Health Insurance Plans

University of Missouri

Faculty and

Staff Benefits

Your 2015Annual EnrollmentDecision Guide

You must select and submit a medical plan choice or waive

coverage during this year’s Annual Enrollment. If you take no

action by October 31, you and your currently enrolled family

members will be defaulted to the Healthy Savings Plan on an

after-tax basis effective January 1, 2015.

Annual Enrollment:October 20 - 31, 2014

This year is differentThis year is different

Questions? Contact the HR

Service Center at 573-882-2146

or [email protected].

This year, the University of Missouri is taking a new

approach to our medical plan offerings – designed to slow

the growth of health care costs for faculty and staff as well

as the university, and reward you for a healthy lifestyle. You

will see an innovative new plan in Columbia, changes to

our existing medical plans and employee contributions, and

expanded wellness incentives.

Medical plan changes New, more descriptive plan names for our medical options:• Healthy Savings Plan: formerly myOptions Health Plan

• PPO Plan: formerly myChoice Health Plan

Healthy Savings Plan changes:• University contribution to Health Savings Account:

º Self only: $400

º Self & spouse: $800

º Self & child(ren): $800

º Family: $1,200

Custom Network Plan: This is a new option for those who

live and/or work in the Columbia area. The plan offers a

focused network of providers – most affiliated with the

University of Missouri Heath System.

PPO Plan changes: • Deductible

º In-network: $350/person; $1,050/family

º Non-network: $700/person; $2,100/family

• Out-of-Pocket Maximum:

º In-network: $3,600/person; $7,200/family

º Non-network: $7,500/person; $15,000/family

º Prescription drugs: $3,000/person; $6,000/family

• Elimination of discounted physician copay for using

university providers

New medical and vision plan employee contributions: see enclosed premium insert for details.

Up to $450 in wellness incentivesThe university is increasing its commitment to your health with

new wellness resources and rewards. See page 2 for details.

Active enrollment required—take action to make sure your coverage for 2015 is the right fit for youUnlike previous years, you must select and submit a medical

plan choice or waive coverage. Both you and the university

contribute a significant amount toward your medical

coverage. With this kind of investment, you should make

sure you enroll in the medical option that best suits your

needs. If you take no action by October 31, 2014, you and your currently enrolled family members will be defaulted to the Healthy Savings Plan for 2015 and pay taxes on the premiums. If you previously waived coverage and do not waive coverage or select a medical plan, you will default to employee only coverage and pay taxes on the premiums.

Understand your options• Read this Decision Guide and use the myBenefit Decision

Center in myHR at http://myhr.umsystem.edu to compare

the medical plans.

• Attend a Town Hall, department or one-on-one education

session, or watch an annual enrollment video. Visit http://

umurl.us/2015AE for information.

• Go to http://umurl.us/2015WELL to learn more about our

new wellness incentives.

Take action • Enroll online through the University of Missouri’s myHR

at http://myhr.umsystem.edu. Annual Enrollment runs

from October 20 to 31, 2014. You need to take action by

October 31, 2014; otherwise you will be defaulted to the

Healthy Savings Plan and pay taxes on the premiums.

(See page 4 for details.)

• Learn more about and start earning your 2015 Wellness

Incentive by visiting http://umurl.us/2015WELL. You’ll be

asked to make the wellness pledge during the enrollment

process. (See page 2 for details.)

• Provide Proof of Relationship for any dependents you are

adding to your benefit plans. View proof of relationship

requirements at https://uminfopoint.umsystem.edu/sites/

hr/Benefits/ProofofRelationship.pdf.

After enrollment• Watch your home mail in early December for a

Confirmation of Elections Statement and verify that your

elections match the changes you submitted during Annual

Enrollment. You’ll receive ID cards for your medical plan

by the end of the year. Be sure to use your new card when

visiting your provider after January 1, 2015.

1

What’s new for 2015

What you need to do

What’s insideWhat’s new for 2015 1

What you need to do 1

Earn up to $450 in 2wellness incentives

Your 2015 medical plan options 4

Healthy Savings Plan 4

Custom Network Plan 5

PPO Plan 6

Prescription drug coverage 7

Compare your medical 8plan options

HSAs and FSAs: what’s 10the difference?

Resource list 12

Questions? Contact the HR

Service Center at 573-882-2146

or [email protected].

This year, the University of Missouri is taking a new

approach to our medical plan offerings – designed to slow

the growth of health care costs for faculty and staff as well

as the university, and reward you for a healthy lifestyle. You

will see an innovative new plan in Columbia, changes to

our existing medical plans and employee contributions, and

expanded wellness incentives.

Medical plan changes New, more descriptive plan names for our medical options:• Healthy Savings Plan: formerly myOptions Health Plan

• PPO Plan: formerly myChoice Health Plan

Healthy Savings Plan changes:• University contribution to Health Savings Account:

º Self only: $400



º Family: $1,200

Custom Network Plan: This is a new option for those who

live and/or work in the Columbia area. The plan offers a

focused network of providers – most affiliated with the

University of Missouri Heath System.

PPO Plan changes: • Deductible

º In-network: $350/person; $1,050/family

º Non-network: $700/person; $2,100/family

• Out-of-Pocket Maximum:

º In-network: $3,600/person; $7,200/family

º Non-network: $7,500/person; $15,000/family

º Prescription drugs: $3,000/person; $6,000/family

• Elimination of discounted physician copay for using

university providers

New medical and vision plan employee contributions: see enclosed premium insert for details.

Up to $450 in wellness incentivesThe university is increasing its commitment to your health with

new wellness resources and rewards. See page 2 for details.

Active enrollment required—take action to make sure your coverage for 2015 is the right fit for youUnlike previous years, you must select and submit a medical

plan choice or waive coverage. Both you and the university

contribute a significant amount toward your medical

coverage. With this kind of investment, you should make

sure you enroll in the medical option that best suits your

needs. If you take no action by October 31, 2014, you and your currently enrolled family members will be defaulted to the Healthy Savings Plan for 2015 and pay taxes on the premiums. If you previously waived coverage and do not waive coverage or select a medical plan, you will default to employee only coverage and pay taxes on the premiums.

Understand your options• Read this Decision Guide and use the myBenefit Decision

Center in myHR at http://myhr.umsystem.edu to compare

the medical plans.

• Attend a Town Hall, department or one-on-one education

session, or watch an annual enrollment video. Visit http://

umurl.us/2015AE for information.

• Go to http://umurl.us/2015WELL to learn more about our

new wellness incentives.

Take action • Enroll online through the University of Missouri’s myHR

at http://myhr.umsystem.edu. Annual Enrollment runs

from October 20 to 31, 2014. You need to take action by

October 31, 2014; otherwise you will be defaulted to the

Healthy Savings Plan and pay taxes on the premiums.

(See page 4 for details.)

• Learn more about and start earning your 2015 Wellness

Incentive by visiting http://umurl.us/2015WELL. You’ll be

asked to make the wellness pledge during the enrollment

process. (See page 2 for details.)

• Provide Proof of Relationship for any dependents you are

adding to your benefit plans. View proof of relationship

requirements at https://uminfopoint.umsystem.edu/sites/

hr/Benefits/ProofofRelationship.pdf.

After enrollment• Watch your home mail in early December for a

Confirmation of Elections Statement and verify that your

elections match the changes you submitted during Annual

Enrollment. You’ll receive ID cards for your medical plan

by the end of the year. Be sure to use your new card when

visiting your provider after January 1, 2015.

1

What’s new for 2015

What you need to do

What’s insideWhat’s new for 2015 1

What you need to do 1

Earn up to $450 in 2wellness incentives

Your 2015 medical plan options 4

Healthy Savings Plan 4

Custom Network Plan 5

PPO Plan 6

Prescription drug coverage 7

Compare your medical 8plan options

HSAs and FSAs: what’s 10the difference?

Resource list 12

The university is introducing exciting changes to the

wellness program for 2015 that reward your efforts toward

living healthfully – with up to $450 in your paycheck!

It starts with making a Wellness Pledge…When you enroll for 2015 benefits, you’ll be asked to sign a

“Wellness Pledge” or decline to participate in the program.

Making the pledge is a new (and required) step toward

earning up to $450 in wellness incentives. Note that taxes

will be withheld from this amount.

My Wellness Pledge 1. I pledge to wear a seatbelt 100% of the time while in a motor vehicle.2. I pledge to increase my knowledge of healthy eating.3. I pledge to become aware of applicable preventive medical and dental exams for myself and my family.4. I pledge to exercise regularly.

…Then take additional action to earn your reward1. Complete the rest of the activities on the “Educate

Yourself” list to earn 150 points by April 30, 2015, and

receive $150 in your May 2015 paycheck.

2. Complete additional activities that you choose from the

“Invest in Yourself” list to earn 300 points by September

30, 2015, and receive another $300 in your October 2015

paycheck.

For details and to get started, visit http://umurl.us/2015WELL.

Who has access to your information?The Personal Health Assessment and biometric information

that you provide in Tier 1 are stored in a third-party data

system maintained by Cerner Corporation and protected

by the Health Insurance Portability and Accountability

Act (HIPAA). This information is not shared with Coventry,

UM’s medical administrator. The data is de-identified and

accumulated to provide collective information that assists

the university in developing programs to address general

health behaviors and prevalent health issues.

Educate Yourself (Tier 1)Complete all 150 points from these activities by April 30, 2015, to earn $150

Invest in Yourself (Tier 2)Complete all 300 points from these activities by September 30, 2015, to earn an additional $300

You must complete Tier 1 to be eligible for the Tier 2 incentive.

Healthy Activity Activity Points Maximum Points

Get my Flu Shot 50 50

Remain Tobacco-free or Complete a Tobacco Cessation Program 100 100

Complete a Personal Health Action Plan 10 50

Take an Online Wellness Workshop 25 150

Listen to Mindfulness Meditation or Yoga Recordings 10 100

Complete a UM Mindfulness-Based Stress Reduction Course* 100 100

Participate in a Weight Watchers© Program for at least 3 months 100 100

Complete a UM Eat for Life Course* 100 100

Engage in Physical Activity, On or Off Campus 10 100

Walk 1 Million Steps 100 200

Bike 500 Miles 100 200


Make my Wellness Pledge 50 50

Complete my Online Personal Health Assessment 50 50

Complete my Biometric Health Screening 50 50

Here’s how it all works together:

Federal law requires the university to provide an alternative

for any employee who has a health condition or disability

that makes it unreasonably difficult (or medically

inadvisable) to attempt to meet a standard in a wellness

program. If you think you might be unable to meet a

program standard due to your health status or disability,

contact [email protected] to discuss how this

applies and the alternatives available to you.

Important note for tobacco users:

In 2016, you and your enrolled family

members will receive a medical plan

premium discount for being tobacco-free.

We understand that quitting tobacco can be a difficult

process. That’s why we’re letting you know about this a

year in advance – so you have the time to take action.

To help you get started, our 2015 wellness program

described above offers you 100 points towards your Tier 2

incentive for remaining tobacco-free or participating in a

tobacco cessation program. Visit http://umurl.us/tobacco

to learn about available tobacco cessation programs.

Educate yourself. Invest in yourself.Earn up to $450 in wellness incentives.

3

* Only first-time participants in these courses may earn activity points.

The university is introducing exciting changes to the

wellness program for 2015 that reward your efforts toward

living healthfully – with up to $450 in your paycheck!

It starts with making a Wellness Pledge…When you enroll for 2015 benefits, you’ll be asked to sign a

“Wellness Pledge” or decline to participate in the program.

Making the pledge is a new (and required) step toward

earning up to $450 in wellness incentives. Note that taxes

will be withheld from this amount.

My Wellness Pledge 1. I pledge to wear a seatbelt 100% of the time while in a motor vehicle.2. I pledge to increase my knowledge of healthy eating.3. I pledge to become aware of applicable preventive medical and dental exams for myself and my family.4. I pledge to exercise regularly.

…Then take additional action to earn your reward1. Complete the rest of the activities on the “Educate

Yourself” list to earn 150 points by April 30, 2015, and

receive $150 in your May 2015 paycheck.

2. Complete additional activities that you choose from the

“Invest in Yourself” list to earn 300 points by September

30, 2015, and receive another $300 in your October 2015

paycheck.

For details and to get started, visit http://umurl.us/2015WELL.

Who has access to your information?The Personal Health Assessment and biometric information

that you provide in Tier 1 are stored in a third-party data

system maintained by Cerner Corporation and protected

by the Health Insurance Portability and Accountability

Act (HIPAA). This information is not shared with Coventry,

UM’s medical administrator. The data is de-identified and

accumulated to provide collective information that assists

the university in developing programs to address general

health behaviors and prevalent health issues.

Educate Yourself (Tier 1)Complete all 150 points from these activities by April 30, 2015, to earn $150

Invest in Yourself (Tier 2)Complete all 300 points from these activities by September 30, 2015, to earn an additional $300

You must complete Tier 1 to be eligible for the Tier 2 incentive.


Get my Flu Shot 50 50

Remain Tobacco-free or Complete a Tobacco Cessation Program 100 100

Complete a Personal Health Action Plan 10 50

Take an Online Wellness Workshop 25 150

Listen to Mindfulness Meditation or Yoga Recordings 10 100

Complete a UM Mindfulness-Based Stress Reduction Course* 100 100

Participate in a Weight Watchers© Program for at least 3 months 100 100

Complete a UM Eat for Life Course* 100 100

Engage in Physical Activity, On or Off Campus 10 100

Walk 1 Million Steps 100 200

Bike 500 Miles 100 200


Make my Wellness Pledge 50 50

Complete my Online Personal Health Assessment 50 50

Complete my Biometric Health Screening 50 50

Here’s how it all works together:

Federal law requires the university to provide an alternative

for any employee who has a health condition or disability

that makes it unreasonably difficult (or medically

inadvisable) to attempt to meet a standard in a wellness

program. If you think you might be unable to meet a

program standard due to your health status or disability,

contact [email protected] to discuss how this

applies and the alternatives available to you.

Important note for tobacco users:

In 2016, you and your enrolled family

members will receive a medical plan

premium discount for being tobacco-free.

We understand that quitting tobacco can be a difficult

process. That’s why we’re letting you know about this a

year in advance – so you have the time to take action.

To help you get started, our 2015 wellness program

described above offers you 100 points towards your Tier 2

incentive for remaining tobacco-free or participating in a

tobacco cessation program. Visit http://umurl.us/tobacco

to learn about available tobacco cessation programs.

Educate yourself. Invest in yourself.Earn up to $450 in wellness incentives.

3

* Only first-time participants in these courses may earn activity points.

The university offers you a choice of three medical

plan options:

• Healthy Savings Plan

• NEW: Custom Network Plan

• PPO Plan

This section provides a summary of the plans; refer to

pages 8-9 for a side-by-side comparison. Visit http://umurl.

us/2015AE to view a plan comparison video.

Healthy Savings PlanThe Healthy Savings Plan offers lower premiums than

your other medical options, along with the opportunity to

benefit from a Health Savings Account (HSA), which can

help reduce your taxable income and provide a health care

financial nest egg for the future. Although your deductible

will be higher, part of that cost is covered by university

contributions to your HSA.

Are you eligible for this plan?Any benefit-eligible employee can choose this plan.

Your 2015medical

plan options

How the plan works The Healthy Savings Plan covers the same medical services

as the other medical plan options, and you’ll have access

to the same broad provider network as the PPO Plan. The

main difference is in how the plan works.

• The university contributes to an HSA for you. Your HSA

can be used for eligible medical, prescription, dental

and vision expenses. If you don’t spend all the money

in your HSA in 2015, it will roll over and can be used in

future years.

• The university contribution to your HSA is based on your

coverage level:

º Self only: $400



º Family: $1,200

• You have the choice of seeing in-network or

out-of-network providers. If you stay in-network, your

costs may be much lower.

• Cole• Cooper• Howard

• Moniteau• Osage• Randolph

• Audrain• Boone• Callaway

5

Custom Network Plan – For those who live or work in the Columbia areaIf you live or work in the Columbia area, the Custom Network

Plan offers you an attractive combination of low premiums,

comprehensive coverage and a high-quality provider network

affiliated with the University of Missouri Health System.

Are you eligible for this plan?To enroll in the Custom Network Plan, you must live or work

in one of the following counties:

• In-network preventive care is covered at 100% (meaning

there is no charge to you and no deductible applies).

Preventive care includes annual physical exams (including

associated lab and X-ray services), immunizations and

well-child care. You can find preventive care guidelines at

www.ummedcvty.com.

• As you incur other covered expenses, you can use your

HSA funds or pay directly until you meet your annual

deductible. The in-network deductible is:

º $1,500 for single coverage

º $3,000 for family coverage

• After you meet the deductible, you’ll pay 10% of the

cost of covered in-network services until you reach the

out-of-pocket maximum, which includes deductibles,

coinsurance and prescription drug charges.

• Once you meet your annual out-of-pocket maximum, the

plan will pay 100% of covered expenses for the rest of

the calendar year.

See page 10 for more details on HSAs and page 8 for more

Healthy Savings Plan coverage details.

About network providersThis innovative network gives you access to University of

Missouri Health Care and Capital Region Medical Center

providers, clinics and hospitals, as well as others. Visit

www.ummedcvty.com to see the list of network providers.

How the plan worksWith this plan, you have the choice of seeing in-network or

out-of-network providers. If you stay in-network, your costs

may be much lower.

How the Custom Network and PPO plans cover prescription drugs

Under the Healthy Savings Plan, you benefit from the prescription drug

discount but pay the full cost of covered prescription drugs until you

meet the deductible. After you meet the deductible, you pay 10% of

covered prescription costs until you reach the combined medical and

prescription drug out-of-pocket maximum. At that point, the plan pays

100% of covered prescription costs for the rest of the calendar year.

Custom Network Plan PPO Plan

No deductibleFormulary Generic: greater of $7 copay or 20% coinsuranceFormulary Brand: greater of $15 copay or 20% coinsuranceNon-Formulary Brand: greater of $30 copay or 50% coinsurance


$3,000/person$6,000/family

$75 deductibleFormulary Generic: greater of $7 copay or 20% after deductibleFormulary Brand: greater of $15 copay or 20% after deductibleNon-Formulary Brand: greater of $30 copay or 50% after deductible



Retail Prescriptions(up to 31-day supply)

Mail Order Prescriptions(up to 90-day supply) Includes University of Missouri Health System Pharmacies

Prescription Drug Out-of-Pocket Maximum

How the Healthy Savings Plan

covers prescription drugs

Prescription drug coverage

7

• You’ll pay no deductible for in-network services or

prescription drugs.






www.ummedcvty.com.

• Your in-network office visit copayment will be only $5

for non-specialists and $25 for specialists. You’ll also

have access to Mizzou Quick Care Clinics at each of the

Columbia Hy-Vee stores for only a $5 copayment.

• Once you meet your annual out-of-pocket maximum,

the plan will pay 100% of eligible expenses (including

coinsurance and copayments) for the rest of the

calendar year.

• If you do not currently have a university provider, you can call

573-884-0432 on an ongoing basis to help identify primary

care and specialty physicians.

See page 8-9 for more coverage details.

PPO PlanThe PPO Plan has the same Coventry provider network as

before. You’ll pay higher premiums than for the other two

plans. Unlike the Custom Network Plan, you’ll need to pay a

deductible even if you use in-network providers.




may be much lower.

• In-network preventive care is covered at no charge

(meaning there is no charge to you and no deductible

applies). Preventive care includes annual physical

exams (including associated lab and X-ray services),

immunizations and well-child care. You can find

preventive care guidelines at www.ummedcvty.com.

• For most covered expenses, you’ll pay out of your pocket

until you reach the annual deductible. The in-network

deductible is:

º $350/person

º $1,050/family

• Your in-network office visit copayment will be $15 for

non-specialists and $25 for specialists. There will no longer

be a discount under this plan for using university providers.

• For in-network retail prescription drugs, you’ll pay a $75

deductible plus a copayment or coinsurance.


plan will pay 100% of expenses (including deductibles,


calendar year.

See page 9 for more coverage details.

How the Custom Network and PPO plans cover prescription drugs

Under the Healthy Savings Plan, you benefit from the prescription drug

discount but pay the full cost of covered prescription drugs until you

meet the deductible. After you meet the deductible, you pay 10% of

covered prescription costs until you reach the combined medical and

prescription drug out-of-pocket maximum. At that point, the plan pays

100% of covered prescription costs for the rest of the calendar year.

Custom Network Plan PPO Plan




$75 deductibleFormulary Generic: greater of $7 copay or 20% after deductibleFormulary Brand: greater of $15 copay or 20% after deductibleNon-Formulary Brand: greater of $30 copay or 50% after deductible



Retail Prescriptions(up to 31-day supply)

Mail Order Prescriptions(up to 90-day supply) Includes University of Missouri Health System Pharmacies

Prescription Drug Out-of-Pocket Maximum

How the Healthy Savings Plan

covers prescription drugs

Prescription drug coverage

7

• You’ll pay no deductible for in-network services or

prescription drugs.






www.ummedcvty.com.

• Your in-network office visit copayment will be only $5

for non-specialists and $25 for specialists. You’ll also

have access to Mizzou Quick Care Clinics at each of the

Columbia Hy-Vee stores for only a $5 copayment.

• Once you meet your annual out-of-pocket maximum,

the plan will pay 100% of eligible expenses (including


calendar year.

• If you do not currently have a university provider, you can call

573-884-0432 on an ongoing basis to help identify primary

care and specialty physicians.

See page 8-9 for more coverage details.

PPO PlanThe PPO Plan has the same Coventry provider network as

before. You’ll pay higher premiums than for the other two

plans. Unlike the Custom Network Plan, you’ll need to pay a

deductible even if you use in-network providers.




may be much lower.

• In-network preventive care is covered at no charge

(meaning there is no charge to you and no deductible

applies). Preventive care includes annual physical

exams (including associated lab and X-ray services),

immunizations and well-child care. You can find

preventive care guidelines at www.ummedcvty.com.

• For most covered expenses, you’ll pay out of your pocket

until you reach the annual deductible. The in-network

deductible is:

º $350/person

º $1,050/family

• Your in-network office visit copayment will be $15 for

non-specialists and $25 for specialists. There will no longer

be a discount under this plan for using university providers.

• For in-network retail prescription drugs, you’ll pay a $75

deductible plus a copayment or coinsurance.


plan will pay 100% of expenses (including deductibles,


calendar year.

See page 9 for more coverage details.

Annual Premium

Annual Wellness IncentiveOpportunity

Annual University Contribution to Health Savings Account

Your Net Annual Cost*

HealthySavings Plan

$1,020

-$450

-$400

$170

PPO Plan

$1,824

-$450

$0

$1,374

CustomNetwork Plan

$2,760

-$450

$0

$2,310

HealthySavings Plan

$2,040

-$450

-$800

$790

CustomNetwork Plan

$2,352

-$450

$0

$1,902

HealthySavings Plan

$1,740

-$450

-$800

$490

PPO Plan

$3,096

-$450

$0

$2,646

CustomNetwork Plan

$3,864

-$450

$0

$3,414

HealthySavings Plan

$2,856

-$450

-$1,200

$1,206

PPO Plan

$5,112

-$450

$0

$4,662

Self, Spouse & Children

2015 coverage cost and contributions overview Self Self & Spouse Self & Child(ren)

Compare your medical plan options

9

In-Network

$0

$0

$5 copay (includesMizzou Quick Care)

$25 copay

$50 copay

No charge

$100 copay/visit

$300 copay/confinement ($0 copay for maternity delivery)

$100 copay/visit


Out-of-Network

$500/person$1,500/family

30% after deductible







$100 copay/visit after deductible


In-Network Out-of-Network

$3,000/single coverage$6,000/family coverage









N/A

N/A


In-Network


$0

$15 copay

$25 copay

$50 copay

No charge after annual deductible


$300 copay/confinement after deductible



Out-of-Network











What you pay for in-network covered expenses in 2015* Healthy Savings Plan Custom Network Plan PPO Plan

Deductible

Preventive Services

Primary Care Office Visit

Specialist Office Visit

Urgent Care

Lab & X-ray

Outpatient Visit

Inpatient Visit

Emergency Room

Medical Plan Out-of-Pocket Limit (Deductible, copays & coinsurance)

Prescription Drug Out-of-Pocket Limit*

Combined Medical & Prescription Drug Out-of-Pocket Limit*


N/A


$0








N/A

N/A



N/A

The Custom Network Plan and PPO

Plan have separate out-of-pocket

limits for medical and prescription

drug expenses. However, the

Healthy Savings Plan combines

medical and prescription drug

out-of-pocket limits. See page 7 for

details on prescription drug benefits.


N/A

CustomNetwork Plan

$1,380

-$450

$0

$930

PPO Plan

$3,648

-$450

$0

$3,198

*

*Does not include out-of-pocket costs for medical and prescription drugs. Use the myBenefit Decision Center in myHR to compare plan out-of-pocket costs.

Annual Premium

Annual Wellness IncentiveOpportunity

Annual University Contribution to Health Savings Account

Your Net Annual Cost*

HealthySavings Plan

$1,020

-$450

-$400

$170

PPO Plan

$1,824

-$450

$0

$1,374

CustomNetwork Plan

$2,760

-$450

$0

$2,310

HealthySavings Plan

$2,040

-$450

-$800

$790

CustomNetwork Plan

$2,352

-$450

$0

$1,902

HealthySavings Plan

$1,740

-$450

-$800

$490

PPO Plan

$3,096

-$450

$0

$2,646

CustomNetwork Plan

$3,864

-$450

$0

$3,414

HealthySavings Plan

$2,856

-$450

-$1,200

$1,206

PPO Plan

$5,112

-$450

$0

$4,662

Self, Spouse & Children

2015 coverage cost and contributions overviewSelf Self & Spouse Self & Child(ren)

Compare your medical plan options

9

In-Network

$0

$0

$5 copay (includesMizzou Quick Care)

$25 copay

$50 copay

No charge

$100 copay/visit

$300 copay/confinement ($0 copay for maternity delivery)

$100 copay/visit


Out-of-Network











In-Network Out-of-Network










N/A

N/A


In-Network


$0

$15 copay

$25 copay

$50 copay

No charge after annual deductible


$300 copay/confinement after deductible



Out-of-Network











What you pay for in-network covered expenses in 2015*Healthy Savings Plan Custom Network Plan PPO Plan

Deductible

Preventive Services

Primary Care Office Visit

Specialist Office Visit

Urgent Care

Lab & X-ray

Outpatient Visit

Inpatient Visit

Emergency Room

Medical Plan Out-of-Pocket Limit (Deductible, copays & coinsurance)

Prescription Drug Out-of-Pocket Limit*

Combined Medical & Prescription Drug Out-of-Pocket Limit*


N/A


$0








N/A

N/A



N/A

The Custom Network Plan and PPO

Plan have separate out-of-pocket

limits for medical and prescription

drug expenses. However, the

Healthy Savings Plan combines

medical and prescription drug

out-of-pocket limits. See page 7 for

details on prescription drug benefits.


N/A

CustomNetwork Plan

$1,380

-$450

$0

$930

PPO Plan

$3,648

-$450

$0

$3,198

*

*Does not include out-of-pocket costs for medical and prescription drugs. Use the myBenefit Decision Center in myHR to compare plan out-of-pocket costs.

If you want to contribute to an

FSA for 2015, be sure to make your

election by the Annual Enrollment

deadline, October 31, 2014.

• You receive a debit card that you can use to pay for

eligible expenses once funds are available in your account.

• You have online access to your HSA, similar to a checking

account. You can instantly see your account balance and

track and pay your expenses.

• You can invest your HSA funds in select mutual funds,

once your account balance is over $2,000.

• Your HSA funds and any earnings are tax-free as long

as you use them for eligible medical, prescription drug,

dental and vision expenses.

• If you don’t use your entire HSA balance during the

calendar year, it will roll over for use in future years.

• If you leave the university, you take your HSA money

with you.

• If you are selecting this plan during Annual Enrollment,

your HSA will be established on January 1, and the

university contribution will be available within three to

four weeks after your HSA is established.

• If you are currently enrolled in an FSA and switching to

an HSA for the next plan year, you must use all your FSA

funds by December 31 of the current plan year. If you

have funds left over, you can still enroll in the HSA, but

HSAs and FSAs:what’s the difference?

11

you cannot carry over any funds from the FSA, and the

university cannot contribute to your HSA until after April 1.

Flexible Spending AccountsYou have the option of enrolling in the Health Care and/or

Dependent Care Flexible Spending Accounts (FSAs) to

help pay for health and dependent care expenses with

pre-tax dollars. Use the myBenefit Decision Center in

myHR at http://myhr.umsystem.edu to help estimate your

contributions. You must enroll in the FSAs each year – your

elections do not carry over.

Are you eligible for these accounts?You can only enroll in the Health Care FSA if you select

the Custom Network Plan or PPO Plan. If you enroll in the

Healthy Savings Plan, you’ll have a Health Savings Account

(HSA) instead.

You can enroll in the Dependent Care FSA no matter which

medical option you choose.

How the FSAs workThere are two separate FSAs (Health Care and Dependent

Care) but they work the same way:

• You contribute to the accounts on a pre-tax basis, so you

save money in taxes.

• Your maximum contribution is:

º Health Care FSA: $2,500/year

º Dependent Care FSA: $5,000/year

Health Savings AccountIf you enroll in the Healthy Savings Plan, you have the

option of adding your own money to your Health Savings

Account (HSA), along with the university’s contribution.

Are you eligible for this account?You can have an HSA only if you are enrolled in the Healthy

Savings Plan. You cannot have an HSA if:

• You are covered by another health plan (including

Medicare).

• You are claimed as a dependent on someone else’s

tax return.

• You or your spouse are enrolled in a Health Care FSA.

How the HSA works• You contribute to the HSA on a pre-tax basis, so you save

money on taxes.

• Your maximum contribution*, after the university’s

contribution, is based on your coverage level:

º Self only: $2,950/year

º Self & spouse: $5,850/year

º Self & child(ren): $5,850/year

º Family: $5,450/year

• You can submit your claims online or via fax and have

your reimbursements deposited directly into your

preferred account.

• You can use the Health Care FSA for eligible medical,

prescription drug, dental and vision expenses.

• You can use the Dependent Care FSA for eligible

dependent care expenses.

• You have online access to your FSA, so you can instantly

track your expenses and account balance.

• You can use your Health Care FSA funds from January

1 of the current plan year through March 31 of the next

plan year. However, if you are changing from an FSA to

an HSA, all FSA funds must be used by December 31.

Due to increased claims submissions at year-end, be sure

to submit claims early since reimbursements can take

longer than the normal two business days.

• Funds not used by March 31, 2015, cannot be rolled over.

• If you leave the university, the money stays in your

account through the end of the plan year. However, you

may only use it for eligible expenses incurred before your

termination date.

For details, visit the University of Missouri myTotal Rewards

website at www.umsystem.edu/totalrewards.

*Age 55 and older may contribute an additional $1,000/year.

If you want to contribute to an

FSA for 2015, be sure to make your

election by the Annual Enrollment

deadline, October 31, 2014.

• You receive a debit card that you can use to pay for

eligible expenses once funds are available in your account.

• You have online access to your HSA, similar to a checking

account. You can instantly see your account balance and

track and pay your expenses.

• You can invest your HSA funds in select mutual funds,

once your account balance is over $2,000.

• Your HSA funds and any earnings are tax-free as long

as you use them for eligible medical, prescription drug,

dental and vision expenses.

• If you don’t use your entire HSA balance during the

calendar year, it will roll over for use in future years.

• If you leave the university, you take your HSA money

with you.

• If you are selecting this plan during Annual Enrollment,

your HSA will be established on January 1, and the

university contribution will be available within three to

four weeks after your HSA is established.

• If you are currently enrolled in an FSA and switching to

an HSA for the next plan year, you must use all your FSA

funds by December 31 of the current plan year. If you

have funds left over, you can still enroll in the HSA, but

HSAs and FSAs:what’s the difference?

11

you cannot carry over any funds from the FSA, and the

university cannot contribute to your HSA until after April 1.

Flexible Spending AccountsYou have the option of enrolling in the Health Care and/or

Dependent Care Flexible Spending Accounts (FSAs) to

help pay for health and dependent care expenses with

pre-tax dollars. Use the myBenefit Decision Center in

myHR at http://myhr.umsystem.edu to help estimate your

contributions. You must enroll in the FSAs each year – your

elections do not carry over.

Are you eligible for these accounts?You can only enroll in the Health Care FSA if you select

the Custom Network Plan or PPO Plan. If you enroll in the

Healthy Savings Plan, you’ll have a Health Savings Account

(HSA) instead.

You can enroll in the Dependent Care FSA no matter which

medical option you choose.

How the FSAs workThere are two separate FSAs (Health Care and Dependent

Care) but they work the same way:

• You contribute to the accounts on a pre-tax basis, so you

save money in taxes.

• Your maximum contribution is:

º Health Care FSA: $2,500/year

º Dependent Care FSA: $5,000/year

Health Savings AccountIf you enroll in the Healthy Savings Plan, you have the

option of adding your own money to your Health Savings

Account (HSA), along with the university’s contribution.

Are you eligible for this account?You can have an HSA only if you are enrolled in the Healthy

Savings Plan. You cannot have an HSA if:

• You are covered by another health plan (including

Medicare).

• You are claimed as a dependent on someone else’s

tax return.

• You or your spouse are enrolled in a Health Care FSA.

How the HSA works• You contribute to the HSA on a pre-tax basis, so you save

money on taxes.

• Your maximum contribution*, after the university’s

contribution, is based on your coverage level:

º Self only: $2,950/year

º Self & spouse: $5,850/year

º Self & child(ren): $5,850/year

º Family: $5,450/year

• You can submit your claims online or via fax and have

your reimbursements deposited directly into your

preferred account.

• You can use the Health Care FSA for eligible medical,

prescription drug, dental and vision expenses.

• You can use the Dependent Care FSA for eligible

dependent care expenses.

• You have online access to your FSA, so you can instantly

track your expenses and account balance.

• You can use your Health Care FSA funds from January1 of the current plan year through March 15 of the next plan year. However, if you are changing from an FSA to an

HSA, all FSA funds must be used by December 31. Due to

increased claims submissions at year-end, be sure to

submit claims early since reimbursements can take longer

than the normal two business days.

• Funds not used by March 15, 2015, cannot be rolled over.

• If you leave the university, the money stays in your

account through the end of the plan year. However, you

may only use it for eligible expenses incurred before your

termination date.

For details, visit the University of Missouri myTotal Rewards

website at www.umsystem.edu/totalrewards.

*Age 55 and older may contribute an additional $1,000/year.

To contact plan providers…

Resource list

Benefit Administrator Phone Website

Coventry

Custom Network and PPO Plans:Express ScriptsAccredo (specialty drugs)

Healthy Savings Plan: Coventry (through Medco)

Healthy for Life

ASI

Health Equity

www.ummedcvty.com

www.express-scripts.com

www.ummedcvty.com

www.wellness.umsystem.edu

www.asiflex.com

www.healthequity.com

Medical Plans

Prescription Drugs

Healthy for Life Wellness Program

Flexible Spending Accounts

Health Savings Account

800-613-7721

800-955-1201

800-378-7040

573-884-1312

800-659-3035

877-372-5383

12

Campus Phone Email

[email protected]

[email protected]

[email protected]

[email protected]

MU, UM System, MUHC

UMKC

Missouri S&T

UMSL

573-882-2146

816-235-1621

573-341-4241

314-516-5639

To contact your campus benefits representative…

This Annual Enrollment Decision Guide provides a summary of various plans included in the University of Missouri System benefit program effective January 1, 2015. Complete details of the plans are included in the University of Missouri Collected Rules and Regulations (CRR) and policies. If there is a difference between this Annual Enrollment Decision Guide and the CRR, then the CRR will govern in every instance. In addition, the University of Missouri System reserves the right to change or terminate the benefits program, individual plans or any provisions of any plans at any time.

Visit myHR at http://myhr.umsystem.edu

Visit http://umurl.us/2015AE

Visit http://umurl.us/2015AE to make an individual appointment

Compare medical plan benefits and costs,estimate HSA and FSA contributions

Annual Enrollment information, videosand other resources

Learn about medical plan options

myBenefit DecisionCenter

Annual Enrollmentwebpage

One-on-one support

Resource Description How to Find

For more information about your medical choices and how to enroll…

To contact plan providers…

Resource list

Benefit Administrator Phone Website

Coventry

Custom Network and PPO Plans:Express ScriptsAccredo (specialty drugs)

Healthy Savings Plan: Coventry (through Medco)

Healthy for Life

ASI

Health Equity

www.ummedcvty.com

www.express-scripts.com

www.ummedcvty.com

www.wellness.umsystem.edu

www.asiflex.com

www.healthequity.com

Medical Plans

Prescription Drugs

Healthy for Life Wellness Program

Flexible Spending Accounts

Health Savings Account

800-613-7721

800-955-1201

800-378-7040

573-884-1312

800-659-3035

877-372-5383

12

Campus Phone Email

[email protected]

[email protected]

[email protected]

[email protected]

MU, UM System, MUHC

UMKC

Missouri S&T

UMSL

573-882-2146

816-235-1621

573-341-4241

314-516-5639

To contact your campus benefits representative…

This Annual Enrollment Decision Guide provides a summary of various plans included in the University of Missouri System benefit program effective January 1, 2015. Complete details of the plans are included in the University of Missouri Collected Rules and Regulations (CRR) and policies. If there is a difference between this Annual Enrollment Decision Guide and the CRR, then the CRR will govern in every instance. In addition, the University of Missouri System reserves the right to change or terminate the benefits program, individual plans or any provisions of any plans at any time.

Visit myHR at http://myhr.umsystem.edu

Visit http://umurl.us/2015AE

Visit http://umurl.us/2015AE to make an individual appointment

Compare medical plan benefits and costs,estimate HSA and FSA contributions

Annual Enrollment information, videosand other resources

Learn about medical plan options

myBenefit DecisionCenter

Annual Enrollmentwebpage

One-on-one support

Resource Description How to Find

For more information about your medical choices and how to enroll…

Columbia

Health Insurance Plans

Documents