UCP 2021 Dual Comp Faculty Benefits Summary 4.8.21

MEDICAL INSURANCE

MEDICAL PLAN INFORMATION

65%+ FTE FACULTY 75%+ FTE STAFF

ELIGIBILITY

PLAN INFORMATION (TWO AVAILABLE)

PPO

HDHP

IN NETWORK

OUT OF NETWORK

IN NETWORK

OUT OF NETWORK

ANNUAL DEDUCTIBLE

$1, 2 00 INDIVIDUAL $2, 4 00 FAMILY

$3, 6 00 PER PERSON $ 7,4 00 FAMILY

$1, 8 00 INDIVIDUAL $3, 6 00 FAMILY

$ 6 00 INDIVIDUAL $1, 2 00 FAMILY

ANNUAL HEALTH SAVINGS ACCOUNT FUNDING (UC)

$32 5 – $825 EE $650 $1,650 FAMILY*

$325 – $825 EE $650 - $1,650 FAMILY *

NOT APPLICABLE

NOT APPLICABLE

65% AFTER DEDUCTIBLE

COVERED 100%

COVERED 100%

PREVENTIVE CARE**

65 % AFTER DEDUCTIBLE

COVERED SERVICES

80 % AFTER DEDUCTIBLE

65 % AFTER DEDUCTIBLE

80% AFTER DEDUCTIBLE

65% AFTER DEDUCTIBLE

TIER 1 (GREATEST VALUE): $20 TIER 2 (BRAND): $40 TIER 3 (HIGHER COST BRAND): $55 TIER 4 (SPECIALTY): 25% CO-INS, $250MAX

80 % AFTER DEDUCTIBLE

RETAIL PHARMACY

MAIL ORDER 90 DAY SUPPLY (MANDATORY FOR

TIER 1: $40 TIER 2: $80 TIER 3 : $110

80 % AFTER DEDUCTIBLE

MAINTENANCE MEDICATIONS)

RATES VARY BASED ON PLAN SELECTION AND ANNUAL BASE PAY*

EMPLOYEE CONTRIBUTION PLAN ADMINISTRATOR

ANTHEM

* BASED ON TOTAL ANNUAL BASE PAY (UC + UCP) ** AS RECOMMENDED BY THE AMERICAN MEDICAL ASSOCIATION

FOR MORE INFORMATION ON MEDICAL PLANS: https://www.uc.edu/employees/hr/work-at-uc.html

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