; Plans
Documents
Resources
Learning Center
Upload
Plans & pricing Sign in
Sign Out
Your Federal Quarterly Tax Payments are due April 15th Get Help Now >>

Plans

VIEWS: 10 PAGES: 10

  • pg 1
									               Deluxe Plan       Standard Plan    Economy Plan
Deductible     $100 per person   $ 250 per person $500 per person
               $300 per family   $500 per family  $1,500 per family
_____________________________________________________________________
Annual Out-of-                   $750 per person
                         $400 per person           $3000 per person
pocket                           $1,250 per family
                         $750 per family           $6,000 per family
Maximum                          Out-of-network    Out-of-network
(does not                        charges do not    charges do not
include                          accrue toward the accrue toward the
deductible)                      out-of-pocket      out-of-pocket
                                 maximum           maximum
_____________________________________________________________________
Coinsurance              80% after                    In-network: 80%     In-network: 80%
(the Percent             deductibe                    after deductible    after deductible
the Plan Pays)
for Most                         Out-of-network:
                         No Network               Out-of-network:
Services                         60% after
                         provisions               60% after
                                 deductible       deductible
_____________________________________________________________________
Lifetime
Maximum               $2,000,000        $2,000,000        $2,000,000
_____________________________________________________________________
Hospital                 100% first 90 days,          In-network: 80%     In-network: 80%
Admissions               then 80% after               after deductible    after deductible
                         deductible
                                 Out-of-network:  Out-of-network:
                                 60% after        60% after
                                 deductible       deductible
_____________________________________________________________________
Preventive Care          Up to $400 per               Up to $400 per      Up to $400 per
                         person per year              person per year     person per year
                         toward preventive            toward preventive   toward preventive
                         related Medical              related Medical     related Medical
                         services, covered            services, covered   services, covered
                         at 100% with no              at 100% with no     at 100% with no
                         deductible                   deductible          deductible

               Includes annual   Includes annual   Includes annual
               physical benefits physical benefits physical benefits
_____________________________________________________________________
All UA Choice plan benefits are subject to allowable changes.
Pharmacy Highlights
                         Deluxe Plan                 Standard Plan    Economy Plan
Network                  80% of generic              $7 copay for     $10 copay for generic
Pharmacy: 30                                         generic
day supply       80% of brand                       $20 copay for brand
(charges do not                    $10 copay for
apply to         $500 annual        brand           $40 copay for non-
medical out-of- out-of-pocket                       perferred brand
pocket           maximum
maximum)
_______________________________________________________________________
Home Delivery: 80% of generic      $7 copay for     $25 copay for generic
100 day supply                     generic
(charges do not 80% of brand                        $50 copay for brand
apply to medical                   $10 copay for
out-of-pocket    $500 annual       brand            $100 copay for non-
maximum)         out-of-pocket                      preferred brand
                 maximum
_______________________________________________________________________
Non-Network      80% after         Pay retail price Pay retail price at time
Pharmacy         medical           at time of       of purchase, submit
(charges do not deductible; pay    purchase, submit claim form to be
apply to out-of- retail price at   claim form to be reimbursed at
pocket           time of purchase, reimbursed at    negotiated price less
maximums)         submit claim     negotiated price appropriate copayment
                 form to be        less appropriate
                 reimbursed at     copayment
                 negotiated price
                 less the 20%
                 you pay
_______________________________________________________________________
All UA choice pharmacy benefits subject to negotiated price limits.
Dental Highlights
              Deluxe Plan   Standard Plan   Economy Plan
Annual             $2,000          $2,000         $2,000
Maximum
________________________________________________________________
Deductibles
Preventive             $0             $0              $0
________________________________________________________________
Restorative            $0            $25             $50
________________________________________________________________
Prosthetic            $0   $25 (combined     $50 (combined
                          with restorative) with restorative)
________________________________________________________________
Coinsurance

Preventive           100%           100%             80%
________________________________________________________________
Restorative           80%            80%             80%
________________________________________________________________
Prosthetic            50%            50%             50%
________________________________________________________________
Annual              $2,000         $2,000          $2,000
Maximum
________________________________________________________________
Orthodontia             50% Not covered     Not covered
            $1500 lifetime
            maximum
________________________________________________________________
Vision Highlights
               Deluxe Plan       Standard Plan      Economy Plan
Copay          No copay          No copay           No copay
____________________________________________________________________
Exam every 12 VSP network
months         doctor:20% off    VSP network        VSP doctor:20%
               the exam fee      doctor:20% off     off the exam fee
               plus $100         the exam fee plus  plus $100
               allowence         $100 allowence     allowence

               Non-VSP                Non-VSP provider:         Non-VSP provider:
               provider: $100          $100 allowance           $100 allowance
               allowance
____________________________________________________________________
Lenses and
Frames or      $125 allownce          $50 allowence             $50 allowence
contacts every
24 months
____________________________________________________________________
Discounts and  When you go to a VSP network doctor, you will receive a 20%
 Saveings      discount off the doctor's fee for the exam in addition to your
               allowence, up to 20% saving on lens extras (such as scratch
               resistant and anti-reflective coatings and progressives), a 20%
               discount when you purchase a complete pair of prescription
               glasses and a 15 % discount off the cost of your contact lens
               exam (fitting and evaluation). You will also save 20% off an
               additional pair of prescription glasses, including prescription
               sunglasses, from the same VSP network doctor within 12
               months of your last eye exam. You will receive exclusive
               pricing on annual supplies of certain brands of contacts. Finally,
               although none of the plans provides coverage for laser eye
               surgery, you can get a discount on laser vision correction
               through a VSP network doctor.
___________________________________________________________________
UA CHOICE FY 08 RATES
                                         26 Payrolls
                        Employee Bi-    Dependent Bi    Total Bi Weekly   Annual Charge
Deluxe Plan (26 pay)    Weekly Charge   Weekly Charge       Charge
Employee                  $51.74            N/A             $51.74           $1,345
Employee + Spouse         $51.74          $35.08             86.82            2,257
Employee + Child(ren)     $51.74          $28.08            $79.82           $2,075
Employee + Family         $51.74          $63.20           $114.94           $2,988
                        Employee Bi-    Dependent Bi    Total Bi Weekly   Annual Charge
Standard Plan           Weekly Charge   Weekly Charge       Charge
Employee                  $23.27            N/A             $23.27           $605
Employee + Spouse         $23.27           $6.62            $29.89           $777
Employee + Child(ren)     $23.27           $5.31            $28.58           $743
Employee + Family         $23.27          $11.89            $35.16           $914
                        Employee Bi-    Dependent Bi    Total Bi Weekly   Annual Charge
Economy Plan            Weekly Charge   Weekly Charge       Charge
Employee                   $3.00            N/A              $3.00            $78
Employee + Spouse          $3.00           $3.93             $6.93           $180
Employee + Child(ren)      $3.00           $1.62             $4.62           $120
Employee + Family          $3.00           $8.54            $11.54           $300
                                         19 Payrolls
                        Employee Bi-    Dependent Bi    Total Bi Weekly   Annual Charge
Deluxe Plan             Weekly Charge   Weekly Charge       Charge
Employee                  $70.79            N/A             $70.79           $1,345
Employee + Spouse         $70.79          $48.00           $118.79            2,257
Employee + Child(ren)     $70.79          $38.43           $109.22           $2,075
Employee + Family         $70.79          $86.48           $157.27           $2,988

                        Employee Bi-    Dependent Bi    Total Bi Weekly   Annual Charge
Standard Plan           Weekly Charge   Weekly Charge       Charge
Employee                  $31.85            N/A             $31.85           $605
Employee + Spouse         $31.85           $9.06            $40.91           $777
Employee + Child(ren)     $31.85           $7.27            $39.12           $743
Employee + Family         $31.85          $16.27            $48.12           $914
                        Employee Bi-    Dependent Bi    Total Bi Weekly   Annual Charge
Economy Plan            Weekly Charge   Weekly Charge       Charge
Employee                   $4.11            N/A              $4.11            $78
Employee + Spouse          $4.11           $5.37             $9.49           $180
Employee + Child(ren)      $4.11           $2.22             $6.33           $120
Employee + Family          $4.11          $11.69            $15.80           $300
                      FY08 Bi-Weekly AD&D Rates
                              Employee Only       Employee and Family
12-Month Employees                1.15                   2.31
_______________________________________________________________________
9, 10, and 11-Month               1.58                   3.16
Employees
_______________________________________________________________________
                                 Bi-Weekly Supplemental Life Insurance Rates
                                               Effective July 1, 2007
                                            Rates for 12 month employees
           Under 30 30 - 34     35 -39     40 - 44     45 - 49     50 - 54    55 - 59     60 - 64
 $25,000        0.47        0.7       0.81       1.16         1.74          3         5.2       7.04
 $50,000        0.93      1.39        1.62       2.31         3.47          6      10.39       14.08
 $75,000        1.39      2.08        2.43       3.47          5.2          9      15.58       21.12
$100,000        1.85      2.77        3.24       4.62         6.93         12      20.77       28.16
$125,000        2.31      3.47        4.04       5.77         8.66         15      25.97        35.2
$150,000        2.77      4.16        4.85       6.93       10.39          18      31.16       42.24
$175,000        3.24      4.85        5.66       8.08       12.12          21      36.35       49.27
$200,000         3.7      5.54        6.47       9.24       13.85          24      41.54       56.31
$225,000        4.16      6.24        7.27      10.39       15.58          27      46.74       63.35
$250,000        4.62      6.93        8.08      11.54       17.31          30      51.93       70.39
$275,000        5.08      7.62        8.89       12.7       19.04          33      57.12       77.43
$300,000        5.54      8.31         9.7      13.85       20.77          36      62.31       84.87
$325,000           6          9       10.5         15         22.5         39       67.5        91.5
$350,000        6.47        9.7      11.31      16.16       24.24          42       72.7       98.54
$375,000        6.93     10.39       12.12      17.31       25.97          45      77.89      105.58
$400,000        7.39     11.08       12.93      18.47         27.7         48      83.08      112.62
                                           Rates for 9, 10 and 11- month employees
           Under 30 30 - 34     35 -39     40 - 44     45 - 49     50 - 54    55 - 59     60 - 64
 $25,000        0.64      0.95        1.11       1.58         2.37       4.11       7.11        9.64
 $50,000        1.27        1.9       2.22       3.16         4.74       8.22      14.22       19.27
 $75,000         1.9      2.85        3.32       4.74         7.11      12.32      21.32        28.9
$100,000        2.53      3.79        4.43       6.32         9.48      16.43      28.43       38.53
$125,000        3.16      4.74        5.53         7.9      11.85       20.53      35.53       48.16
$150,000        3.79      5.69        6.64       9.48       14.22       24.64      42.64       57.79
$175,000        4.43      6.64        7.74      11.06       16.58       28.74      49.74       67.43
$200,000        5.06      7.58        8.85      12.64       18.95       32.85      56.85       77.06
$225,000        5.69      8.53        9.95      14.22       21.32       36.95      63.95       86.69
$250,000        6.32      9.48       11.06      15.79       23.69       41.06      71.06       96.32
$275,000        6.95     10.43       12.16      17.37       26.06       45.16      78.16      105.95
$300,000        7.58     11.37       13.27      18.95       28.43       49.27      85.27      115.58
$325,000        8.22     12.32       14.37      20.53       30.79       53.37      92.37      125.22
$350,000        8.85     13.27       15.48      22.11       33.16       57.48      99.48      134.85
$375,000        9.48     14.22       16.58      23.69       35.53       61.58     106.58      144.48
$400,000       10.11     15.16       17.69      25.27         37.9      65.69     113.69      154.11
65 +
         15
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A

65 +
       20.53
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Important Contact Numbers
With questions about…       Contact…                  Or Visit…
Medical or Dental Plans     Blue Cross at             www.premera.com
                            (800) 364 -2982
_________________________________________________________________________________________
Prescription Drugs          PharmaCare at             www.prharmacare.com/members
                            (800) 569 -2178
_________________________________________________________________________________________
Vision Plans                VSP at                    www.vsp.com
                            (800) 877 -7195
_________________________________________________________________________________________
Flexible Spending Accounts  Fringe Benefits           www.fbmc-benefits.com
                            Management Company at
                            (800) 342 - 8017
_________________________________________________________________________________________
Employee Assistance         ComPsych, the Guidance    www.guidanceresorces.com
Program                     Resources Company
                            (866) 465 -8934           (enter University of Alaska ID:GC5901Q)
__________________________________________________________________________________________
Other Issues                UAA Human Resources       786 -4608
Eligibility,                UAF Human Resources       474 -7700
Enrollment process,          GI Human Resources       474 -6010
Address Changes             UAS Human Reosources      465 -6473
Life event channges, or     Statewide Human           450 -8200
Life insurance              Resources
_________________________________________________________________________________________

								
To top