UVA Health Plan 2022

Choose the Right Health Plan Option For You


Open Enrollment for plan year 2022 is now closed. Please contact the HR Solution Center if you have questions about the Open Enrollment process.


2021 continues 2020's "anything but normal" year. UVA leadership cares deeply about you and continues to look for ways to help. We want to make the Open Enrollment/benefits review process as easy and painless as possible and are giving you many varied opportunities to learn what you need to know to be an informed benefits consumer.

Key Takeaways

For the 2022 plan year, there are no changes to premiums, coinsurance, or copays for the Basic, Value, and Choice Health options for full-time employees. However, there are action items for you to take.

Ensure you're aware of all UVA health plan changes for this year. For the 2022 Plan year, these include:

Part-Time Employees - Part-time employees will receive the same employer contribution to their premium as full-time employees.​ There will be one premium rate for all benefits-eligible employees within each employee category, resulting in much lower premiums for part-time employees.

HSA Employee Contribution - The employee maximum contribution to the Health Savings Account for Basic Health participants will increase in 2022 (employer seed funds will remain the same):

  • Individual - $3,650
  • Family - $7,300
  • Catch-up (age 55+) - $1,000 (no change)

NEW Spouse Eligibility - 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.

New Hearing Benefit - One annual hearing exam will be covered, performed by an audiologist as a cost-share benefit.​ Medically necessary hearing aids will be covered, up to $1,200 every 48 months.​

Expanded Infertility Benefit - Waives some of the medical requirements for infertility eligibility, specifically, removing Aetna's infertility definition for UVA Health Plan participants. This will make the infertility benefit more widely available. Consult an A1A team member or view the revised Clinical Policy Bulletin with the definition removed on page 2.​

Basic and Value Changes - You said in the 2018 Benefits Preferences Survey that maintaining health plan premium rates was very important to you. To keep premiums stable for another year, the following changes will occur January 1, 2022:

  • Basic Health - The out-of-pocket maximum for all three health plan options will be the same. This means that the Basic Health out-of-pocket maximum will return to its 2018 levels of $5,500 for individuals and $11,000 for families for in-network services, and $11,000 for individuals and $22,000 for families for out-of-network services, to match that of the Choice and Value health plan options.​
  • Value Health - Participants will see an increase in their out-of-network deductible, totaling $2,400 for individuals and $4,800 for families.​

UVA J Visa Health Plan - The UVA J1 Visa Health Plan will be called the UVA J Visa Health Plan, effective January 1, 2022.​ There are no premium increases for 2022 for those previously enrolled in the UVA J1 Visa Health Plan. See the UVA J Visa Health Plan 2022 webpage for additional details and changes.

 

UVA Health Plan Options

UVA offers 3 health plan options: Choice, Value, and Basic Health. All three health plan options offer the same services but different ways of paying for these services. These options apply to full- and part-time benefits-eligible employees:

  1. Basic Health - least expensive option with highest deductible, lowest premium, and a Health Savings Account with UVA contribution of $1,000 (employee only) or $1,500 (employee + spouse, child, or family) to offset the high deductible
  2. Value Health - mid-range option with medium deductible, higher premium
  3. Choice Health - most expensive option with lowest deductible, highest premium

When researching which option fits your needs, consider not only your health care needs, but your comfort with how you pay for your medical costs. If you prefer the less expensive option, are you financially prepared to cover 100% of your medical expenses up to your deductible?

If you are on a J Visa, or 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.

  • How the Plan Options are the Same

    • 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
    • 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
  • How the Plan Options are Different

    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?
  • Compare Plan Options

    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
    • Aetna Tools: Visit the Aetna website and click on “Log in/Register” to access these resources:​​​​​  
    • 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, Picwell 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.
    • ALEX - a step-by-step virtual assistant who helps you choose benefits. Enter basic information and ALEX responds with what’s available and how to get the best value for your investment. View this fun sneak peek video of 2022 benefits.
    • Podcasts - Enjoy a short podcast on Retirement, presented in an informal way. Links for the podcast and a written transcripts of it are on the right sidebar on this and all Open Enrollment pages.
    • 2022 Open Enrollment Overview Video: This video provides a high-level summary of 2022 benefits changes, action items for you to take, and resources to help select your benefits
    • 2022 Open Enrollment Powerpoint: This powerpoint reports on 2022 benefits changes, resources, premiums, and keys dates to remember
    • OE Presentations: Virtual and in-person Open Enrollment presentations are available to assist you with your benefits choices. You can see the schedule for them here.
    • Personalized Assistance - If, after reviewing materials and resources on the Open Enrollment website, you would like additional 1:1 personalized assistance, please 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 13, with appointment start times from 8:00 am to 4:00 pm.
    • Still Need Help? Contact the UVA HR Solution Center, by email  at AskHR@virginia.edu or by phone at 434.243.3344

    When you are ready to enroll, log in to Workday and follow the instructions in your inbox for Open Enrollment.

    2022 Open Enrollment Comparison Table, Employee Only

    2022 Open Enrollment Comparison Table, Employee + Child

    2022 Open Enrollment Comparison Table, Employee + Spouse

    2022 Open Enrollment Comparison Table, Family

  • Eligibility Requirements for any of the UVA Health Plan Options

    Requirements for eligibility for any of the UVA Health Plan options:

    • Employee: Must be an Academic 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 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 (NEW for 2022) 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, are eligible to be a dependent on the UVA employee's health coverage.

      • For UVA Dental and Davis Vision: Must be legally recognized as 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.
  • Basic Health Eligibility

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

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

    • 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 2022

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

Action Items

  • Before Open Enrollment Opens

    Just like getting an annual physical, it is a good idea to also check 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 15 - October 13. 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:

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

    Review the Workday Benefits Tiles video so you are familiar with the steps you will need to take:

    • Modify medical, dental, vision benefits, if desired
    • Enroll in FSA or HSA, if desired
    • Confirm beneficiaries for life insurance
    • Modify long-term disability coverage, if applicable
    • Add or modify dependents, if applicable

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

  • During Open Enrollment October 4 - 15

    Attend benefits vendor webinars through October 13. 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 2022 during Open Enrollment. 2021 elections for FSAs and HSAs will NOT automatically carry over to 2022.
    • 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.
    • Confirm home address, phone number, and social security numbers for dependents in Workday.
    • Confirm or change beneficiaries for life insurance.

    Print elections once submitted in Workday, or save as PDF.

    Look for additional Open Enrollment tasks in your Workday inbox.

  • After Open Enrollment Closes

    Don't forget to redeem your 2021 Hoos Well rewards in the Hoos Well portal by November 30, 2021.

    If you switched to Basic Health for the first time, spend down your Full FSA to $0.00 by December 30, 2021.

2022 UVA Health Plan Premiums

Select your employee category to see 2022 UVA Health Plan premiums. The tables for 2022 will show both the Employee Premium (what you contribute each month) and the Employer Premium (what UVA contributes toward your health plan option each month).

For the 2022 plan year, there are no changes to premiums, coinsurance, or copays for the Basic, Value, and Choice Health options for full-time employees.

Beginning January 1, 2022, part-time Academic and Medical Center employees will receive the same employer contribution to their premium as full-time employees, resulting in much lower premium rates.

  • Faculty, Classified Staff, Medical Center Team Members, Research Associates, Senior Professional Research Staff, and University Staff (Full-time and Part-time)

    For the 2022 plan year, there are no changes to premiums, coinsurance, or copays for the Basic, Value, and Choice Health options for full-time employees.

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

    2022 Monthly Premiums

    Monthly Rate - BASIC Employee Rate Employer Rate Total Rate
    Employee $20.00 $464.25 $484.25
    Employee + Child(ren) $25.25 $821.75 $847.00
    Employee + Spouse $33.25 $1,055.50 $1,088.75
    Family $63.00 $1,510.50 $1,573.50
    Monthly Rate - VALUE Employee Rate Employer Rate Total Rate
    Employee $87.50 $470.00 $557.50
    Employee + Child(ren) $140.25 $833.25 $973.50
    Employee + Spouse $176.25 $1,075.00 $1,251.25
    Family $282.25 $1,528.75 $1,811.00
    Monthly Rate - CHOICE Employee Rate Employer Rate Total Rate
    Employee $183.00 $493.25 $676.25
    Employee + Child(ren) $370.25 $821.75 $1,192.00
    Employee + Spouse $477.00 $1,055.50 $1,532.50
    Family $706.00 $1,510.50 $2,216.50
  • Housestaff

    For the 2022 plan year, there are no changes to premiums, coinsurance, or copays for the Basic, Value, and Choice Health options for full-time employees.

    2022 Monthly Premiums

    Monthly Rate - VALUE Employee Rate Employer Rate Total Rate
    Employee $62.75 $494.75 $557.50
    Employee + Child(ren) $63.00 $910.50 $973.50
    Employee + Spouse $64.25 $1,187.00 $1,251.25
    Family $64.50 $1,746.50 $1,811.00
    Monthly Rate - CHOICE Employee Rate Employer Rate Total Rate
    Employee $78.00 $598.25 $676.25
    Employee + Child(ren) $89.25 $1,102.75 $1,192.00
    Employee + Spouse $91.50 $1,441.00 $1,532.50
    Family $101.50 $2,115.00 $2,216.50
  • Postdoctoral Fellows

    For the 2022 plan year, there are no changes to premiums, coinsurance, or copays for the Value and Choice Health options for postdoctoral fellows. 

    2022 Monthly Premiums

    Monthly Rate - VALUE Total Rate
    Single $501.50
    Postdoc + Child(ren) $743.75
    Postdoc + Spouse $1,028.50
    Family $1,481.75
    Monthly Rate - CHOICE Total Rate
    Single $559.00
    Postdoc + Child(ren) $848.75
    Postdoc + Spouse $1,163.00
    Family $1,678.00
  • Temporary and Wage Employees

    For the 2022 plan year, there are no changes to premiums, coinsurance, or copays for the Basic, Value, and Choice Health options for full-time employees.

    2022 Monthly Premiums

    2022 Monthly Premiums - BASIC Employee Rate Employer Rate Total Rate
    Employee $181.50 $234.75 $416.25
    Employee + Child/Children $503.00 $234.75 $737.75
    Employee + Spouse $717.50 $234.75 $952.25
    Family $1,146.25 $234.75 $1,381.00

COBRA Premiums

As a COBRA participant, you can choose enrollment only in the same option in which you were enrolled on your last day of coverage as an active employee, Postdoc Fellow, or Housestaff. Monthly COBRA premiums are listed below. 

COBRA participants: Visit Chard Snyder COBRA Customer Service on the web or call 888.878.6175.

  • Active Employees and Research Associates

    2022 Active Employees and Research Associates Cobra BASIC Cobra VALUE Cobra CHOICE
    Employee $493.94 $568.65 $689.78
    Employee + Child/Children $863.94 $992.97 $1,215.84
    Employee + Spouse $1,110.53 $1,276.28 $1,563.15
    Family $1,604.97 $1,847.22 $2,260.83
  • Active Wage Employees

    2022 Active Wage Employees  Cobra BASIC
    Employee $424.58
    Employee + Child/Children $752.51
    Employee + Spouse $971.30
    Family $1,408.62
  • Postdoctoral Fellows

    2022 Postdoctoral Fellows  Cobra Value Cobra Choice
    Postdoc $511.53 $570.18
    Postdoc + Child/Children $758.63 $865.73
    Postdoc + Spouse $1,049.07 $1,186.26
    Family $1,511.39 $1,711.56
  • Housestaff

    2022 Housestaff  Cobra VALUE Cobra CHOICE
    Employee $568.65 $689.78
    Employee + Child/Children $992.97 $1,215.84
    Employee + Spouse $1,276.28 $1,563.15
    Family $1,847.22 $2,260.83

UVA Health Plan Coordination With Medicare and Other Plans

If you have coverage under other group or individual plans or receive payments for an illness or injury caused by another person, the benefits you receive from this Plan may be adjusted. This may reduce the benefits you receive from this Plan. The adjustment is known as coordination of benefits (COB).

Benefits available through other groups or individual plans, contracts or other arrangements, are coordinated with this Plan. This includes automobile insurance coverage, where a health benefit is to be provided, arranged, or paid for, on an insured or uninsured basis. Members involved in an automobile accident should contact Aetna regarding COB.

“Other plans” include any other plan of dental or medical coverage provided by:

  • Group insurance or any other arrangement of group coverage for individuals, regardless of whether that plan is insured
  • Motor vehicle personal injury protection benefit (PIP) or optional motor vehicle insurance, to the extent of applicable law. Whenever legally possible, this Plan will be secondary.

  • Which Plan Pays First?

    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:

      IF:  THEN:
    1. One plan has a COB provision and the other plan does not The plan without a COB provision determines its benefits and pays first
    2. One plan covers you as a dependent and the other covers you as an employee or retiree

    The plan that covers you as an employee or retiree determines its benefits and pays first. Note: If you are Medicare-eligible, this rule may be reversed. Please see rule 3, below.

    3. You are eligible for Medicare and not actively working These Medicare Secondary Payer rules apply:

    - The plan that covers you as a dependent of a working spouse determines its benefits and pays first

    - Medicare pays second

    - The plan that covers you as a retired employee pays third

    4. A child’s parents are married or living together (whether or not married) The plan of the parent whose birthday occurs earlier in the calendar year determines its benefits and pays first. If both parents have the same birthday, the plan that has covered the parent the longest determines its benefits and pays first. But if the other plan does not have this “parent birthday” rule, the other plan’s COB rule applies.
    5. A child’s parents are separated or divorced with joint custody, and a court decree does not assign responsibility for the child’s health expenses to either parent, or states that both parents are responsible for the child’s health coverage The “birthday rule” described in rule 4 applies
    6. A child’s parents are separated or divorced, and a court decree assigns responsibility for the child’s health expenses to one parent The plan covering the child as the assigned parent’s dependent determines its benefits and pays first
    7. A child’s parents are separated, divorced or not living together (whether or not they have ever been married) and there is no court decree assigning responsibilities for the child’s health expenses to either parent Benefits are determined and paid in this order:

    - The plan of the custodial parent pays, then

    - The plan of the spouse of the custodial parent pays, then

    - The plan of the non-custodial parent pays, then

    - The plan of the spouse of the non-custodial parent pays.

    8. You have coverage as an active employee (that is, not as a retiree or laid off employee) and coverage as a retired or laid off employee. Or you have coverage as the dependent of an active employee and coverage as the dependent of a retired or laid off employee The plan that covers you as an active employee or as the dependent of an active employee determines its benefits and pays first. This rule is ignored if the other plan does not contain the same rule. Note: this rule does not apply if the rule 2 (above) has already determined the order of payment.
    9. You are covered under a federal or state right of continuation law (such as COBRA) The plan other than the one that covers you under a right of continuation law will determine its benefits and pay first. This rule is ignored if the other plan does not contain the same rule. Note: this rule does not apply if rule 2 (above) has already determined the order of payment.
    10. The above rules do not establish an order of payment The plan that has covered you for the longest time will determine its benefits and pay 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.

  • Coordination with Medicare

    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.

Additional Information

  • Dependents: While reviewing your benefit elections, be sure to check any dependent information listed and confirm that each dependent’s social security number, birth date, and continued eligibility for coverage is accurate. Now is the time to drop ineligible dependents.
  • FAMIS Virginia’s Affordable Health Care for Children: To see if you qualify for FAMIS, go to Cover Virginia and call 1.855.242.8282, Option 8 to apply.

Resources

Overall, I found this open enrollment period to be pretty smooth. Thank you for all the resources you offer to help in the process. Thank you! Hai Yan Chen Dendy, Assistant Director, The Virginia College Advising Corps

FAQs - UVA Health Plan

  • Can married UVA employees share a UVA health plan?

    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, (new for 2022):

    • 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. 
  • How do I decide what health plan option is best for me?

    Try our health care analytical tools, Picwell or ALEX, to help you choose.

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

    You can map out what you’ll need from your benefits in 2022 by reviewing how you’ve used them in 2021 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 2022:

    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?

  • How do preventive care services compare between the three health plan options?

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

  • Wage Employees and the Affordable Care Act

    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).

    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.

  • What's the difference between a beneficiary and a dependent?

    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 2022 webpage.

  • Who is eligible for the UVA Health, Dental, and Vision Plans?

    Detailed information about eligibility for the UVA Health, Dental, and Vision Plans can be found on the Eligibility 2022 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 2022 webpage)
    • Children of eligible UVA employees - children (as defined on the Eligibility 2022 webpage) are eligible through their birthday at age 26, or longer if documented to have mental or physical disabilities (see the Eligibility 2022 webpage for more details)

    The Basic Health option has some additional requirements; please visit the Eligibility 2022 webpage for those details.

  • How does cost-sharing work between me and Aetna?

    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 new Medical Scenarios webpage, or call Aetna for customized scenarios based on your preferred health plan option and potential future health care expenses.

    How you and Aetna share health care costs

  • Where can I obtain a flu vaccine? What is the cost?

    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.

    Flu Shot Updates

FAQs - UVA Health Plan and Medicare

  • Can I sign up for the Basic Health or the Basic Health HSA if I’m enrolling in Medicare?

    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 2022 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 2022 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.

  • Can I sign up for Basic Health or the Basic Health HSA if my spouse on my UVA Health Plan is enrolled in Medicare?

    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.

  • Do I (or my spouse) have to enroll in Medicare once I turn 65? I am already enrolled in the UVA Health Plan.

    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). 

FAQs - UVA Health Plan and J Visa

FAQs - Prescription Drug Program

  • How do my deductible, coinsurance, and min/max tiers work with prescription drugs?

    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.

    Tier Choice Value Basic

    Tier 1

    Generic, low cost

    $6 co-pay

    30-day supply

    $6 co-pay

    30-day supply

    Deductible + 20% for up to 90-day supply

    Tier 2

    Brand, Preferred

    Deductible + 20%

    $34 min/$150 max

    30-day supply

    Deductible + 20%

    $34 min/$150 max

    30-day supply

    Deductible + 20% for up to 90-day supply

    Tier 3

    Brand, Non-Preferred

    Deductible + 20%

    $68 min/$225 max

    30-day supply

    Deductible + 20%

    $68 min/$225 max

    30-day supply

    Deductible + 20% for up to 90-day supply

     

  • Where can I find more information about prescription coverage?

    You can find information on our Prescription Drug Program 2022 webpage.

    If you need additional details, contact Aetna for assistance.

  • Where can I obtain my specialty medication?

    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.

Having trouble finding what you’re looking for?

We strive to make the information on every webpage clear and easy to find. Please let the HR Communications team know if you're having trouble finding what you're looking for, so we can improve your experience on this page in the future. 

For non-website questions or concerns about benefits and Open Enrollment, please contact the HR Solution Center by phone at 434.243.3344, or by email at AskHR@virginia.edu.

For previous Open Enrollment email communications, see the right sidebar box on this page labeled "Open Enrollment Emails."