The University of St. Thomas

Medical Insurance

Medical insurance coverage helps you and your family access routine and preventative health care at a reasonable cost and protects against the catastrophic costs of major illness or injury.

The University’s medical insurance program is self-funded.  This means that the University pays the total costs of medical claims made against its health-care plans.  It does not transfer the claims costs or the risk of claims to a third party (insurer).  However, the University has retained the services of Blue Cross Blue Shield of Minnesota (BCBSM) to provide third-party administrative services, such as access to a network of providers, reinsurance protection against catastrophic loss and processing claims.

By self-funding its health-care insurance program, the University effectively serves as its own insurance company, with one important distinction.  Unlike some insurers, the University does not price the medical plan to make a profit.  Employees who elect to participate in the University’s plans pay a portion of the cost through deductibles and coinsurance.  The University pays the remainder of the claim costs. 

Eligible employees' paychecks are generally reduced on a pre-tax basis by the amount of their health insurance contribution. This pre-tax plan is governed by Internal Revenue Service regulations and, as a result, there are certain limitations on an enrollee's ability to make changes to coverage levels during the year.

Annual Enrollment is held on a yearly basis during late fall at which time employees can change their medical plan and/or the level of coverage.

Below are a few highlights of each plan:

$500/$1,000 Deductible + Copay Plan

Brief Summary
Summary of Benefits and Coverage
Summary Plan Description

  • $35 office visit co-pay.
  • $500 employee-only deductible, $1,000 employee plus dependent(s) and/or family deductible.
  • 80/20 hospital benefit - you pay 20% of the hospital visit cost up to the out-of-pocket maximum.
  • Out-of-pocket maximum for plan year is $2,000 employee-only and $4,000 for employee plus dependent(s) and/or family. 
  • Prescription Drug Co-pays:
    • $15 co-pay for generic drugs
    • $35 co-pay for name brand drugs on the formulary list
    • $85 co-pay for name brand drugs that are not on the formulary list

$1,250/$2,500 Deductible Plan

Brief Summary
Summary of Benefits and Coverage 
Summary Plan Description

  • $1,250 employee-only deductible, $2,500 employee plus dependent(s) and/or family deductible.
  • 80/20 hospital benefit - you pay 20% of the office visit and/or hospital visit cost after reaching your annual deductible up to the out-of-pocket maximum.
  • Out-of-pocket maximum for plan year is $2,500 employee-only and $5,000 for employee plus dependent(s) and/or family. 
  • Prescription Drug Co-pays:
    • $15 co-pay for generic drugs
    • $35 co-pay for name brand drugs on the formulary list
    • $85 co-pay for name brand drugs that are not on the formulary list

$2,500/$5,000 Deductible Plan - HDHP

Brief Summary
Summary of Benefits and Coverage
Summary Plan Description

  • $2,500 employee-only deductible, $5,000 employee plus dependent(s) and/or family deductible.
  • After the deductible, 100% coverage for all services and prescriptions.
  • Out-of-pocket maximum for plan year is $2,500 employee-only and $5,000 for employee plus dependent(s) and/or family. 
  • The HDHP includes the cost of prescription drugs in the deductible.  There are no drug co-pays.

Before requesting a change to your current election during a plan year, contact a benefits team member to check your eligibility.

More information is available by clicking on the following links:

Medical insurance forms can be found in our Forms Library.