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Affordable Care Act (ACA)


ACA Full-time Insurance Announcement

USU will begin offering medical coverage to ACA full-time employees on July 1, 2015. If any non-benefited employees wish to purchase medical coverage from the marketplace prior to July 1, 2015, please go to www.healthcare.gov or to www.cuidadodesalud.gov/es. They may also call (800) 318-2596 to speak with a trained navigator who can assist them with the health insurance marketplace. They can also purchase insurance through any private company licensed to sell health insurance.


New Terms

ACA Full-time Employee:  There is a “reasonable expectation” at the start of employment that the employee will be working full-time  (30+ hrs/week), even if only for a limited (>3 months) time. The employee will be eligible for ACA medical benefits immediately.

ACA Variable Employee:  A position with hours that fluctuate during employment. The employee may work 30+ hours/week at certain times. However, based on facts and circumstances at the beginning of employment, it cannot be determined that the employee is reasonably expected to work an average of 30+ hours/week.

Initial/Standard Measurement Period:  A 1-year period of time during which work hours are measured to determine potential future eligibility for access to ACA Medical Benefit coverage. Initial Measurement Period will begin on employee start date. Standard Measurement Period is May 1 – April 30. 

Standard Stability Period:  A 1-year period of time following the Initial/Standard Measurement Period where, if the employee became eligible for medical coverage during the Initial/Standard Measurement Period (averaged 30+ hrs/week for 12 months), the employee can be covered by ACA medical. Standard Stability Period is July 1 – June 30.


Documents

Affordable Care Act FAQs

ACA Full-time Employee Notice (for non-benefited employees expected to work 30+ hrs/week)

ACA Pre-Qualified Employee Notice (for a non-benefited employee who has pre-qualified for medical coverage)

ACA Variable Employee Notice (for non-benefited employees expected to work less than 30 hrs/week)


ACA Medical Insurance Information

USU Medical Plan Comparison

USU works with Blue Cross Blue Shield to offer 2 medical networks and 3 medical insurance plans to choose from. These plans are available to benefited and ACA eligible employees. Direct questions to the HR Solutions Center: (435) 797-0122

Wellness (White)

The coinsurance rate is 70/30

Deductible per Person $750
Deductible per Family $1500

Doctor Visit Co-Pay after deductible $35
Hospitalization Co-Pay after deductible $250

Maximum Out-Of-Pocket per Person $3,750
Maximum Out-Of-Pocket per Family $7,500

Generic prescription $5
Formulary prescription 35%
Non-Formulary prescription 50%

RX Co-insurance Maximum per Person $1,500
RX Co-insurance Maximum per Family $3,000

View Summary of Benefits and Coverage.

View Premiums »

High Premium (Blue)

The coinsurance rate is 80/20

Deductible per Person $500
Deductible per Family $1,000

Doctor Visit Co-Pay after deductible $30
Hospitalization Co-Pay after deductible $200

Maximum Out-Of-Pocket per Person $3,000
Maximum Out-Of-Pocket per Family $6,000

Generic prescription $5
Formulary prescription 35%
Non-Formulary prescription 50%

RX Co-insurance Maximum per Person $1,250
RX Co-insurance Maximum per Family $2,500

View Summary of Benefits and Coverage.

View Premiums »

Choice High Deductible Health Plan (HDHP)

The coinsurance rate is 80/20

Deductible per Person $1,500
Deductible per Family $3,000

Doctor Visit Co-Pay after deductible 20%
Hospitalization Co-Pay after deductible 20%

Maximum Out-Of-Pocket per Person $5,000
Maximum Out-Of-Pocket per Family $10,000

Generic prescription 20% after deductible
Formulary prescription 20% after deductible
Non-Formulary prescription 20% after deductible

RX Co-insurance Maximum per Person n/a
RX Co-insurance Maximum per Family n/a

View Summary of Benefits and Coverage.

View Premiums »

 

Two Medical Networks

Utah State University works diligently to provide you with the best possible medical insurance options at the lowest cost. USU and Regence BCBS will offer 2 new insurance network options to benefit eligible employees for the 2015-16 plan year. The network options are:

Provides access to 40 Utah hospitals including Logan Regional Hospital, Cache Valley Specialty Hospital, University of Utah Hospital, Huntsman Cancer Hospital and Primary Children’s Hospital.

This is the broadest network offered. It currently provides access to 49 Utah hospitals including Logan Regional Hospital, Cache Valley Specialty Hospital, University of Utah Hospital, Huntsman Cancer Hospital, Primary Children’s Hospital and McKay-Dee Hospital

Regence Advantages - Health-related products and services available to those on the Regence Blue Cross Blue Shield medical insurance.