Medical Insurance

Medical insurance coverage helps you and your family access routine and preventive 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 claims processing.

By self-funding our health care insurance program, the University effectively serves as its own insurance company.  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 premiums. This pre-tax plan is governed by IRS 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 in the University's medical insurance plan 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
Plan Overview
$500/$1,000 Deductible + Copay Plan Summary of Benefits and Coverage - 2014
$500/$1,000 Deductible + CoPay Plan SPD - 2014

  • $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.
  • Calendar year medical out-of-pocket maximum for the plan year is $2,000 employee-only and $4,000 for employee plus dependent(s) and/or family.  Calendar year prescription drug out-of-pocket maximum is $2,000 for individual and $4,000 for family.  Non-covered charges and charges in excess of the allowed amount do not apply to the out-of-pocket maximum. 
  • 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
Plan Overview
$1,250/$2,500 Deductible Plan Summary of Benefits and Coverage - 2014
$1,250/$2,500 Deductible Plan SPD - 2014

  • $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.
  • Calendar year medical out-of-pocket maximum is $2,500 individual and $5,000 for family.  Calendar year prescription drug out-of-pocket maximum is $2,500 for individual and $5,000 for family.  Non-covered charges and charges in excess of the allowed amount do not apply to the out-of-pocket maximum. 
  • 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
Plan Overview
$2,500/$5,000 Deductible Plan - HDHP Summary of Benefits and Coverage - 2014  
$2,500/$5,000 Deductible Plan - HDHP SPD - 2014

  • $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.
  • Calendar year out-of-pocket maximum is $2,500 for individual and $5,000 for family.  The in- and out-of-pocket maximums for in- and out-of-networks cross apply.  Non-covered charges and charges in excess of the allowed amount do not apply to the out-of-pocket maximum  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.