Grow Your Knowledge about Health Plan Options

• They cover the same ranges of services, including prescription drugs
• Preventive care services (in-network only) are covered at 100%, with no deductible
• You must satisfy your annual deductible before coverage begins for most services; then you and your health plan option share the cost of covered services (co-insurance), up to the out-of-pocket maximum
• The out-of-pocket maximum is the same for all 3 health plan options:
  • $5,500 Individual
  • $11,000 Family
• Once you reach the out-of-pocket maximum, your health plan option pays for covered services at 100% for the rest of the year
• You can elect coverage for you and your eligible dependents
• Aetna is the plan administrator for medical services and prescription drug benefits

The services are the same for all three health plan options. It's how you pay for them that is different: 

• Would you want to pay more in premiums up front (Value or Choice) and pay less out of pocket for using health care services throughout the year?
• Or pay less in premiums (Basic) and pay more out of pocket as you use the services?
• The premiums and deductibles are different for each health plan option

Compare the three health plan options using the resources and tools below.

• Medical Scenarios webpage - You told us you wanted to know the costs for common medical procedures and how they play out across the three health plan options, in order to help you better compare values. We heard you! Go to the new UVA Health Plan Medical Scenarios webpage to see six common medical scenarios. Each scenario offers estimates for what each service could potentially cost you. While we cannot guarantee the accuracy of any cost estimate, these scenarios should give you a good understanding of how your premiums, deductibles, co-pays, co-insurance, and out-of-pocket threshold factor together to impact your total cost.
• Maximum Out-of-Pocket Comparison - The "UVA Health Plan Options at a Glance" tables below show your potential maximum annual out-of-pocket costs (premiums, deductibles, out-of-pocket max) for in-network services, for Basic, Value and Choice Health options. Each table represents one employee group (individual, + spouse, + child, family). The tables include the UVA employer contribution to HSA for Basic Health participants. Each table is to scale, relative to its out-of-pocket maximum.
• UVA Health Plan Schedule of Benefits Comparison - The UVA Health Plan Schedule of Benefits Comparison  compares various health services (professional services, preventive services, urgent care, etc.) for the Basic, Value, and Choice Health options, and shows deductibles, coinsurance, and copay amounts for each option
• UVA Health Plan Comparison Tools
  • Summary of Coverage and Benefits Glossary - English
  • Summary of Coverage and Benefits Glossary - Spanish
  • Basic Health
    • Basic Health schedule of benefits
    • Basic Health summary of benefits and coverage
  • Value Health
    • Value Health schedule of benefits
    • Value Health Out of Area (OOA) schedule of benefits (If your work location zip code in Workday is more than 50 miles from Charlottesville, you will automatically be covered under this option if you enroll in Value Health)
    • Value Health summary of benefits and coverage
    • Value Health OOA summary of benefits and coverage
  • Choice Health
    • Choice Health schedule of benefits
    • Choice Health summary of benefits and coverage
• Aetna Tools: Visit the Aetna website and click on “Log in/Register” to access these resources:​​​​​  
  • Find Care & Pricing Tool - compares costs to give you real-time, personalized estimates and provides average in-network and out-of-network costs 
  • Aetna Institute of Quality List: Lists IOQ facilities
  • Aetna Digital Care Tool- provides drug cost estimates based on the selected UVA Health Plan option. Use the links below to compare drug prices for the UVA Health Plan options.
    1. Enter the name of the drug
    2. Click "search" to view the estimate and plan details.
       • Basic Health 
       • Value Health
       • Choice Health
• ALEX Go (formerly called Picwell) - an online personalized tool that uses big data to compare information you input with millions of other Americans to determine the best fit. Previously just available for health plan options, ALEX Go now includes details about health, dental, vision, and benefits savings accounts, including how much you should save in your Basic Health HSA for anticipated medical bills.
• Personalized Assistance - If, after reviewing materials and resources on the Open Enrollment website, you would like additional 1:1 personalized assistance, please email AskHR@virginia.edu or call 434.243.3344 to schedule a Zoom appointment with one of our HR professionals. HR is offering a limited number of benefits appointments from now until Wednesday, October 11, with appointment start times from 8:00 am to 4:00 pm.

To be eligible for the UVA Health Plan:

• Employee: Must be an Academic Division or Medical Center salaried employee of UVA, full- or part-time, and regularly scheduled to work at least 20 hours/week

  • J visa holders are only eligible for the UVA J Visa Health option. Federal government regulations prohibit J visa holders from enrolling in the Basic, Value or Choice Health options.
• Spouse:

  • For the UVA Health Plan: 

    • Must be legally recognized as a spouse in the Commonwealth of Virginia and have no access to Affordable Healthcare Coverage of minimum value (as defined by the Affordable Care Act) through their non-UVA employer; OR

    • Must have access to affordable health coverage of minimum value through their non-UVA employer but ALL of their health options are HMOs and the spouse lives outside the HMOs' defined service areas. The spouse is therefore eligible to be a dependent on the UVA employee's health coverage.

  • For UVA Dental and Davis Vision: Must be legally recognized as a spouse in the Commonwealth of Virginia.

• Children: Must be your biological, step, adopted, or foster child, or any child declared a dependent on your federal tax return for whom you are the legal guardian with permanent custody. Children are eligible to the end of the birth month in which they turn 26.

• Children With Disabilities: Must be incapable of self-support due to a mental or physical disability. May continue beyond age 26, as long as:

  • Required documentation is approved in advance by the Aetna Claims Administrator prior to the dependent’s 26th birthday
  • They are unmarried
  • They live with you 100% of the time
  • They are declared a dependent on your federal tax return
  • For further details and additional assistance, contact Aetna Member Services at 800.987.9072, or the UVA Health Plan Ombudsman.

In order to enroll in the Basic Health plan option, you must:

• Be eligible for UVA’s Health Savings Account (HSA) progra

• Be enrolled in a high deductible health plan (HDHP) if you are covered by another health care plan

• Not be covered by any part of Medicaid or Tricare, or be enrolled in Medicare Part A or Part B in the year 2023

• Not be a J Visa holder (federal government regulations prohibit J Visa holders from enrolling in the Basic Health option)

Just like getting an annual physical, it is a good idea to also review your benefits annually. You can do this by navigating to Workday and confirming the benefits you previously selected continue to meet the needs of you and/or your family.

Note key dates on your calendar.

Attend Open Enrollment presentations and benefits vendor webinars September 13 - October 4. See the schedule.

Review how you used your health plan last year. Did you use it for:

• Medical or dental procedures?
• Glasses or contact lenses?
• Changes in dependent care?
• Replacements to medical or assistive devices?
• Life events, like marriage, new children?

Review how you spent any funds and used your benefits by going to your benefit accounts:

• Medical & Pharmacy claims: Aetna website
• Dental: United Concordia website
• Vision:
  • Aetna website
  • Davis Vision website
• Flexible Spending Account/Health Savings Account: Fidelity website

Plan for use-or-lose benefits early with your Dependent Daycare Account and FSA.

If you're adding a new dependent to your health plan, have your dependent verification documentation ready to upload into Workday during Open Enrollment. You will not be able to submit your benefits elections if you have added a new dependent to your health plan and have not provided the required documentation.

Confirm home address, phone number, and add missing social security numbers for dependents in Workday.

Review new resources: New mini videos above offer the personal stories of employees experiencing different scenarios involving their benefits, that led them to decisions during Open Enrollment.

Attend benefits vendor webinars through October 4. See the schedule.

Review Benefits and Make Changes in Workday:

• Modify medical, dental, vision benefits, if desired.
• Re-Elect FSA/HSA - Even if you do not want to make any changes to your health, dental, or vision plans, you still need to re-elect the FSA and HSA programs for 2024 during Open Enrollment. 2023 elections for FSAs and HSAs will NOT automatically carry over to 2024.
• Add or drop dependents, if applicable. Adding a spouse or dependent requires documentation confirming their relationship to you in order for your Open Enrollment change request to be approved. If you change your health, dental, or vision options, remember to re-add your dependents. If you add new dependents, you must upload required documentation.
• Confirm home address, phone number, and add missing social security numbers for dependents in Workday.
• Change supplemental retirement and life insurance options, if desired.
• Print elections once submitted in Workday, or save as PDF.

Look for additional Open Enrollment tasks in your Workday inbox.

Don't forget to earn and record activities for your 2023 Hoos Well rewards in the Hoos Well portal by November 30, 2023.

If you switched to Basic Health for the first time, spend down your Full FSA to $0.00 by December 31, 2023.

Look for additional Open Enrollment tasks in your Workday inbox.

The monthly premiums below apply to both part-time and full-time employees.

2024 Monthly Premiums

2024 Monthly Premiums

2024 Monthly Premiums - CHOICE

2024 Monthly Premiums - VALUE

2024 Monthly Premiums

Benefits-eligible Academic Division and Medical Center wage employees may only enroll in Basic Health.

To find out if benefits under this Plan will be reduced, Aetna must first use the rules listed below, in the order shown, to determine which plan is primary (pays its benefits first). The first rule that applies in the chart below will determine which plan pays first:

When the other plan pays first, the benefits paid under this Plan are reduced as shown here:

• The amount this Plan would pay if it were the only coverage in place, minus
• Benefits paid by the other plan(s)

This prevents the sum of your benefits from being more than you would receive from just this Plan. If your other plan(s) pays benefits in the form of services rather than cash payments, the Plan uses the cash value of those services in the calculation.

You are eligible for Medicare if you are:

• Eligible for, and covered by, Medicare
• Eligible for, but not covered by Medicare because you:
  • Refused Medicare coverage
  • Dropped Medicare coverage
  • Did not make a proper request for Medicare coverage

When you are eligible for Medicare, Aetna must determine whether this Plan or Medicare is the primary plan.

When This Plan is Primary

This Plan is primary, and Medicare is secondary, if a covered person is eligible for Medicare and falls into one of the following categories unless eligible for Medicare due to End Stage Renal Disease (ESRD):

• An active employee, regardless of age
• A totally disabled employee who is:
  • Not terminated or retired
  • Not receiving Social Security retirement or Social Security disability benefits
• A Medicare-eligible dependent spouse of:
  • An active employee
  • A totally disabled employee who is not terminated or retired
• Any other person for whom this Plan’s benefits are payable to comply with federal law

When this Plan is the primary plan, Aetna will not take Medicare benefits into consideration when determining the benefits payable by the Plan.

End-Stage Renal Disease

This Plan is primary for the first 30 months after any covered person becomes eligible for Medicare due to End-Stage Renal Disease (ESRD). The Plan will pay benefits for a covered expense first, before Medicare benefits are available.

Medicare becomes the primary plan, and this Plan is secondary, beginning with the 31st month of Medicare eligibility due to ESRD. If you’re eligible for Medicare only because of permanent kidney failure, your Medicare coverage will end 12 months after the month in which you stop dialysis treatments or 36 months after the month in which you have a kidney transplant.

When Medicare is Primary

Medicare is the primary plan, and this Plan is secondary, if a covered person is eligible for Medicare and does not fall into one of the categories above or is in their 31st month or later of Medicare eligibility due to ESRD.

These rules are based on regulations issued by the Centers for Medicare and Medicaid Services (CMS), and may be amended or changed at any time. It is the intent of the Plan to abide by the Medicare Secondary Payer Rules. If the Plan in any way conflicts with regulations issued by CMS, the Plan will pay Benefits in accordance with CMS regulations.

WDA offers step-by-step assistance directly in Workday. You can also review the Open Enrollment Workday Job Aid on the Workday Central webpage (behind NetBadge), "Happening Now" section.

A summary of how to review and elect your benefits in Workday is below:

• Navigate to Workday.
• In your Workday Inbox, click on the message titled "Open Enrollment Change: [Your Name] on 01/01/2024"; click on "Let's Get Started."
• Open Enrollment in Workday is organized into "tiles" for each benefit; you will see two sections, one for Health Care and Accounts, and one for Insurance. Each section has multiple tiles. You will start with Health Care and Accounts.
• You will have three edit options at the bottom of every tile:
  • Manage to make changes to a benefit you already have
  • Enroll to add a new benefit
  • View to see a benefit that is not editable in Workday (more on this further down)
• Select a tile and choose the edit option for that tile.
• Once you've selected or waived a benefit in the Health Care and Accounts section, click on Confirm and Continue -- this will take you to a separate window to select or waive eligible dependents for that benefit. Dependents previously enrolled who are eligible will show up automatically, you just need to select or waive each one of them.
• Click Save to update the benefit tile. This does NOT submit your elections, it just saves the individual benefit tile details you've selected. 
• Repeat the above process for all six Health Care and Accounts tiles.
• Workday now offers you a status update on which benefits you’ve touched: "Reviewed," "Updated" or blank if you haven't touched a benefits tile yet.

• Once you've completed the Health Care and Accounts section, move on to the Insurance section. You will see multiple tiles under Insurance.
• Select a tile and choose the edit option for that tile.
• Please note that some life insurance benefits are VIEWABLE in Workday but not changeable. Each of these tiles will direct you to where you need to go to make changes. Some of these changes may be outside of Workday.​
• Once all your benefits have been reviewed and edited as needed, attach any required documents such as birth certificate for new dependents, then click on Review and Sign -- here you can read the summary of what's you elected.
  • New Basic Health participants: Sign and submit the HSA Terms and Conditions authorization form on the Review and Sign page. This document authorizes Fidelity to open your HSA and is required to receive the 2024 employer contribution.
  • New Dependents: If you added new dependents during Open Enrollment (spouse or children), upload required documentation into Workday. You will see a Spousal Affidavit on the Review and Sign page.
• Click on the I Accept box, then click on Submit to complete your Open Enrollment process.
• Print this page or save it as a PDF.

You can make changes to your elections as long as the Open Enrollment period is open, even after you have submitted your elections.

• From the Benefits app in Workday, click on Change Open Enrollment
• You will be making changes to what has been previously submitted. Any changes made will need to be resubmitted. If you do not resubmit, the changes will be deleted and the previous submission will remain in effect.
• Move through the same tiles to elect or waive coverage.
• Once changes are complete, electronically sign at the bottom of the last page and press the Submit button.
• Print the new confirmation of benefits elections or save as a PDF.

Look for additional tasks in Workday related to your Open Enrollment elections:

• Dependents and Beneficiaries: If you changed your dependents or beneficiaries in Workday, look for possible additional action items in your Workday Inbox.

Yes, two UVA spouses may choose who covers and who waives, or they may have separate plans.

An employee's non-UVA spouse who has access to health benefits that meet affordability and minimum value standards as defined by the Affordable Care Act is generally not eligible for coverage as a dependent on the employee's UVA Health Plan. However:

• Spouses whose remote employer offers affordable health care that provides minimum value, but ALL of their health options are HMOs and the spouse lives outside the HMOs' defined service areas, are eligible to be a dependent on the UVA employee's health coverage. 

Try our health care analytical tool, ALEX Go, to help you choose.

Look at the Medical Scenarios webpage to learn how the deductible, coinsurance, copayment, and out-of-pocket maximum affect your cost across the 3 health plan options for various common medical scenarios.

You can map out what you’ll need from your benefits in 2024 by reviewing how you’ve used them in 2023 and thinking about anything new you might need next year. Reviewing how you’ve spent funds and used benefits over the last year can be a huge help when selecting a plan. The following resources can help you look back, in order to take care of yourself in 2024:

• Medical & Pharmacy Claims: Aetna website
• Dental: United Concordia member website
• Vision: Davis Vision member website
• Flexible Spending Accounts/Health Savings Accounts:  Fidelity website

Here are helpful questions to ask yourself. Do you have: 

• Any medical or dental procedures planned? 
• Any upcoming glasses or contact lens needs?
• Any changes in dependent care ?
• A need for replacements to medical or assistive devices?
• Potential life events — for example, new marriage, new children, or children after age 13 no longer eligible for Dependent Care FSA funds?
• Dependents' social security numbers listed correctly in Workday?​

Remember that choosing a health plan option is a personal choice about how you pay for health care services. The services are the same for all three health plan options. It's how you pay for them that is different. Would you want to pay more in premiums up front and pay less out of pocket for using health care services throughout the year? Or pay less in premiums and pay more out of pocket as you use the services?

Preventive care services (in-network only) are the same for all three health plan options, and are covered at 100%, with no deductible.

The Affordable Care Act Employer mandates that large employers (50+ employees) must offer health insurance that is affordable and provides minimum value to 95% of their full-time employees (or FTE equivalent) and their children up to age 26, or be subject to penalties.

What are the requirements for Academic Wage employees?

The Commonwealth has specific guidelines built within the Manpower Control Program that UVA is required to follow regarding working hour limitation for wage employees. This is a budgeting requirement, and we are mandated by the guidelines as a state institution of higher education.

Are there limitations regarding hours worked for Academic Wage employees?

Wage employees cannot work more than an average of 29 hours per week in a 12-month measurement. All wage employees are monitored through weekly reporting, and terminated prior to reaching 1500 hours.

What are the requirements for Medical Center Wage employees?

The Medical Center is not mandated by the Commonwealth, and as such they do offer benefits to wage employees who meet the ACA mandate.

Wage employees who average 30 hours per week in the 12-month measurement period are eligible for the Basic Wage Health (no HSA).

Academic division and medical center FT/PT employees who transfer to a wage position within the plan year may also qualify based on their hours.

What time frame are wage employees' hours monitored?

October to October. The plan is effective 1/1 through 12/31 of the current plan year.

A dependent is a person who is eligible to be covered by you under the health, dental and vision plans. A beneficiary can be a person or a legal entity that is designated by you to receive a benefit, such as life insurance.

A spouse included in your medical coverage and designated as a recipient of your life insurance is both a dependent and a beneficiary.

For another example, a parent is not an eligible dependent for medical coverage but could be designated as a beneficiary.

For additional details about required documentation for eligible dependents, visit the Open Enrollment Eligibility 2024 webpage.

Detailed information about eligibility for the UVA Health, Dental, and Vision Plans can be found on the Eligibility 2024 webpage. In a nutshell, the Plans are open to:

• UVA Academic and Health System salaried employees, full-time or part-time working at least 20 hours/week, except J visa holders, who are eligible for the UVA J Visa Health Plan
• Spouses of eligible UVA employees (some exception noted on the Eligibility 2024 webpage)
• Children of eligible UVA employees - children (as defined on the Eligibility 2024 webpage) are eligible through their birthday at age 26, or longer if documented to have mental or physical disabilities (see the Eligibility 2024 webpage for more details)

The Basic Health option has some additional requirements; please visit the Eligibility 2024 webpage for those details.

Below is a simple illustration of how deductibles, coinsurance, and out-of-pocket maximums work for a single employee on Basic Health. For additional examples, please see the Medical Scenarios webpage, or call Aetna for customized scenarios based on your preferred health plan option and potential future health care expenses.

UVA employees and their dependents, covered by the UVA Health Plan may obtain a flu shot through their Primary Care Physician, or at a pharmacy in Aetna's National Pharmacy Network, if you present your Aetna ID card at the pharmacy.

Flu vaccines are covered at no cost, as a preventive service through the UVA Aetna Health Plan. When obtained through an in-network Primary Care Physician, or at a pharmacy in  Aetna's National Pharmacy Network. 

Here is a list of vaccine providers within the Aetna network.

If you went to a participating pharmacy and were charged for your flu vaccine, you can submit a reimbursement to Aetna. Complete steps 1-25 in the reimbursement form, and attach your receipt and other supporting documentation.

No. If you plan to enroll in Medicare, you are not eligible to sign up for Basic Health and are not eligible for a Basic Health HSA. The UVA Health Plan does not allow movement from one health plan option to another during the year for any reason. Therefore, you cannot move from Basic Health to Value Health or Choice Health or vice versa anytime during 2024 if you are thinking about enrolling in Medicare for the same year. You will be out of compliance with IRS which may incur a penalty and will have to address this when you complete your 2023 tax returns.

When considering health plan options during Open Enrollment, make sure your choices for the following calendar year are appropriate for the entire year.

Yes. You may use HSA funds for your spouse even if your spouse is on Medicare. The spouse must be declared on your federal income taxes as a dependent (i.e. filing jointly), and the expense in question is not already covered by Medicare. Otherwise, if the expense is eligible, not already covered by the health plan, and your spouse is a tax dependent, then you may use HSA funds to pay for it.

You and your Medicare-eligible dependent will still receive $1,500 seed money for your Basic Plan HSA.

You do not have to enroll in Medicare until you end your employment with UVA. Your benefits counselor will provide you with the form CMS-L564 to negate the late enrollment penalty. 

You can choose to enroll in part A, and waive part B, but this will terminate your eligibility for the HDHP (Basic Health). 

If you have been newly granted a J Visa during the year, you must move from the UVA Health Plan to the UVA J Visa Health Plan. These are two entirely different health plans, and moving from one to the other is allowed throughout the year in order to comply with federal health coverage requirements.

If you have been on the UVA J Visa Health Plan and are newly granted a different type of visa, you must stay on the UVA J Visa Plan for the rest of the calendar year.

Basic Health participants have a deductible that applies to both medical and prescription costs. You must pay for covered health care services and prescriptions up to your deductible amount before the UVA Health Plan begins to pay. 

Value and Choice Health participants have a deductible that applies to both medical and prescription costs for tier 2 and tier 3 retail drugs. You must pay for covered prescriptions up to your deductible amount before the UVA Health Plan begins to pay for tier 2 and tier 3 retail prescriptions. Tier 1 medications and specialty prescriptions are not subject to the deductible.

The table below shows costs for retail pharmacy outside of UVA pharmacies (such as CVS, Kroger, etc.); excludes specialty prescriptions and mail order prescriptions.

You can find information on our Prescription Drug Program 2024 webpage.

If you need additional details, contact Aetna for assistance.

To get specialty prescription drugs, you must use the UVA Specialty Pharmacy, which can be reached at 434.297.5500 or by email at specialtymedsrx@virginia.edu.