fees, medical and mental health services, and prescription drug benefits which are subject to deductibles and out of network copays, on a “usual, customary and reasonable” basis. The cost of the HSA deductibles, as elected by each participating member, shall be borne entirely by the employee.  Prescription drugs (including mail order options) are included under the medical deductible.

The University currently offers three (3) high deductible Health Savings Account (“HSA”) plans. Beginning January 1, 2016, an employee’s share of medical insurance premiums will be based on the following:

1. Medical plan choice (option 1, 2, or 3 – see below)
2. Coverage type (employee only, employee + spouse, employee + child(ren), and employee + family)
3. Employee’s annual base pay

Please see appendix to determine your individualized rate.  Premiums will be deducted from participant’s pay on a pre-tax basis.  

Medical Plan 1

Preventative services (which may include immunizations, vaccines, annual wellness exams, and medically-appropriate health screenings) are covered at 100% by insurance.  All other in-network services are subject to $3,000 (single) or $6,000 (family) embedded deductible.  After meeting the deductible, coverage is 100% (no coinsurance) for in-network services. Out-of-network services and other terms, conditions, and exclusions are as outlined in the provider’s certificate of coverage or summary plan description (SPD).

Medical Plan 2

Preventative services (which may include immunizations, vaccines, annual wellness exams, and medically-appropriate health screenings) are covered at 100% by insurance.  All other services are subject to $3,000 (single) or $6,000 (family) embedded deductible.  After meeting the deductible, participants must pay 10% co-insurance up to maximum out-of-pocket expenses of $4,000 (single) or $8,000 (family) for network services.  Out-of-network services and other terms, conditions, and exclusions are as outlined in the provider’s certificate of coverage or summary plan description (SPD).

Medical Plan 3

Preventative services (which may include immunizations, vaccines, annual wellness exams, and medically-appropriate health screenings) are covered at 100% by insurance.  All other services are subject to $5,000 (single) or $10,000 (family) embedded deductible.  After meeting the deductible, participants must pay 25% co-insurance and pharmacy (Rx) copays of $10 (Tier 1), $35 (Tier 2), and $60 (Tier 3) up to maximum out-of-pocket expenses of $6,000 (single) or $12,000 (family) for network services.  Out-of-network services and other terms, conditions, and exclusions are as outlined in the provider’s certificate of coverage or summary plan description (SPD). 

Contributions to HSA – The University will contribute $500 per year (prorated for new hires) to each employee that participates in the University’s medical plan (typically in January or February). To be eligible, a member must establish an HSA account at Ohio Valley Bank. Employees may also make voluntarily pre-tax contributions (via payroll deduction) to their HSA up to the IRS established limits.  Please contact Human Resources for additional information and forms.

Working Spouse Rule – Effective January 1, 2016, the University implemented a “Working Spouse” for medical coverage. It requires a working spouse (if applicable) must enroll in his/her employer’s group medical plan in order to be eligible to be enrolled in the University’s group medical plan.  In these cases, the spouse’s employer’s plan provides primary coverage for the spouse and the University’s medical plan provides secondary coverage. Please contact Human Resources for additional information and forms.