Medical Plans

The University offers five medical plan options; some are designed to save you money and others to give you more options.

You have 30 days from your date of employment or your newly benefits-eligible job to enroll in a medical plan. Use the resources included here to help you decide which plan is the best choice for you and your family.

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The Medical Plan Comparison (pdf) gives you a side-by-side look at plan coverage for services ranging from office visits to hospital services to lab and x-ray services to prescription drugs and much more.

Which Medical Plans Are Available to You?

The medical plan options that are available to you vary by geographic location. Each of the geographic locations has a base plan that is the most widely used plan in that area and offers low rates and copayments. Because you can select your medical plan based on where you live or work, you can choose a plan in either geographic location. However, to choose the ACO Plan, you must live in one of the counties in their service area.

  • Medica Elect/Essential is a base plan in specific zones within the state.
  • Medica Choice Regional is another base plan offered in a specific zone within the state.
  • Medica ACO Plan is a defined network plan. To participate in one of the four ACOs, you must live in one of the defined network areas: Twin Cities metro area; southern Minnesota and western Wisconsin; northern Minnesota, eastern North Dakota, and northwestern Wisconsin; or northwestern Minnesota and northeastern North Dakota
  • Medica Choice National is an open network plan available statewide with coverage nationwide.
  • Medica HSA is a high deductible plan with a health savings account, available statewide with national coverage.

 

Choosing a Plan

You’re eligible for medical coverage if you meet the benefits eligibility requirements, but signing up for a plan is not required.

You’ll want to select a plan that is associated with the region either where you live or work. See the Medical Zones and Base Plan Map (pdf).

Since the plans cover the same types of health care services, you’ll also want to pay attention to differences in the provider networks, the biweekly rates, and some of the set amounts that you will pay out of your pocket up front when you go to the doctor such as copays, deductibles, and coinsurance.

Keep these questions in mind as you research the plans:

  • Does the plan meet the needs of you and your family?
  • Is your doctor covered in the network?
  • Is the plan available in your geographical region?
  • Are you comfortable with the associated costs such as copays, deductibles, and rates?

Visit the Medica website for more information to help you select a medical plan or call their Customer Service at 952-992-1814 or 877-252-5558; TTY users, please call 711.

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Resources to Help You Make Your Decision

Use the 2017 Guide for UPlan Benefits Enrollment (pdf) to learn more about your options.

If you want to do a deeper dive in your research, the 2017 Medical Summary of Benefits (pdf) has the details on the full range of benefits in your medical plan.

If you have a question about enrolling for benefits or about the medical plans, you may find the UPlan Members’ Frequently Asked Questions (pdf) helpful.

 

What is the Cost Each Pay Period?

What the University Pays

If your appointment is 75% time or greater, the University pays toward the cost of your rates. However, if your appointment is 50% to 74% time, you pay the full cost of the rates.

For the base plan, the University pays 87% of the cost of employee-only coverage and 80.5% of the cost of each tier with dependents. For the other plans, your rate will include the additional cost of that plan.

What You Pay

Your cost depends on whether or not you participate in the Wellness Program. Your cost is shown in the UPlan Standard Rates table if you did not participate.

If you are a new employee, your rates for 2017 are also the UPlan Standard Rates.

Participation in the Wellness Program is a way to reduce the amount you pay. If you earned the required number of wellness points for a $400 or $600 reduction, your cost is shown on the UPlan Wellness Program Rates table.

New Employees: How to Reduce Your Medical Rate for 2018

If you earn the required number of wellness points from your effective date of coverage to August 31, 2017, you can reduce your 2018 UPlan medical rates by either $400 a year if you have employee-only coverage or $600 a year if you have family coverage.

 

How Do I Enroll in Medical Coverage?

New Employees Enrolling in a Medical Plan

You have 30 days from your date of employment or your newly benefits-eligible job to enroll in a medical plan through MyU. Your medical coverage starts on the first day of the month following your first day in your new job.

If you’re not happy with your first choice, you can choose a different plan if you’re still within the first 30 days, and it will be retroactive to your initial date of coverage.

Do I Have to Sign Up for a Medical Plan?

No, you can waive coverage. But if you change your mind and want medical coverage, you’ll have to wait until the annual Open Enrollment in November or if you have a family status change.

New Employees Enrolling Eligible Dependents

If you have a family, you can add your legal spouse and your dependent children from birth through age 25 (up to 26th birthday) to your coverage. If you have any questions about eligibility, go to the Benefits Eligibility section for the full definition of eligible dependents.

The University will ask you to verify that your dependents are eligible. Typically, it means sending copies of your marriage certificate, birth certificate, or tax forms. 

Need More Information?

Check the schedule for the New Employee Benefits Enrollment Workshop if you would like help enrolling in your benefits.

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Using Your Medical Plan

Member ID Card

The medical plan you selected will send member ID cards to your home for you and each covered family member. You are automatically enrolled in the UPlan Pharmacy Program when you enroll in a medical plan; and you will also receive member ID cards from Prime Therapeutics.

Understanding an Explanation of Benefits

After you’ve seen a doctor or other care provider, you will receive a document from Medica that shows the amount that Medica paid on those services. This record of the services you received is called an Explanation of Benefits or EOB. It isn’t easy to interpret so check out Understanding an Explanation of Benefits (pdf) for help figuring out what you need to know.

Member Guide to Medica

The Member Guide to Medica (pdf) explains some of your health care options and has important information about your rights and responsibilities as a consumer. It also tells where to find more information if you need it.

Questions about Your Plan or Provider Options?

Questions related to your medical plan can be answered with a call to Medica Customer Service or a with a visit to their website.  

Medica
952-992-1814
877-252-5558
TTY users, please call 711

 

Additional Benefits with Your Medical Plan

When you choose a medical plan, you get access to a number of benefits designed to make getting care easier for you. All are available at no additional cost.