2021 Benefits Guide University of Missouri System - University of Missouri ...
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2021 Benefits Guide University of Missouri System C O L U M B I A | K A N S A S C I T Y | R O L L A | S T. L O U I S
Discrimination is against the law
The Curators of the University of Missouri complies with applicable Federal civil rights laws and does not discriminate on
the basis of race, color, national origin, age, disability, or sex. The Curators of the University of Missouri does not exclude
people or treat them differently because of race, color, national origin, age, disability or sex.
The Curators of the University of Missouri:
■ Provides free aids and services to people with disabilities to communicate effectively with us, such as:
◦ Qualified sign language interpreters
◦ Written information in other formats (large print, audio, accessible electronic formats, other formats)
■ Provides free language services to people whose primary language is not English, such as:
◦ Qualified interpreters
◦ Information written in other languages
If you need these services, contact Carol Wilson, Director, Benefits.
If you believe that The Curators of the University of Missouri has failed to provide these services or discriminated in another
way on the basis of race, color, national origin, age, disability or sex, you can file a grievance with:
Carol Wilson, Director, Benefits
1105 Carrie Francke Drive, Suite 108, Columbia, MO 65211
Phone: 573-882-2406
Fax: 573-882-9155
wilsoncaro@umsystem.edu
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Carol Wilson, Director,
Benefits, is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights,
electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf,
or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
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ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 1-844-634-1237.Welcome
Colleagues,
This has been a year of unexpected challenges for our institution, our state, the
nation and the world. I know that each member of our university community is
facing their own unique set of challenges as well, so I’d like to start by saying
thank you. Your resilience means we continue to provide the many services that
are so meaningful to our students, our state and beyond.
Each day, I’m inspired by the collective dedication of our faculty and staff. I
know it inspires my team, too, as they work to provide high-quality benefits and
find solutions that support your needs. Part of their work is a benefits review,
which Human Resources (HR) conducts each year in collaboration with the
Total Rewards Advisory Committee (TRAC), the UM System Office of Finance
and our vendor partners. TRAC is comprised of members representing faculty
and staff from each university, the hospital and retirees (umurl.us/trac). This Marsha Fischer
annual process helps us proactively manage our costs and provide a strong Associate Vice President for
benefit to our university community. Human Resources and CHRO
University of Missouri System
Because there have been several changes to the benefit plans, I encourage
you to review this guide. Just like it is important to get your health checked annually, the same annual “benefit
check-up” is important to help you make choices that support you and your family in the coming year. This
guide has been designed to help you understand your insurance plans, as well as the many other benefits
available to you. The HR website has been updated with the new information and HR specialists are ready to
help, as needed.
I appreciate the many individuals, including our benefits team and TRAC members, who help keep our
coverage competitive and affordable. Health care and other benefits are personal and important, so while the
changing landscape of health care provides many new and ongoing challenges, we are dedicated to finding
solutions that will best support our faculty, our staff and our university as a whole.
Marsha Fischer
Associate Vice President for Human Resources and Chief Human Resources Officer (CHRO)
University of Missouri System
Please note, you must submit a medical insurance choice during your enrollment period.
If you are a newly benefit-eligible faculty or staff member, you must take action during your initial enrollment
period, even if your decision is to waive coverage for one or all of the plans offered. If you fail to do so, you
will default to the self-only coverage level of the Healthy Savings Plan and pay taxes on your premiums.
If you are a current faculty or staff member, Annual Enrollment provides you an annual opportunity to
review and change your benefits for the following calendar year. Review your current benefit plan elections
in myHR, including enrolled dependents and designated beneficiaries, and make changes as necessary
during the Annual Enrollment period. If you do not make changes to your elections, your current enrollments
will continue into the new calendar year, with the exception of Flexible Spending Accounts (FSAs).
You must re-enroll in Health Care and Dependent Care FSAs each year.Table of Contents Healthy Savings Plan 3 Health Savings Account 4 Custom Network Plan 5 PPO Plan 7 Flexible Spending Account 9 Premiums 10 Medical Plan Comparison Chart 11 Dental 13 Vision 14 Life, Long Term Disability and Accidental Death and Dismemberment 15 Enroll in myHR 16 After you Enroll 17 Other Benefits and Retirement Planning 18 This guide provides a summary of various plans included in the University of Missouri System benefit program effective January 1, 2021. Summary Plan Descriptions (SPDs) for each plan described herein can be found on the UM System website. At the time of printing, SPDs on the website pertain to the 2020 plan year; SPDs for the 2021 plan year will be available in early 2021. Information in the 2021 SPD for each plan will vary from the information in the 2020 SPDs. Therefore, the 2020 SPDs should not be relied upon to determine plan benefits effective January 1, 2021. The SPD serves as both the Plan document and the SPD. In the event of a discrepancy between this guide and the SPD, the SPD will govern in every instance. The University of Missouri System reserves the right to change or terminate the benefits program, individual plans or provisions at any time.
Healthy Savings Plan
Facts and Tips The Healthy Savings Plan is available regardless of location. The plan is coupled with
a Health Savings Account (HSA). Your employer makes an annual contribution to help
In-network services increase your savings for qualified health care expenses.
Care Cost About the plan
Preventive ■ You pay the full cost of medical services and prescription drugs until you reach your
$0
care annual deductible.
Primary 15% after ■ The price of in-network medical services and prescription drugs is discounted. You pay
care deductible the total of that discounted price until the deductible is met.
Specialist 15% after
■ After you meet the deductible, you pay 15% of the cost of covered in-network medical
care deductible
services and prescription drugs until you reach the out-of-pocket limit (comprised of
15% after deductibles, coinsurance and prescription drug charges).
Urgent care
deductible
■ Once the annual out-of-pocket limit is met, the plan will pay 100% of covered services
Lab and 15% after and prescription drugs for the rest of the year.
x-ray deductible
■ The deductible for the Healthy Savings Plan combines medical services and prescription
Outpatient 15% after
care deductible drug expenses, rather than having one deductible for each. Similarly, the out-of-pocket
limit combines medical and prescription expenses.
Inpatient
care 15% after ■ You may be eligible for a Dependent Care Flexible Spending Account (FSA) but not a
(includes deductible Health Care FSA since you have access to an HSA.
maternity delivery)
■ For those in the Columbia area, 90-day fills/refills are available at Mizzou pharmacies at
Durable
medical
15% after the same cost as mail-order. Participants may fill specialty medications through a Mizzou
deductible Specialty Pharmacy (www.muhealth.org/specialty-pharmacy) or Accredo.
equipment
Emergency 15% after
room deductible Deductibles and out-of-pocket limits
15% after In-network Out-of-network***
Ambulance
deductible
Combined medical and $1,750/self $3,500/self
Prescription drug: prescription deductible $3,500/family* $7,000/family*
Retail 35% or more
■ Formulary generic: Coinsurance 15% after deductible
after deductible
15% after deductible
■ Formulary brand: Combined medical and $3,500/self $7,000 or more/self
15% after deductible prescription out-of-pocket limit $7,000/family* $14,000 or more/family*
■ Non-formulary brand: * Only the individual or family amount must be satisfied, based on whether you choose self or family.
15% after deductible ** 90-day fill/refill at Mizzou pharmacies at same cost as mail-order.
*** Please refer to the Summary Plan Description for additional details on allowable/eligible expenses when using
Prescription drug: an out-of-network provider.
Mail**
■ Formulary generic:
15% after deductible
■ Formulary brand:
15% after deductible
■ Non-formulary brand:
15% after deductible
Note Did you know?
Visit umurl.us/benadmin to
access provider directories Virtual Visits allow you to connect with a
for each plan. For medical doctor via video on your mobile device,
insurance plans, navigate to
“Medical” on the list and click
tablet or computer without an appointment,
“find a doctor.” any time. Learn more at umurl.us/virtualvis.
3Health Savings Account
If you enroll in the Healthy Savings Plan, you may be eligible to sign up for a Health Facts and Tips
Savings Account (HSA) through Optum Bank to help cover your health care expenses.
To be eligible: Employer contribution
■ You must be covered by a qualified high-deductible health plan (UM System Healthy (by coverage level*):
Savings Plan) on the first day of the month. ■ Self:
■ You may not be covered by another health plan (including any part of Medicare). $400
■ You may not be claimed as a dependent on someone else’s tax return. ■ Self and spouse:
$800
■ You or your spouse may not be enrolled in a general purpose Health Care Flexible
Spending Account. ■ Self and child(ren):
$800
Visit umurl.us/hsa for more information on HSAs.
■ Self, spouse and
child(ren):
Getting funds into the account $1,200
Your employer’s annual contribution appears as a lump sum within 45 days of enrollment
in most cases. For elections made during Annual Enrollment, your funds will appear by the *Contribution is prorated
end of January. These funds count toward the IRS annual maximum savings allowed for for enrollment after the first
your coverage level*, and the amount contributed depends on the time of year you enroll. quarter.
■ If you are switching from a Health Care Flexible Spending Account (FSA) in 2020 to an A change in coverage level
HSA in 2021, your 2020 FSA must have a zero balance by December 31, 2020, or it will during the plan year will not
delay contributions to your HSA until April 1, 2021. result in additional employer
contributions.
■ You can contribute pre-tax money until annual contributions reach the IRS maximum,
although this is not required to receive your employer’s contribution. You can change Visit umurl.us/hsa for
your contributions at any time. additional information on
HSAs.
Spending funds from the account Contribution limits
■ You’ll receive a debit card for your HSA that you can use when paying for eligible The IRS contribution limits
expenses, and you can request additional cards for family members. for Health Savings Account
contributions are $3,600/self
■ You can manage your HSA online through myUHC.com to track and pay expenses.
and $7,200/family.
■ If you don’t use the entire HSA balance during the calendar year, the money will roll over
for use in future years. Remember to reduce your
■ If you switch health plans in future years or leave your job, all the HSA money goes with own election by the amount
you as yours to keep, including the contributions by your employer (however, you may the University will contribute
to your account to avoid
need to pay a monthly fee on the account).
exceeding the limit.
Similarly, if a spouse also
contributes to an HSA, the
combined total contributions
(including employer
contributions) cannot exceed
the family limit.
Note
If you are newly enrolled in
the Healthy Savings Plan
and chose to open a Health
Savings Account, Optum
Bank will send a welcome
packet to your home
address. In some cases, you
may be required to submit
additional information to
establish your HSA.
4Custom Network Plan
Facts and Tips If your home address or official business unit is located in an eligible region around
Columbia or St. Louis, the Custom Network Plan for the associated location is available to
In-network services you. This plan features a focused, narrow network of providers who are working to improve
the quality of your care and share savings and efficiencies with you when you stay in-
Care Cost network.
Preventive
$0 What’s the same in Columbia and St. Louis?
care
■ There are separate deductibles for in-network services and retail prescription drugs.
Primary $15
care copay/visit ■ Once you meet your annual out-of-pocket limit, the plan pays 100% of eligible
Specialist $40 coinsurance and copayment expenses for the rest of the calendar year.
care copay/visit ■ You may enroll in two types of Flexible Spending Accounts (FSA): Health Care FSA and
$50 Dependent Care FSA. These accounts help you pay for medical or child care using pre-
Urgent care
copay/visit tax dollars; eligible expenses differ between the types.
$5/basic
Lab and Columbia
$100/
x-ray**** ■ Your network consists primarily of providers affiliated with University of Missouri Health
advanced
Outpatient 10% Care, with services such as:
care after deductible ◦ Virtual Visits: Connect with a doctor via video on your mobile device, tablet or
computer for a $15 copay. Learn more at umurl.us/virtualvis.
Inpatient ◦ Mizzou Doc Fast Pass: Establish care with in-network primary care physicians/
care 10%
(includes after deductible specialists or schedule same or next-day primary care by calling (573) 884-0432.
maternity delivery) ◦ Mizzou Quick Care: Visit an in-network quick care clinic for $15. Learn more at
Durable umurl.us/muquick.
$75 ◦ HEALTHConnect: A patient portal connects you to MUHC providers and services.
medical
copay
equipment ■ Mizzou pharmacy is the preferred network pharmacy for retail and 90-day prescriptions,
$250 but members have access to Express Scripts’ nationwide network. Participants may
Emergency
room
copay/visit fill specialty medications through a Mizzou Specialty Pharmacy (www.muhealth.org/
after deductible specialty-pharmacy) or Accredo.
$200 copay/
Ambulance occurrence St. Louis
after deductible
■ Your network consists primarily of providers affiliated with Mercy Health System, with
Prescription drug: services such as:
Retail ◦ Mercy Care Management: Every provider and case manager is connected to the same
Greater of (after Rx deductible): electronic medical record, allowing for in-the-moment collaboration to ensure you get
■ Formulary generic: the right care at the right time.
$7 copay or 20% ◦ Virtual Visits: Connect with a doctor via video on your mobile device, tablet or
coinsurance computer for a $15 copay. Learn more at umurl.us/virtualvis.
■ Formulary brand: ◦ Nurse-On-Call: Connect with a nurse any time to get help making informed decisions
$15 copay or 25% about health needs.
coinsurance
■ Non-formulary brand: ■ Pharmacy coverage is provided by Express Scripts with access to pharmacies nationwide
$30 copay or 50% and mail order services. Specialty medications must be filled through Accredo.
coinsurance
Deductibles and out-of-pocket limits
Prescription drug:
In-network Out-of-network***
Mail**
Greater of (after Rx deductible): Medical deductible $200/self; $600/family $1,500/self; $4,500/family*
■ Formulary generic: Prescription deductible Retail: $50/person; Mail: $0
$15 copay or 20%
coinsurance Coinsurance 10% 50% or more after deductible
■ Formulary brand: $3,500/self; $10,500 or more/self;
$30 copay or 25% Medical out-of-pocket limit
$7,000/family* $21,000 or more/family*
coinsurance
■ Non-formulary brand: Prescription out-of-pocket limit $5,050/self; $10,100/family*
$60 copay or 50% * Self amounts must be satisfied for all individuals until family deductible is met.
coinsurance ** 90-day fill/refill at Mizzou pharmacies at same cost as mail-order.
*** Please refer to the Summary Plan Description for additional details on allowable/eligible expenses when using
an out-of-network provider.
**** For lab and x-ray services, “Basic” includes services such as x-ray, blood work, lipid panel, etc. “Advanced”
includes services such as CT scan, PET scan, MRI, etc.
5You may be eligible for both the Custom Network Plan in Columbia and St. Louis (i.e., your official business unit is located
in an eligible Columbia-area county but your home address is in an eligible St. Louis-area county, or vice versa). In this
case, you may enroll in either of the two plans.
Note: The narrow network of providers for Columbia and St. Louis are different. A narrow network offers a smaller pool
of in-network providers in exchange for decreased premium or service costs. You will only have in-network access to
providers associated with the plan in which you enroll. That is, enrolling in the Columbia plan makes Columbia’s narrow
network available to you, and enrolling in the St. Louis plan makes St. Louis’s network available to you.
Visit umurl.us/benadmin to access provider directories for each plan. For medical insurance plans, including the Custom
Network Plan, navigate to “Medical” on the list and click “find a doctor” under the bullet point labelled “Provider directory.”
Counties with a custom network
Columbia-area plan:
■ Audrain (MO) ■ Cole (MO) ■ Moniteau (MO)
■ Boone (MO) ■ Cooper (MO) ■ Osage (MO)
■ Callaway (MO) ■ Howard (MO) ■ Randolph (MO)
St. Louis-area plan:
■ Franklin (MO) ■ St. Louis (MO) ■ Jersey (IL)
■ Gasconade (MO) ■ St. Louis City (MO) ■ Macoupin (IL)
■ Jefferson (MO) ■ Ste. Genevieve (MO) ■ Madison (IL)
■ Lincoln (MO) ■ Warren (MO) ■ Monroe (IL)
■ Montgomery (MO) ■ Washington (MO) ■ Montgomery (IL)
■ Pike (MO) ■ Bond (IL) ■ Pike (IL)
■ St. Charles (MO) ■ Calhoun (IL) ■ Randolph (IL)
■ St. Francois (MO) ■ Clinton (IL) ■ St. Clair (IL)
6PPO Plan
Facts and Tips The PPO Plan is available regardless of your location. It is a traditionally structured
medical insurance plan with a broad network of providers. You pay deductibles for medical
In-network services expenses and prescription drugs even if you use in-network services. This means, for most
Columbia, Rolla and St. Louis covered expenses, you’ll pay for expenses until you reach the annual deductible.
Care Cost Those who work for the University of Missouri-Kansas City (UMKC) business unit and
enroll in the PPO Plan will automatically have access to an area-specific tiered feature that
Preventive $0 provides additional savings when using providers recognized as offering high-quality, cost-
care
effective care.
Primary $20
care copay/visit
About the plan
Specialist $40 ■ There are separate deductibles for in-network services and retail prescription drugs.
care copay/visit
Urgent $50 ■ Once you meet your annual out-of-pocket limit, the plan pays 100% of expenses
care copay/visit (including coinsurance and copayments) for the remainder of the calendar year.
Applicable
Lab and coinsurance^
■ You can enroll in two types of Flexible Spending Accounts (FSA): Health Care FSA and
x-ray after deductible Dependent Care FSA. These accounts help you pay for medical or child care using pre-
Applicable tax dollars. Eligible expenses differ between the types.
Outpatient coinsurance^
care after deductible ■ For those in the Columbia area, 90-day fills/refills are available at Mizzou pharmacies at
Inpatient
the same cost as mail-order. Participants may fill specialty medications through a Mizzou
Applicable
care coinsurance^ Specialty Pharmacy (www.muhealth.org/specialty-pharmacy) or Accredo.
(includes
after deductible
maternity delivery)
Durable Deductibles and out-of-pocket limits
medical $75 copay
equipment In-network Out-of-network***
Emergency $250 Kansas City and Rolla: Kansas City and Rolla:
room copay/visit
after deductible $500/self coverage; $1,000/self coverage;
$1,500/family coverage* $3,000/family coverage*
$200 copay/
Ambulance occurrence Medical deductible
after deductible Columbia and St. Louis: Columbia and St. Louis:
$800/self coverage; $1,600/self coverage;
Prescription drug: $2,400/family coverage* $4,800/family coverage*
Retail
Greater of (after Rx deductible): Prescription deductible Retail: $75/person; Mail-order: $0
■ Formulary generic:
$7 copay or 20%
Kansas City and Rolla:
coinsurance
■ Formulary brand: 10% coinsurance
$15 copay or 25% after deductible Columbia, Kansas City,
coinsurance ^Coinsurance Rolla and St. Louis:
■ Non-formulary brand: Columbia and St. Louis: 40% or more after deductible
$30 copay or 50% 20% coinsurance
coinsurance after deductible
Prescription drug: Medical out-of-pocket limit
$3,500/self; $10,500 or more/self;
Mail** $7,000/family* $21,000 or more/family*
Greater of (after Rx deductible):
■ Formulary generic: Prescription out-of-pocket limit $5,050/self; $10,100/family*
$15 copay or 20%
coinsurance * Self amounts must be satisfied for all individuals until family deductible is met.
■ Formulary brand: ** 90-day fill/refill at Mizzou pharmacies at same cost as mail-order.
$30 copay or 25% *** Please refer to the Summary Plan Description for additional details on allowable/eligible expenses when using
coinsurance an out-of-network provider.
■ Non-formulary brand:
$60 copay or 50%
coinsurance
7Kansas City tiered feature Facts and Tips
UMKC business unit participants have access to two tiers of providers within UHC’s Choice
Plus Network. In-network services
Kansas City
■ Tier 1: Includes premium care physicians; providers rated as having two hearts (♥♥) by
UHC because of their high-quality, cost-effective care. Utilizing this tier may help you Care Cost
lower costs for services. Preventive
■ Tier 2: Includes certain types of specialists; providers rated as having one heart (♥) by $0
care
UHC; and providers who are unrated or do not meet the criteria for designation.
Primary $15
care ♥♥ copay/visit
UMKC business unit participants who sign up for the PPO Plan enjoy savings when they
use Tier 1 providers but will always have access to a broad network through Tier 2. Primary $25
care ♥ copay/visit
Additionally, save when using non-hospital-affiliated, free-standing facilities, ambulatory
Specialist $35
surgical centers or physician offices (designated network) instead of outpatient hospital
care ♥♥ copay/visit
facilities (network) for services such as labs, x-rays, scans and outpatient surgery.
Specialist $40
care ♥ copay/visit
Urgent $50
care copay/visit
Did you know? Lab and
x-ray 10% after
(designated deductible
Virtual Visits allow you to connect with a network)
doctor via video on your mobile device, Lab and
20% after
tablet or computer without an appointment, x-ray
deductible
(network)
any time. Learn more at umurl.us/virtualvis.
Outpatient
care 10% after
(designated deductible
network)
Outpatient 20% after
care
(network)
deductible
Inpatient
care 10% after
(includes deductible
maternity delivery)
Durable
medical $75 copay
equipment
$250 copay/
Emergency
visit after
room
deductible
$200
copay/
Ambulance occurrence
after
deductible
Note
Visit umurl.us/benadmin to
access provider directories
for each plan. For medical
insurance plans, navigate to
“Medical” on the list and click
“find a doctor.”
8Flexible Spending Account
Facts and Tips Both a Health Care Flexible Spending Account (FSA) and a Dependent Care FSA may be
available to you depending on your medical enrollment choices. You do not need to enroll
Contribution limits in a medical plan to be eligible for a Health Care FSA; however, you cannot enroll if you
Set aside up to $2,750 (and/or your spouse) currently participate in a Health Savings Account (HSA). Any benefit-
per year in Health Care eligible employee can enroll in the Dependent Care FSA regardless of medical plan
FSA contributions and up enrollment. ASIFlex (asiflex.com) administers both kinds of FSA.
to $5,000 per household
for Dependent Care FSA
contributions. More information about FSAs is available online at umurl.us/fsa.
Note About Health Care FSAs
If you do not use all your The Health Care FSA is an account that allows you to set aside pre-tax dollars to pay for
contributions within the plan out-of-pocket medical, dental and vision expenses.
year, you forfeit any money
left in your account at the Use your FSA to reimburse health care expenses for you, your spouse or any tax
end of the year (no rollover). dependent, even if your dependents are not enrolled in your UM medical, dental or vision
However, the Health Care
plans. You may elect to use an ASIFlex debit card when making purchases with your Health
FSA has a 2.5-month grace
period, allowing additional
Care FSA, providing flexibility and convenience.
time to spend your funds.
About Dependent Care FSAs
The Dependent Care FSA allows you to use pre-tax dollars to pay for out-of-pocket
Newly benefit-eligible
After the plan year begins, if childcare and/or elder care dependent expenses. A difference from the Health Care FSA is
you are newly benefit-eligible that any benefit-eligible faculty or staff member — regardless of the medical plan they are
on any day other than the enrolled in — may also use a Dependent Care FSA for child/day care expenses. You must
first of the month, coverage enroll in a Dependent Care FSA separately from a Health Care FSA.
in the Health Care FSA and/
or Dependent Care FSA will Eligible expenses include day care, babysitting, general-purpose day camps and pre-K
not begin until the first day of
expenses. Ineligible expenses include overnight camps; care provided by your tax
the following month.
dependent, your spouse or your child who is under the age of 19; and care provided while
you are not at work.
Note
If you leave your employer,
Getting funds into the account
you are no longer eligible for
■ You must enroll each year you wish to have an FSA (elections do not carry over from
the FSA and remaining funds
in your account can only be year to year).
used for eligible expenses ■ You contribute your own pre-tax money to the FSA automatically through payroll
incurred while you were deductions (up to the IRS maximum).
enrolled in the plan.
Spending funds from the account
■ If you are a new Health Care FSA enrollee, you will receive a welcome packet that
provides instructions for applying for an ASIFlex debit card to pay for eligible expenses.
Additional cards for other family members can be requested. You may also submit claims
for reimbursement online, by fax or mail.
■ If you enroll in a Health Care FSA, your full annual election is available to you on your
first day of coverage and you can submit reimbursement requests for eligible expenses
immediately even though the money you set aside is deducted from each paycheck over
the course of the year.
■ Manage your FSA online and instantly track expenses and account balances through the
ASIFlex website.
9Premiums
Monthly premiums are deducted during the month of coverage. Employees who are paid bi-weekly will have half the
monthly premium deducted from their first two bi-weekly paychecks of the month.
Healthy Savings Plan Custom Network Plan
Coverage level Employee cost UM cost Total Coverage level Employee cost UM cost Total
Self only $58 $385 $443 Self only $84 $461 $545
Self and spouse $160 $788 $948 Self and spouse $232 $934 $1,166
Self and child(ren) $133 $751 $884 Self and child(ren) $203 $884 $1,087
Self, spouse, and children $258 $1,179 $1,437 Self, spouse, and children $366 $1,401 $1,767
PPO Plan Dental
Coverage level Employee cost UM cost Total Coverage level Employee cost UM cost Total
Self only $176 $589 $765 Self only $14.76 $14.76 $29.52
Self and spouse $417 $1,220 $1,637 Self and spouse $29.52 $29.52 $59.04
Self and child(ren) $374 $1,152 $1,526 Self and child(ren) $35.82 $35.82 $71.64
Self, spouse, and children $632 $1,848 $2,480 Self, spouse, and children $50.58 $50.58 $101.16
Vision Basic Life* (per $1,000 of coverage)
Coverage level Employee cost UM cost Total Plan type Employee cost UM cost Total
Self only $5.59 $0 $5.59 Option A $0 $0.046 $0.046
Self and spouse $11.15 $0 $11.15 Option B $0.022 $0.046 $0.068
Self and child(ren) $12.17 $0 $12.17
Self, spouse, and children $19.26 $0 $19.26 Dependent Life Additional
Insurance- Life Insurance*
Long Term Disability* (per $100 of covered monthly salary) Spouse/Sponsored (per $1,000 of coverage)
Plan type Employee cost UM cost Total Adult Dependent*
(per $1,000 of coverage)
Core Plan (Option A) $0 $0.136 $0.136
Age as of Amount Age as of
Buy-up Plan (Option B) $0.14 $0.136 $0.276 January 1 January 1 Amount
< 30 $0.064 < 25 $0.05
Accidental Death and Dismemberment 25 – 29 $0.06
(per amount listed) 30 – 34 $0.073
35 – 39 $0.10 30 – 34 $0.08
Coverage amount Self Self and dependents
35 – 39 $0.09
$25,000 $0.35 $0.50 40 – 44 $0.155
40 – 44 $0.10
$50,000 $0.70 $1.00 45 – 49 $0.228
$75,000 $1.05 $1.50 45 – 49 $0.15
50 – 54 $0.346
$100,000 $1.40 $2.00 50 – 54 $0.23
55 – 59 $0.537
$125,000 $1.75 $2.50 55 – 59 $0.43
60 – 64 $0.837
$150,000 $2.10 $3.00 60 – 64 $0.66
65 – 69 $1.32
65 – 69 $1.27
Dependent Life Insurance- Child 70 – 74 $2.11 70 – 74 $2.06 - $2.76
(per amount listed)
75 – 79 $3.449 75 – 79 $3.04 - $4.35
Coverage amount
80 – 84 $5.36 80 – 84 $4.74 - $6.87
$5,000 $0.32
85 – 89 $8.399 85 – 89 $7.53 - $10.43
$10,000 $0.64
90+ $12.977 90 – 94+ $11.24 - $16.02
$15,000 $0.96
Coverage amounts: *Evidence of insurability may be
$20,000 $1.28 $10,000, $20,000, $30,000, required. Visit umurl.us/life for
more information.
$25,000 $1.60 $40,000, $50,000
10Medical Plan Comparison Chart
What you pay for covered expenses in 2021
HEALTHY SAVINGS PLAN CUSTOM NETWORK PLAN
In-network Out-of-network** In-network Out-of-network**
DEDUCTIBLES
Medical $200/self coverage $1,500/self coverage
deductible $1,750/self coverage $3,500/self coverage $600/family* coverage $4,500/family* coverage
$3,500/family* coverage $7,000/family* coverage
(combined) (combined)
Prescription Retail: $50/person Retail: $50/person
deductible Mail-order: $0/person Mail-order: $0/person
35% or more 50% or more after
Preventive care $0 $0
after deductible deductible
35% or more 50% or more after
Primary care 15% after deductible $15 copay/visit
after deductible deductible
35% or more 50% or more after
Specialist care 15% after deductible $40 copay/visit
after deductible deductible
35% or more $50 copay/visit
Urgent care 15% after deductible $50 copay/visit
after deductible or more
SERVICES
35% or more $5 copay/basic^^ 50% or more
Lab and x-ray 15% after deductible
after deductible $100 copay/advanced^^ after deductible
35% or more 10% coinsurance 50% or more
Outpatient care 15% after deductible
after deductible after deductible after deductible
Inpatient care 35% or more 10% coinsurance 50% or more
15% after deductible
(includes maternity delivery) after deductible after deductible after deductible
Durable 35% or more 50% or more
15% after deductible $75 copay
medical equipment after deductible after deductible
Emergency room 15% or more $250 copay/visit $250 copay/visit
15% after deductible
care after deductible after deductible or more after deductible
15% or more $200 copay/occurrence $200 copay/occurrence
Ambulance 15% after deductible
after deductible after deductible or more after deductible
Prescription drug: Greater of Greater of
Retail 35% or more (after Rx deductible): (after Rx deductible):
Formulary generic 15% after deductible $7 copay/20% coinsurance $30 copay or 50%
after deductible
Formulary brand $15 copay/25% coinsurance network costs after
Non-formulary brand $30 copay/50% coinsurance annual deductible****
Rx
Prescription drug:
Greater of: Greater of:
Mail*** 35% or more $30 copay or 50%
$15 copay/20% coinsurance
Formulary generic 15% after deductible
after deductible $30 copay/25% coinsurance network costs after
Formulary brand $60 copay/50% coinsurance
annual deductible****
Non-formulary brand
$10,500 or more
OUT-OF-POCKET**
Medical plan $3,500/self coverage /self coverage
out-of-pocket limit $7,000 or more $7,000/family* coverage $21,000 or more
$3,500/self coverage /self coverage /family* coverage
$7,000/family* coverage $14,000 or more
(combined) /family* coverage
Prescription drug (combined) $5,050/self coverage
out-of-pocket limit $10,100/family* coverage
11Notes
PPO PLAN *Considerations for “self”
and “family” are different for
In-network Out-of-network** the Healthy Savings Plan
Kansas City and Rolla: Kansas City and Rolla: than for the Custom Network
$500/self coverage; $1,000/self coverage; Plan and PPO Plan. See the
glossary (umurl.us/glossary)
$1,500/family coverage* $3,000/family coverage*
for details.
Columbia and St. Louis: Columbia and St. Louis:
$800/self coverage; $1,600/self coverage; **Refer to the Summary
$2,400/family coverage* $4,800/family coverage* Plan Description (SPD)
for additional details on
Retail: $75/person Retail: $75/person allowable and eligible
Mail-order: $0/person Mail-order: $0/person expenses when using an out-
KC tiered feature Tier 1 (♥♥) Regular network / KC tiered feature Tier 2 (♥) of-network provider.
40% or more
$0 $0 after deductible
***90-day fill/refill at Mizzou
Regular network: $20 copay/visit 40% or more pharmacies at same cost as
$15 copay/visit mail-order.
KC Tier 2 (♥): $25 copay/visit after deductible
40% or more ****Member will be required
$35 copay/visit $40 copay/visit
after deductible to pay the difference between
40% or more non-participating pharmacy
$50 copay/visit $50 copay/visit and participating pharmacy
after deductible
charge.
Applicable coinsurance 40% or more
after deductible^ after deductible ^Columbia and St. Louis:
Applicable coinsurance 40% or more In-network
• 20% coinsurance
after deductible^ after deductible
Applicable coinsurance 40% or more
Kansas City:
after deductible^ after deductible
In-network
40% or more • 10% after deductible:
$75 copay
after deductible Tier 1 providers;
all durable medical
$250 copay/visit $250 copay/visit or more
equipment; services
after deductible after deductible obtained at free-standing
$200 copay/occurrence $200 copay/occurrence facilities, ambulatory
after deductible or more after deductible surgical centers and
physician offices
Greater of (after Rx deductible): Greater of (after Rx deductible): • 20% after deductible:
$7 copay or 20% coinsurance $30 copay or 50% Tier 2 providers; services
$15 copay or 25% coinsurance network costs after annual obtained at outpatient
$30 copay or 50% coinsurance deductible**** hospital facilities
Rolla:
In-network
Greater of: Greater of: • 10% coinsurance
$15 copay or 20% coinsurance $30 copay or 50%
$30 copay or 25% coinsurance network costs after annual
$60 copay or 50% coinsurance deductible**** ^^ For lab and x-ray services,
“Basic” includes services
such as x-ray, blood work,
$10,500 or more lipid panel, etc. “Advanced”
$3,500/self coverage /self coverage includes services such as CT
$7,000/family* coverage $21,000 or more scan, PET scan, MRI, etc.
/family* coverage
$5,050/self coverage
$10,100family* coverage
12Dental
Facts and Tips Dental insurance is administered by Delta Dental and is available to you regardless of your
location. Coverage is offered for three classes of reasonable and customary expenses:
Note preventive, basic and major services. Dental coverage has a maximum annual benefit of
Services listed here $1,500 for each individual enrolled in the plan. This cap is for preventive, basic and major
describe eligible dental care combined. Learn more about dental insurance at umurl.us/dental.
expenses; orthodontics are
not an eligible expense.
Reimbursements are limited Services and coverage
to fees determined to be Service Coverage
reasonable and customary.
Class A services
Preventive care for routine oral exams, cleaning, x-rays, 100% (no deductible)
Note sealants and fluoride
Visit umurl.us/benadmin to
access provider directories Class B services
for each plan. Dental plan Basic care for treatments such as fillings, oral surgery and 80% after annual deductible
information is listed under extractions
“Dental.”
Class C services
50% after annual deductible
Major treatment such as bridgework, dentures and crowns
About the network
The University dental plan utilizes a passive network, which means you have the ability
to receive services from network or non-network providers. No matter your provider, your
deductible and coinsurance remain the same as long as charges are reasonable and
customary.
However, using either of Delta Dental’s two networks, PPO or Premier, may help you
achieve more affordable services. The Delta Dental PPO Network offers the lowest
negotiated services, often resulting in the greatest savings.
Deductible by coverage level
Coverage level Deductible
Self $100
Self, spouse and/or child(ren) $300
13Vision
Vision insurance is administered by EyeMed Vision Care (EyeMed) and utilizes the Insight Facts and Tips
network. The plan provides a discounted group rate; that discounted group rate is available
at all locations where EyeMed is accepted. The plan does not have a deductible and offers Frequency
coverage for a number of eye care expenses, some of which are outlined in the table ■ Examination:
below. Charges on amounts over the indicated limits or on optional features are discounted. Once every 12 months
Learn more about vision insurance at umurl.us/vision. ■ Lenses (in lieu of
contact lenses):
Once every 12 months
Services and coverage ■ Contact lenses (in lieu
Service Coverage of lenses): Once every
12 months
Eye exam
$10 copay ■ Frames: Once every 24
(with dilation as necessary)
months
Frames
$0 copay; $140 allowance, 20% off balance over $140
(any available at provider location) Non-insurance
Standard: Up to $40 maximum
discounts
Contact lens fitting and follow-up EyeMed also offers discounts
Premium: 10% off retail to University employees not
Conventional: $0 copay, $140 allowance, enrolled in vision insurance.
15% off balance over $140 Learn more at umurl.us/
Contact lenses healthtool.
Disposable: $0 copay, $140 allowance,
(allowance includes materials only)
plus balance over $140
Hearing support
Medically necessary: $0 copay, paid-in-full EyeMed members have
Single, bifocal, trifocal and lenticular: $25 copay access to hearing care
discounts through Amplifon.
Standard progressive: $80 copay
Call (877) 203-0675 to find
Premium progressive (tier 1): $100 copay a provider and activate your
Standard plastic lenses Premium progressive (tier 2): $110 copay discount.
Premium progressive (tier 3): $125 copay
Note
Premium progressive (tier 4): $80 copay, 20% off retail Visit umurl.us/benadmin to
less $120 allowance access provider directories
for each plan. Vision plan
Covered lens options information is listed under
$0 copay
(standard polycarbonate under age 19) “Vision.”
14Life, Long Term Disability and
Accidental Death and Dismemberment
Facts and Tips Employees have several options for life insurance to help give peace of mind. The Basic
Life Plan A plan is available at no cost to you and the University subsidizes Basic Life Plan
About premiums B. Other life insurance plan options are also available — the University does not subsidize
■ Premiums for additional premiums for these plans, but negotiates to offer them at a reduced cost. The Long Term
and spouse/sponsored Disability Core Plan (Option A) is also available at no cost to you and University subsidizes
adult dependent life the Buy-up plan (Option B). Unum administers all Life, Long Term Disability and Accidental
coverage vary by age. Death and Dismemberment insurance options.
■ Premiums for
Accidental Death and Life
Dismemberment coverage ■ Basic Life: You are automatically enrolled in Plan A of the Basic Life Plan because it
vary by coverage amount is 100% employer paid. You may opt out of this coverage if you wish. Plan A covers 1x
and coverage level. your base salary. Plan B covers 2x your base salary. With both plans, coverage amount
■ Review premiums specific begins to decrease once you reach age 55. Evidence of insurability is required to
to your situation by increase your coverage level after 31 days of initial eligibility.
accessing the premiums
chart in this guide. ■ Additional Life: You may enroll in coverage at 1x, 2x or 3x your annual base salary to a
maximum of $1,000,000. If you are newly benefit eligible, you may enroll in 1x coverage
Note without providing Evidence of Insurability. Evidence of insurability is required if you
If you are not actively at work choose to enroll in or increase coverage after 31 days of initial eligibility.
due to an illness or injury ■ Dependent Life: For a Dependent Child, coverage is available in increments of $5,000
on the date your Basic Life,
up to a maximum of $25,000. For Spouse/Sponsored Adult Dependent life insurance,
Additional Life or Long-Term
coverage is available in increments of $10,000 up to a maximum of $50,000. Evidence
Disability coverage would
otherwise begin or increase,
of insurability is required for amounts above $20,000 for Spouse/Sponsored Adult
the change will not be Dependent and for any amount when a new election or change is made after 31 days of
effective until you return to initial eligibility. There are also limitations on adding or increasing coverage for a Spouse/
full-time active employment.
Sponsored Adult Dependent who meets the definition of “Totally Disabled” by the plan.
More information about life insurance is available online at umurl.us/life.
Long Term Disability
■ Core Plan (Option A): The Long Term Disability (LTD) Core Plan (Option A) is 100%
paid by your employer, and you are automatically enrolled. The Core Plan (Option
A) covers up to 60% of eligible earnings. The maximum annual base salary covered
is $150,000. If you wish to opt out of this coverage, you must contact your HR
representative to complete a separate form.
■ Buy-up Plan (Option B): The Buy-up Plan (Option B) covers up to 66.67% of your
eligible earnings for a small premium (per $100 of monthly income). However, when
combined with other deductible sources of income, this option allows you to receive
up to 85% of your eligible earnings (paying the lesser of 66.67% or 85% of monthly
earnings less any deductible sources of income). The maximum annual base salary
covered is $150,000. If you are newly benefit eligible, you will have the opportunity to
enroll in the Buy-up Plan (Option B) without providing evidence of insurability. Evidence
of insurability is required if you choose to enroll in the Buy-up Plan (Option B) after 31
days of initially becoming eligible.
In addition, some employees are eligible for Supplemental Individual Disability (IDI). If
you are eligible, Unum will contact you directly during a separate enrollment period each
year; you will not enroll in this plan during the regular annual enrollment period. IDI is
a completely voluntary plan offered to highly-compensated faculty and staff. It can help
replace up to 75% of your income if you have a covered disabling illness or injury.
More information is available online at umurl.us/LTD.
Accidental Death and Dismemberment
Accidental Death and Dismemberment (AD&D) insurance is available in increments of
$25,000 up to a maximum of $150,000. You may also purchase coverage for your family as
a percentage of your own coverage. The plan is 100% paid by you. Learn more by visiting
umurl.us/add.
15Enroll in myHR
Once you’ve decided which insurance plans are best for you, enroll through myHR (myhr.umsystem.edu). If you are
a newly benefit-eligible faculty or staff member, you must take action during your initial enrollment period, even if your
decision is to waive coverage for one or all of the plans offered. If you fail to do so, you will default to self-only coverage in
the Healthy Savings Plan and pay taxes on your premiums.
If you are a current faculty or staff member, Annual Enrollment provides you an opportunity to review and change
your benefits for the following calendar year. Review your current benefit plan elections in myHR, including enrolled
dependents and designated beneficiaries, and make changes as necessary during the Annual Enrollment period. If you do
not make changes to your elections, your current enrollments will continue into the new calendar year except for Flexible
Spending Accounts (FSAs). You must re-enroll in health care and dependent care FSAs each year.
Get ready
■ Prepare to enroll your dependents.
◦ New dependents: In myHR, you will need to specify any spouse, sponsored adult dependent or child you want to
cover in each plan. You’ll need names, dates of birth and Social Security numbers for any new dependents.
◦ Proof of Relationship: Proof of Relationship (POR) is required in order to enroll new dependents. Once your plan
choices are submitted, submit supporting documentation to the HR Service Center or your campus HR Generalist
within the required time frame. Learn more at umurl.us/proof.
■ Select pre-tax vs. after-tax elections. Where pre-tax is an option, you’ll need to know whether you want to enroll in a
plan on a pre-tax or after-tax basis. Premiums are deducted from your paycheck automatically, and selecting pre-tax or
after-tax determines the order in which taxes and premiums are deducted. Learn more at umurl.us/research.
Submit your choices
1. You can make plan changes only during your enrollment period.
2. You are not done with your enrollment until you click both the “Submit Enrollment” button as well as the “Done” button
on the pop-up screen.
3. Open your internet browser and navigate to myhr.umsystem.edu (Firefox or Chrome recommended). Log in with your
username and password. Click “Sign In.”
4. Click the “My Benefits” tile. Then, to access the self-service application, select “Benefits Enrollment” from the menu on
the left side of the screen.
5. Follow the instructions on your screen to select and submit your plan choices or waive coverage.
6. After you click the “Submit Enrollment” button, a “Benefits Alerts” pop-up will appear stating your enrollments have
been submitted. Click “Done.” An email confirmation will be sent to your university email account so you know your
submission was received.
7. Once your Confirmation Statement has been generated, you will receive another email to your university email
account with steps on how to view/print your Confirmation Statement.
◦ If you are a newly benefit-eligible faculty or staff member, your Confirmation Statement is usually available within two
business days.
◦ If you are a current faculty or staff member enrolling during Annual Enrollment, your Confirmation Statement will be
available in December.
Need assistance?
As you’re reviewing the plans available to you, be sure to compare your options. You can book a one-on-one appointment
with your campus HR Generalist to get personalized assistance for all your insurance and enrollment questions. More
information is available at umurl.us/cbr.
For additional assistance, contact the HR Service Center by phone at (573) 882-2146 or toll-free (800) 488-5288, or via
email at hrservicecenter@umsystem.edu. Learn more at umurl.us/hrsc.
16After You Enroll
Watch the mail for important documents
■ New ID cards: Make sure you show your provider your new card(s) at the time of service; benefits are effective even if
you haven’t received your cards yet.
◦ Medical/Prescription: You will receive a single ID card only if you are newly enrolled or have changed plans.
◦ Dental: You will receive an ID card in the subscriber’s name only if you’re newly enrolled.
◦ Vision: You will receive an ID card in the subscriber’s name only if you’re newly enrolled.
■ HSA paperwork: If you are newly enrolled in the Healthy Savings Plan and chose to open a Health Savings Account,
Optum Bank will send a welcome packet to your home address. In some cases, you may be required to submit
additional information to establish your HSA.
Make the most of your health insurance
Preventive services let you take charge of your health and stop problems before they start. If you enroll in medical
insurance, in-network preventive care is covered at 100%. Preventive care includes annual physical exams,
immunizations and well-child care unrelated to a medical diagnosis. A list of what is considered preventive under Health
Care Reform/ACA is available on healthcare.gov or uhcpreventivecare.com.
With vision insurance, annual eye exams are offered with a small copay. Generally speaking, if you’re enrolling in the
dental plan, routine oral exams are covered completely, but it’s always a good idea to check with your provider.
Contact information for all insurance administrators is available at umurl.us/benadmin.
Choose the right type of care
Making an informed decision about your health care needs can save you time and money, but when you are ill or injured,
assessing your condition and choosing the best place to go for treatment isn’t easy. You have many care options, but each
is unique in the services it provides:
■ Primary care physician: Visit your primary care physician when you have a non-life threatening condition during
regular hours of the work week or if you don’t need immediate attention. It’s always best to see your primary care
physician since they know you and your health history. Examples include persistent cough, sore throat or rash.
■ Convenience care clinic: When you experience symptoms as noted above, but it’s after hours or on a weekend, a
convenience care clinic can be a good option. Convenience care clinics are typically available in local retail or drug
stores and usually have extended hours on weekdays and weekends.
■ Virtual visits: No matter when or where you need care, virtual visits can connect you with a doctor through video chat
on your mobile device, tablet or computer. Virtual visits are best for getting care in non-emergency situations that don’t
require hands-on assessment or tests. For example, colds, fevers, migraines or allergies. In most cases, you’ll have the
opportunity to get a diagnoses and prescription (if needed) in 20 minutes or less. Learn more at umurl.us/virtualvis.
■ Urgent care clinic: Urgent care clinics are an appropriate choice when you have an unexpected illness or injury that
requires immediate attention but is not necessarily life-threatening. These clinics offer many resources to treat a wound
or injury and will often do so immediately. Examples include a cut that might need stitches or a sprained ankle.
■ Emergency room: Seek an emergency room when an illness or injury is very serious or life-threatening. In most
cases, you will know the condition is serious, sudden and/or requires immediate attention. If you are unable to get to an
emergency room, call 9-1-1 for assistance. Examples include broken bones with deformed appearances, head trauma,
drug or alcohol overdoses or severe cuts or burns.
17Other Benefits
The UM System offers benefits that extend well beyond your insurance options and focus on helping you further your
education and support the personal health and well-being for you, your family, your friends and your community.
Tuition Assistance
If you meet educational assistance eligibility requirements, 75% of tuition and supplemental fees can be waived for college-
level credit courses up to the allotted course limit. After you have one year of continuous full-time service in a fully benefit-
eligible position, your spouse and/or dependent may also be eligible to have 50% tuition waived for UM System college-level
credit courses up to the allotted limit. Learn more at umurl.us/tuition.
If you’re a veteran of the U.S. Armed Forces, consult your campus veteran services office to learn more about special
programs and tuition benefits available only to veterans.
Employee Assistance Program
All employees and their immediate family members — regardless of eligibility for other benefits — have access to free,
confidential help for personal or professional challenges. Learn more at umurl.us/EAP.
Shared Leave Program
The Shared Leave Program allows employees to donate accrued vacation leave benefits to colleagues in need. Donated
hours are pooled and used to provide additional paid leave benefits to eligible employees who have experienced certain
catastrophic events personally or within their family and have exhausted other sources of paid leave. If you are interested
in donating time or wish to apply, learn more about eligibility and the donation or application process at umurl.us/shrdleave.
Retirement Planning
Many decisions you make during your working years can have a significant impact on your retirement; it is never too early
or too late to take action and plan ahead. Here are a few important tips to remember when considering your planning
strategies:
■ Understand your plan: The UM System has Core Retirement Plans and the plan you’re eligible for depends on your
benefit eligibility and hire status. More information is available at umurl.us/retplans.
■ Name beneficiaries: It is important to name beneficiaries, those you intend to inherit your retirement benefit in the
event of your death, for all your retirement plans. If you haven’t named beneficiaries or need to update your current
beneficiaries, visit umurl.us/retplans for more information.
Voluntary Retirement Plans
All UM System faculty and staff, regardless of hours or benefit eligibility, have the ability to participate in the UM System
Voluntary Retirement Plans. To learn more about available plans, visit umurl.us/retplans.
18Office of Human Resources
Old Alumni Center, Suite 108
1105 Carrie Francke Drive
Columbia, MO 65211You can also read
