NUFlex: More medical coverage FAQs

October 21, 2020

The UNMC/UNO Benefits Office recently sent out a brief survey asking for feedback concerning what questions employees have on health and insurance benefits. (Annual NUFlex enrollment begins Oct. 26.)

To address these questions, the UNMC/UNO Benefits Office will be providing a series of articles this week to go over the most commonly asked questions. If you submitted a question that you do not see an answer for in this series, we encourage you to reach out to the benefits office directly via email.

Today's question and answers will continue to explore the medical coverage offered by the University.

Q: What are the wellness benefits provided under each plan?

A: All three PPO plans offer 100% coverage for preventative services for dependents under the age of 2. For the employee and covered dependents age 2 or older, you are allocated $250 toward preventative services. Any preventative services costing over the $250 will be billed to your deductible and co-insurance. The plan also provides a free annual screening for a routine mammogram that is processed separately from the $250 preventative allowance.

For the HDHP preventative services provided by a Preferred Tier or In-Network provider will be paid at 100%.

Q: What is the Wellstream Health Risk Assessment (HRA) and what are the benefits of taking it?

A: The Wellstream Health Risk Assessment is a brief survey that employees are encouraged to take each year during Annual NuFlex Enrollment. The link for this survey can be found at the top of the medical section under the NuFlex Enrollment tile.

Employees who are enrolled in one of the PPO Plans and complete the assessment will receive the following enhanced benefits:

  • An increased preventative allowance for all covered dependents age 2+. The allowance will go from $250 to $400 for that calendar year.
  • $0 generic drug co-pay through CVS Caremark's mail order program. To sign up visit Caremark or call 1-866-239-4704.
  • A routine colonoscopy through an In-Network provider at age 50 or older (one every 10 years)
  • $0 copay for flu shots administered at an in-network pharmacy and submitted to the prescription drug program (not submitted to the medical plan).

Q: What are the co-pays for prescription drugs?

A: Below is the pricing for a 30-day supply under the PPO Plans:

  • Generic prescriptions - $9
  • Brand name (formulary) - $31
  • Brand name (non-formulary) - $52
    • Please note: There is a $57 annual deductible on the prescription drug plan. This deductible is waived for generic prescriptions.

For employees who elect the Qualified High Deductible Health Plan (QHDHP), prescription drug costs are applied to the deductible and co-insurance. This means that you will be charged the full price of each prescription until you have met your deductible.

Q: What happens when an employee or covered spouse turn age 65 while on a medical plan with the university?

A: If the employee and/or spouse are covered under one of the PPO plans, you are able to stay on these plans. We do not require you to enroll in a Medicare supplement, however, we do encourage you to apply for Part A of Medicare. Once an employee or dependent are no longer covered by an employer plan, we encourage them to sign up for a Medicare supplement, as penalties can be incurred for not enrolling after employer coverage is terminated.

If an employee and/or spouse are enrolled in the QHDHP, they are able to stay on this coverage after attaining the age of 65, however, if they sign up for any part of Medicare, including Part A, they will no longer be allowed to participate in the Health Savings Account (HSA).

Also, if the employee or spouse delays enrolling in Medicare, they will need to stop contributing to their Health Savings Account at least six months prior to their enrollment date. This is due to Medicare Part A enrollments becoming effective with up to six months of retroactive coverage. If the Health Savings Account is not stopped at least six months prior to the Medicare enrollment, there may be a tax penalty incurred.

Q: Are employees able to keep their medical coverage through the university upon retirement?

A: Yes. We would encourage any employee looking at retirement to contact the Benefits Office and schedule a meeting to discuss all retiree benefits.

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