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2014 Health Coverage Changes
The following are changes to the health coverage for 2014:
Preventative Health Coverage paid at 100% in 2014 is required by the Patient Protection and Affordable Care Act (PPACA). Preventive care services are
those provided when you don’t have any symptoms of a disease or medical condition and are not already diagnosed with the condition for which the preventive
service would be provided. Preventive care helps you to prevent some illnesses and helps to detect illness that is present, but where there aren’t any symptoms.
The PPACA requires that preventive care services be covered with no patient cost-sharing (deductible, coinsurance or copayment). The preventive care services
covered with no patient cost-sharing only when you receive it from an in-network health care professional. Click
here for more detailed information on covered services.
·In 2014, The Women’s Health Coverage is mandated to be paid at 100%. However, the University adopted this in 2013 and this coverage continues.
Beginning in 2014, there will no longer be a pre-existing condition limitation on any employees.
Beginning in 2014, the University’s Out of Pocket Maximum (OOP) will change to a true out of pocket maximum and will include:
$15 co-pays, 20% coinsurance, $250 deductible and $100 emergency room co-pays will be included and counted toward the out of pocket max. (the deductible
and co-pays were not counted in 2013)
The Out of Pocket Maximum has increased to:
$3,000 per individual; $6,000 per family in network and
$9,000 per individual; $18,000 per family Out of Network.
This means that the deductible, co-pays, and coinsurance will add together. Once an individual’s 2014 in network deductible, co-pays, and coinsurance total
$3,000, that individual’s in network co-pays coinsurance and any remaining deductible (if any) will be Zero until December 31, 2014.
Adult children of employees can remain on the University’s coverage until December 31st of the year they become 26 years old.
Contact Staff Benefits, extension 4150, with questions.