Benefits Open Enrollment for Plan Year 2023

Open Enrollment is CLOSED


Open Enrollment is now closed. ENTER TO WIN! Complete the post-Open Enrollment survey and be entered in a raffle to win free tickets to UVA’s Basketball game on Tuesday, December 6th vs James Madison or UVA's football game on Saturday, November 19th vs. Coastal Carolina Chanticleers. This is our way of thanking you for your feedback!


Open Enrollment is a time for all UVA benefits-eligible employees and team members to carefully review and elect benefits for the following plan year starting January 1, 2023.​ These benefits include health and dental plans, vision coverage, Health Savings Account, Flexible Spending Account, and Dependent Care Reimbursement Account.

Unless you experience a qualified life event like having a baby or getting married, making changes to these benefits can only be done during Open Enrollment, which this year runs October 3 through 14. ​

​You CAN change your supplemental retirement and life insurance options during Open Enrollment, but supplemental retirement and life insurance changes can be made at any time. ​

On these Open Enrollment webpages, you will find ample resources and information to assist you in making the right decision, be it staying with your current plan or deciding a different one is a better fit.

Key Takeaways

UVA Health Plan

  • For the 2023 plan year, there are no changes to deductibles or copays for the UVA Health Plan.
  • Premiums will increase for the Basic, Value, and Choice Health plan options, and J Visa Health Plan.
  • There are no changes to dental or vision coverage or premiums in 2023.
  • Effective January 1, 2023, visiting faculty will be eligible for dental and vision benefits.
  • Cost-sharing amounts for 30-day, 90-day and Specialty refills of prescription medications will increase for Value and Choice Health participants. There are no changes to the Prescription Drug program for Basic Health participants.

Other Changes

  • The Benefits and Well-Being Expo is back! Plan on attending in person, or attend the benefits presentation and vendor webinars in person or virtually.
  • New mini videos on this website address the health plan changes coming in 2023.
  • Benefits-eligible Medical Center team members will see improved educational assistance benefits.
  • Fidelity will become the new administrator in 2023 for UVA's benefit savings accounts, including the Basic Health HSA, the Full and Limited FSA, and the Dependent Care Reimbursement Account.
  • HSA maximum employee contributions will increase slightly. 

For details on the changes above, scroll down to the Summary section, "Changes for 2023."

There are some other changes and enhancements to be aware of, so please take time to review this webpage. If you need more details, navigate to the topic-specific webpages.

To make the Open Enrollment experience as beneficial for you as possible, you have both in-person and virtual opportunities to learn what you need to know to pre-plan your future emotional, physical, and financial well-being. Whether you want to meet in person or virtually, UVA HR is here to help.

Watch the 2023 Open Enrollment Benefits Presentation

This presentation summarizes 2023 changes, key dates, action items, resources, and how to enroll in Workday.

Action Items

  • BEFORE Open Enrollment Opens

    Note key dates on your calendar.

    Review benefits usage in 2022. 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 Care Account and FSA.

    Attend Open Enrollment benefits presentations September 13 - October 12. See the schedule.

    Watch the Open Enrollment overview video to learn what's new for 2023. 

    Review the Workday Job Aids 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 and phone number, and add social security numbers for dependents in Workday.

  • During Open Enrollment October 3 - 14

    Review Benefits and Make Changes in Workday:

    • Modify medical, dental, vision benefits, if desired.
    • 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.
    • Add missing social security numbers for dependents.
    • Basic Health Participants: Elect/Waive HSA - After you submit your Open Enrollment elections, look for a task in your Workday inbox to sign and submit an HSA Terms & Conditions form, to authorize Fidelity to open your account.
    • Elect/Waive FSA.
    • View insurances, retirement, and long-term disability. Change supplemental retirement and life insurance options, if desired.
    • ORP/MCRP participants - confirm or change beneficiaries for life insurance in Workday. VRS participants - confirm or change beneficiaries for life insurance through VRS's online portal.
    • When you are ready to submit, electronically sign at the bottom of the last page and press the SUBMIT button.
    • Print benefits elections once submitted in Workday, or save as PDF.
  • After Open Enrollment Closes

    Don't forget to earn and record activities for your 2022 Hoos Well rewards in the Hoos Well portal by November 30, 2022.

    If you switched to Basic Health for the first time, spend down your Full FSA to $0.00 by December 31, 2022.

    Look for additional Open Enrollment tasks in your Workday inbox.

Enroll in Workday

  • To review and elect your benefits in Workday

    WDA offers step-by-step assistance directly in Workday. You can also review the Open Enrollment Job Aid

    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 01/01/2023"; 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.
    • One thing Workday doesn’t do in the new tile platform is give you a status update on which benefits you’ve touched. So, it would be a good idea to make a note as you complete them so you can track your progress.
    • 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, click on Review and Sign -- read the summary of what's you elected on that page, and attach any required documents such as birth certificate for new dependents.
    • 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.
  • If you Change Your Mind on an Open Enrollment Choice You Made and Open Enrollment Has Not Closed

    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 After you Submit Your Elections

    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 additional action items in your Workday Inbox. If you added new dependents during Open Enrollment (spouse or children), upload required documentation into Workday.
    • Basic Health participants: After you submit your Open Enrollment event you will receive a task in your Workday inbox to submit the HSA Terms and Conditions authorization form. This document authorizes Fidelity to open your HSA and is required to receive the 2023 employer contribution.

Summary

UVA offers a variety of benefits options, enabling you to customize your benefits to meet your unique needs. The benefits you choose in Open Enrollment will take effect on January 1, 2023.

Benefits are a part of the Total Rewards package UVA offers that not only addresses your health and wellness needs, but also supports you holistically and values you as a unique individual.

Open the sections below for Open Enrollment summary information. Additional details are on the benefit-specific webpages, which you can find in the right sidebar or linked below.

  • Total Rewards Strategy

    HR supports a Total Rewards strategy to support you and your family during your career at UVA:

    • A comprehensive array of benefits
    • Employee community resources to assist employees in meeting basic needs such as emergency housing and utility bills
    • A competitive compensation strategy
    • Employee well-being programs

    Illustration of UVA's Total Rewards package for employees

      

  • Changes for 2023

    UVA Health Plan

    UVA HEALTH PLAN PREMIUMS - Premiums will increase for the Basic, Value, and Choice Health plan options, and the J Visa Health Plan. As a self-insured health plan, the Plan is paid for by employee and employer contributions, and rising prices have an impact on the cost of the health plan. UVA has absorbed these costs for the last three years and held premiums flat for employees. While employee premium rates will increase in 2023, the employer contribution will cover the greatest part of the increases.

    For additional details and health plan premiums, visit the Health Plan 2023 webpage, or watch the new mini video on Health Plan Premium Changes.

    There are no changes to deductibles or copays for the UVA Health Plan.

    DENTAL AND VISION PLANS - There are no changes to dental or vision coverage or premiums for all employees, and now is a good time to learn more about these offerings. Consider requesting pre-determinations from United Concordia before any major dental treatments. Learn how to use your HSA, Limited FSA, and Full Healthcare FSA for dental treatments, eye exams, and eyeglasses. For additional details and premium information, visit the Dental Plan 2023 webpage and the Vision Plan 2023 webpage. 

    PRESCRIPTION DRUG PROGRAM

    • Co-Insurance Change: For Choice and Value Health participants, the maximum values for co-insurance have changed for Maintenance Choice, Preferred Brand, Non-Preferred Brand, and Specialty medications based on increased medical utilization. This means that the maximum co-insurance amount you will pay on a Maintenance Choice, Preferred Brand, Non-Preferred Brand, or Specialty medication will be going up slightly. Look for details about the specific changes on the Prescription Drug Program 2023 webpage, or watch the new mini video on Prescription Drug Program Changes.

    Summary of Material Modifications - Open Enrollment materials constitute a Summary of Material Modifications for UVA Health Plan changes effective Jan. 1, 2023.

    Other Changes

    BENEFITS AND WELL-BEING EXPO - The Benefits and Well-Being Expo is back and in person! With HR specialists and health vendors to meet in person with, seminars and presentations to attend on the UVA Health Plan, investing, retirement, and more, you won't want to miss it!

    For dates and details, please see the Benefits & Well-Being Expo section below.

    EDUCATIONAL ASSISTANCE - Benefits-eligible Medical Center team members will see improved educational assistance benefits. Starting in 2023, the education benefit for tuition will be increasing to the IRS pre-tax limit of $5,250 for all benefited Medical Center team members, and benefits can be paid up front or as a reimbursement after courses are completed.

    The hard-to-fill jobs list is also being discontinued to bring equity to the Educational Assistance benefit and ensure all benefits-eligible employees receive the same opportunity. 

    You’re still required to submit proof of passing and attendance, but these changes should make investing in your personal and career development more convenient, achievable and affordable. The process for applying for educational assistance and submitting your documentation will move to Workday in 2023, with your benefit being paid in your paycheck instead of through accounts payable, so watch for additional details on the Education Benefits webpage and in your Open Enrollment brochure about this new process.  

    You’re also still required to have completed six consecutive months of employment to be eligible. Up to $375 is available for approved professional certification expenses beyond the $5,250 limit. Watch the new mini video on Educational Assistance for Medical Center.

    NEW RESOURCES - New mini videos on this website address the health plan changes coming in 2023:

    HSA/FSA VENDOR CHANGE - Fidelity will become the new administrator in 2023 for UVA's supplemental health savings accounts. This includes the Health Savings Accounts, Flexible Spending Accounts, and Dependent Care Reimbursement accounts. Fidelity, ranked in 2021 as the third largest HSA provider, is a leader in the HSA and FSA industry with over 14 billion dollars in assets and a 42% year-over-year Fidelity HSA asset growth. 

    If you’re already investing with Fidelity, the same familiar platform will integrate with your current retirement accounts, and investing your funds incurs $0.00 account transaction fees (compared to a .25% custodian and load fee with Chard Snyder), helping you accumulate wealth faster. You’ll have a wider range of investment choices, and no minimum needed to invest, compared with $1,000 with Chard Snyder. AND, you’ll have HSA and Dependent Care Reimbursement Account FSA balances on a single card. 

    If you’re eligible for and elect the Basic Health Plan with HSA for 2023, you’ll need to agree to and submit the required HSA Terms & Conditions authorization document that goes to your Workday Inbox following submitting your Open Enrollment elections. Look for additional details on the HSA 2023 webpage or watch the mini video on Benefit Savings Account Vendor Change.

    If you currently have an FSA, plan to spend your remaining funds by December 31, 2022. If you elect to have an FSA again in 2023, it will be established with Fidelity. Looks for additional details on the FSA 2023 webpage

    HSA EMPLOYEE CONTRIBUTION- The Health Savings Account employee maximum contribution will increase in 2023 (employee maximum contribution limits include employer seed funds, these will remain the same):

    • Individual - $3,850 (from $3,600 in 2022)
    • Family - $7,750 (from $7,300 in 2022)
    • Catch-up (age 55+) - $1,000 (no change)
  • Health Plan Comparison

    The UVA Health Plan offers three health plan options: Basic, Value, and Choice. The three health plan options offer the same benefits but with different pay structures.

    HERE IS HOW THEY 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 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 pays for covered services at 100% for the rest of the year for in network services
    • You can elect coverage for you and your eligible dependents
    • Aetna is the plan administrator for medical services and prescription drug benefits

    HERE IS HOW THEY ARE DIFFERENT:

    • Health Plan Schedule of Benefits Comparison - This UVA Health Plan comparison table compares various health services (professional services, preventive services, urgent care, etc.) for the Basic, Value, and Choice Health options and shows deductibles, co-insurance, and co-pay amounts for each option
    • 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.
    • How you pay for your health plan 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 (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?

    To compare out-of-pocket costs for various medical situations across the three health plan options, see the Medical Scenarios 2023 webpage.

    For more information about the UVA Health Plan and the three health plan options, go to the Health Plan 2023 webpage.

    Open Enrollment 2023 Comparison table for Employee ONLY

    Open Enrollment 2023 Comparison table for Employee + Child

    Open Enrollment 2023 Comparison table for Employee + Spouse

    Open Enrollment 2023 Comparison table for Family

  • Health Plan Medical Scenarios with Cost Estimates

    The Health Plan Medical Scenarios webpage offers six common medical scenarios, and estimates for what each service could potentially cost you. (The real costs depend on the services you receive if you see an in-network provider, and how Aetna is billed by the doctor or health care facility). 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.

  • Health Plan Eligibility

    Requirements for eligibility for any of the UVA Health Plans include: 

    • 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 Plan. 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 employers OR 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's residence is outside all the HMOs' defined service areas.

      • For UVA Dental and Davis Vision: Must be legally recognized as spouses 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 and the UVA Health Plan Ombudsman

    Requirements for eligibility for Basic Health include:

    • You are not a wage employee
    • You do not hold a J visa
    • You are not enrolled in Medicare or Medicaid, or are listed as a dependent on someone else’s tax return
    • You, or your spouse, do not have a balance in a full healthcare FSA, are part of a FSA grace period, or your plan year is not over
    • You have not received healthcare benefits from the Veterans Administration (TRICARE) within the last 3 months
    • You do not have a spouse or parent enrolled in a healthcare plan (including a Health Reimbursement Account) that provides you benefits before meeting the annual IRS minimum deductible
    • You have not already contributed the annual federal limit to another HSA, Medical Savings Account (MSA), or HRA in the same calendar year.

    Qualified Life Events: You can make changes to benefits elections during the plan year if you have a qualified life event. Qualified life events and new hire enrollments will need to be completed within 30 days of the event or hire date.

    THE DIFFERENCE BETWEEN BENEFICIARIES AND DEPENDENTS

    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 Eligibility 2023 webpage.

  • 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

    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.

  • Prescription Drug Program

    The Prescription Drug Program is part of the UVA Health Plan, and is administered by Aetna.

    There are some changes coming in 2023 to the Prescription Drug Program for employees enrolled in the UVA Health Plan.

    • For Choice Health and Value Health participants, the maximum values for co-insurance have changed for Maintenance Choice, Preferred Brand, Non-Preferred Brand, and Specialty medications based on increased medical utilization. This means that the maximum co-insurance amount you will pay on a Maintenance Choice, Preferred Brand, Non-Preferred Brand, or Specialty medication will be going up slightly.  
    • There are no changes to the Generic medications
    • There are no changes to the Prescription Drug Program for Basic Health participants. 

    Visit the Prescription Drug Program 2023 webpage for additional details.

    Watch the mini video on Prescription Drug Program changes.

    UVA Pharmacy - medication prices at the UVA Pharmacy are often less expensive than those at other pharmacies for UVA employees. UVA Pharmacies offers a $3 discount per prescription on the member cost-share at all UVA pharmacy locations for UVA Health Plan participants. UVA Pharmacy has 8 locations throughout central Virginia, and UVA Pharmacy at ERC is open 24/7 year round. You can also use this discount on the member cost-share for prescriptions delivered directly to your home. 

    Limited Distribution Specialty Drugs may be filled through the CVS Specialty Pharmacy or UVA Specialty Pharmacy. All other specialty drugs must be filled through the UVA Specialty Pharmacy. 

    Retail pharmacies can distribute a maximum drug supply of 30 days, except for CVS Pharmacies and UVA Pharmacies, which can distribute 90-day fills of maintenance drugs.

    Lists/Resources

    • Aetna Formulary (coming soon): A list of covered medications and information about pricing drug tiers. Note the formulary is for 2021 rates; 2022 rates will be published on the UVA HR Prescription Drug webpage in November or December 2021.
    • Formulary Exclusions (coming soon)
    • Exclusions by Plan Design (coming soon) -medications on this list can not be reviewed for medical exception.
    • Preventive Medicine List: (coming soon) Applicable to Choice, Value, and Basic Health options; drugs on this list are not subject to the deductible
    • Specialty Drug List: (coming soon) A list of Aetna's specialty drugs 
    • Chronic-Preventive Medicine List: (coming soon) Applicable to Choice and Value Health options; drugs on this list are not subject to the deductible
    • ACA Preventive Care Drug List: (coming soon) List of drugs available at no member cost share
    • Maintenance Choice with Opt Out Flyer: Description of fill options for maintenance drugs
    • Step Therapy List: (coming soon) Brand medications requiring use of generics first
    • Prior Authorization List (coming soon) (Non-Specialty Drugs) 
    • Prior Authorization List (coming soon) (Specialty Drugs) 
    • Aetna National Pharmacy Network List: (coming soon) Network pharmacies within 30 miles of Charlottesville
    • CVS ExtraCare Health Program Member Flyer (coming soon)
    • Vaccines Covered by the Aetna Pharmacy Benefit: Vaccines Covered by the Pharmacy Benefit administered by Aetna
    • 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.

    When using the Digital Care Tool, review the Aetna formulary list (coming soon), as your drug may be listed as the generic name within the tool. The Digital Care Tool are cost estimates and based on Aetna's 2020 formulary and pricing. 

    Visit the Prescription Drug Program 2023 webpage for additional details.

  • Dental Plan

    The University offers two UVA Dental Plan options: Basic and Enhanced Dental. Both of these dental plan options are administered by United Concordia. There is no premium or coverage change for either dental plan option for the 2023 plan year for full-time and part-time employees.

    Review the premiums and deductibles for each option below and select the option that best meets your projected needs for 2023. See the Dental Plan Options Comparison Chart for more detailed information about covered services and costs.

      BASIC DENTAL  ENHANCED DENTAL
    Premiums Same as 2022 plan year; see Dental Plan 2023 webpage for rates by employee type Same as 20212 plan year; see Dental Plan 2023 webpage for rates by employee type
    Deductible $50.00, applies to Type B and Type C Services (primary and major restorative services); dental services are listed on the Dental Plan Options Comparison Chart $50.00, applies to Type B and Type C Services (primary and major restorative services); dental services are listed on the Dental Options Comparison Chart
    Annual Maximum Benefit $1,000.00 per person $2,000.00 per person
    Complex Restorative Services 50% of eligible expenses 60% of eligible expenses
    Routine and Preventive Care 100% for in-network 100% for in-network

    Visit the Dental Plan 2023 webpage for current premiums.

    Changes can be made during Open Enrollment, or after a qualified life event like a change in marital status, an addition to the family, or a leave of absence. 

  • Vision Plan

    UVA offers two ways to save on eye care: 

    Davis Vision is an optional vision plan that offers many benefits and provider options. There is no premium or coverage change for Davis Vision for the 2023 plan year for full-time and part-time employees.

    The Aetna Discount Program is part of your benefits with the UVA Health Plan and does not cost an additional fee to participate. The Aetna Discount Program offers discounts on eye exams, prescription eyewear, LASIK laser eye surgery, non-disposable contact lenses, and designer frame options. You can even save on things that don’t need a prescription, like sunglasses, eyeglass chains, lens cases and cleaners.

    Compare costs for you and your family's anticipated eye needs for 2023 while planning for Open Enrollment:

      DAVIS VISION AETNA DISCOUNT PROGRAM
    Premiums

    Employee only: $8.32

    Employee + children: $14.56

    Employee + spouse: $14.98

    Family: 23.30

    Housestaff: $0.00

    $0.00 (included with UVA Health Plan
    Eye Exams for Eyeglasses $0 (once per year)

    $49.00 for eyeglasses exam

    10% off standard fee + $49 for specialty contact lens exam

    Lenses - Price Per Pair:

    - Clear Plastic Single Vision,  Bifocal, Trifocal

    - Polycarbonate

    - Scratch-Resistant Coating

    - Ultraviolet Coating

    - Solid or Gradient Tinting

     

    $0

    $0 or $30

    $30

    $12

    $0

     

    $40 single vision, $60 bifocal, $80 trifocal

    $40

    $15

    $15

    $15

    Frames

    Davis Vision Collection: $0 (up to $160)

    Any frame: $130 discount + 20% off balance*

    Visionworks Frame Allowance: $180 + 20% off balance*

    35% off retail prices
    Contact Lenses (in lieu of eyeglasses)

    Davis Vision Collection: $0 (2 boxes planned replacement or 4 boxes disposable***

    Any contacts: $130 discount + 15% off balance*

    Visually required contacts: $0 (with prior approval)

    $40 (non-disposable conventional contact lenses)
    Laser Vision 40-50% off national average price of traditional LASIK; must be through QualSight location 15% off standard prices or 5% off promotional prices for LASIK services obtained through the U.S. Laser Network

    ** Costs are based on in network providers* Some limitations apply to additional discounts

    *** Number of contact lens boxes may vary based on manufacturers packaging

    For more information, visit the Vision Plan 2023 webpage.

  • Benefits and Well-Being Expo

    The Benefits and Well-Being Expo, hosted by Hoos Well, is back and in person! With HR specialists and health vendors to meet in person with, seminars and presentations to attend on the health Plan, investing, retirement, and more, you won't want to miss it!

    To offer maximum flexibility, the Expo will offer you both in-person and virtual ways to learn about your benefits. You can:

    • Attend the Expo in person at three locations over four days
    • Attend the benefits presentations in person during the Oct. 5 Expo, OR watch them live-streamed on this webpage, OR watch a replay of select Expo webinars after they are complete
    • You can meet in person with the HR Benefits and Leave team, OR schedule a virtual 1:1 appointment with an HR specialist to discuss your benefits.

    Expo Dates

    Sep. 28-29

    • College at Wise, Chapel of All Faiths
    • Sep. 28: 1:00 - 5:00 pm
    • Sep. 29: 8:00 am - 12:00 pm

    Oct. 4

    • UVA Health, Education Resource Center (ERC)
    • 7:00 am - 3:00 pm

    Oct. 5

    • Newcomb Hall, 3rd Floor Ballroom
    • 8:30 am - 2:00 pm

    Expo Presentations

    In addition to around 30 booths hosted by vendors, you will be able to attend in person presentations on October 5, or view live-streamed presentations and select recorded presentations. Connect with UVA benefits counselors and vendors and come prepared with your questions. These presentations will dive deeper into topics like preparing for retirement, maximizing your investments, and benefits changes for plan year 2023. Presentations are 50 minutes in length.

    Oct. 5: Newcomb Hall, 3rd Floor, Commonwealth Room

    • 9:00 am - Open Enrollment, HR Benefits and Leave team 
    • 10:00 am - TIAA                              
    • 11:00 am - Virginia Retirement System (VRS)
    • 12:00 pm - JABA                               
    • 1:00 pm - Fidelity   

    For live-stream links, program, and additional details about the Benefits and Well-Being Expo, please visit the Expo 2023 webpage.

  • Tools to Help You Choose

    Detailed Schedule of Benefits and Summary of Benefits and Coverage

    For details about all health plan schedule of benefits changes, summary of benefits and coverage, and health plan comparisons:

    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.

    When using the Digital Care Tool, review the Aetna formulary list (coming soon), as your drug may be listed as the generic name within the tool. The Digital Care Tool are cost estimates and based on Aetna's 2020 formulary and pricing. 

    Picwell: Picwell is an online personalized tool that uses big data to compare information you input with millions of other Americans to determine the best fit. Picwell has a consolidated profile page that allows users to navigate vertically by scrolling through the stages. Questions are organized by question type. Picwell also offers a side-by-side comparison of plan options, and a “Build-a-plan” to compare a non-company sponsored plan (i.e. spouse or partner's plan) against the UVA plan options.

    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.

    2023 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.

    2023 Open Enrollment Powerpoint: This powerpoint reports on 2023 benefits changes, resources, premiums, and keys dates to remember.

    OE Presentations: Virtual Open Enrollment presentations are available to assist you with your benefits choices. You can see the schedule for them here. You can watch a recording of the benefits presentation here.

    "For Your Benefit" videos: This series offers short informative videos on important benefit topics. Click below to watch: 

    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 virtual Zoom appointment with one of our HR professionals. HR will accommodate as many appointments as possible through Wednesday, October 12.

    For Additional Resources: Visit the Resources 2023 webpage. 

    Still Need Help? Contact the UVA HR Solution Center, by email  at AskHR@virginia.edu or by phone at 434.243.3344.

  • Benefit Savings - HSA, FSA, Supplemental Benefit Credit

    Depending on employee type and health plan enrollment, you may have the option to enroll in a: 

    • Health Savings Account (HSA)
    • Flexible Spending Account (FSA)
    • Limited FSA
    • Dependent Care Reimbursement FSA
    • If you earn $42,000 or less per year, you may have access to a Supplemental Benefit Credit. This automatic credit offers a tax savings to help you pay for out-of-pocket costs such as copayments and coinsurance.

    NEW FOR 2023: Your HSA and FSA (including Dependent Care Reimbursement Account) are moving to Fidelity! Fidelity offers you:

    • More Investment choices ​
    • Lower investment fees​
    • More robust and detailed education offerings, including videos and 1:1 consults​
    • New health savings funds to consider​
    • HSA + FSA balances on one debit card​
    • One platform to see retirement + benefit savings accounts​

    Learn more about the transition to Fidelity by watching the mini video on HSA/FSA Changes for 2023.

    Health Savings Account - All active, benefits-eligible employees enrolled in Basic Health are also enrolled in, and must be eligible for, a Health Savings Account (HSA). HSA funds can be used for eligible health care, prescription, dental, and vision expenses. HSA funds roll over each year and are yours to keep for future health care costs.

    • If you are enrolling in Basic Health, don't forget to sign and return the HSA Terms & Conditions authorization form, which will show up as an additional action item in Workday. 
    • Even if you do not want to contribute to an HSA, you must sign and return the Terms & Conditions authorization form so UVA can deposit its employer contribution. 
    • If you have a Full Healthcare FSA, you must deplete 100% of any remaining funds in your account before December 31. If you do not, your HSA will not be set up until April and you will miss out on any contributions you would like to make.
    • 2022 elections for FSAs and HSAs will NOT automatically carry over to 2023. To continue your HSA, you must re-elect the program for 2023 during Open Enrollment.
      • If you do not re-elect and you had an HSA in 2022, your benefit will be elected, but with $0 employer contribution and $0 employee contribution until you sign the HSA Terms & Conditions authorization form. However, you can add your employee contribution at any time in Workday. 
    • Depending on your employee type, UVA may contribute money to your HSA. Employee only coverage in Basic Health receives a $1,000 annual contribution from UVA. Coverage for employee + dependents in Basic Health receives a $1,500 annual contribution. 
    • You can contribute a maximum of $3,850 for employee only, or $7,750 for employee + dependents. These are pre-tax dollars reserved for health care expenses and carry over beyond your retirement. (employee maximum contribution limits include employer seed funds, these will remain the same)
      • This is a household maximum contribution, i.e. spouses cannot separately contribute the maximum
      • Those age 55 and older may make an additional catch-up contribution of up to $1,000 per year
    • If you are enrolled in an HSA, you are not eligible for a Full Healthcare FSA, but you can enroll in a Limited FSA and/or Dependent Care FSA to maximize your savings. Learn more about a Limited Flexible Spending Account.
    • Funds are sent to your new Fidelity account following your first benefits deduction payroll for 2023
    • For highlights, how to switch from FSA to HSA, and additional resources, visit the HSA 2023 webpage

    Flexible Spending Account - All Health Plan participants may have some form of a Flexible Spending Account (FSA), but Basic Health participants may only have a Limited FSA for eligible dental and vision expenses. 

    • 2022 elections for FSAs and HSAs will NOT automatically carry over to 2023. To continue your FSA, you must re-elect the program for 2023 during Open Enrollment. If you do not, you will not have access to an FSA in 2023.
    • The FSAs and Limited FSAs set aside pre-tax income for certain medical costs
    • The Dependent Care Reimbursement FSA set aside pre-tax income for dependent / child daycare expenses. 
    • These funds must be used by the end of the calendar year. However, UVA has a grace period of 2 1/2 months. This allows you to spend FSA money through March 15 of the following year. After the grace period ends, you will lose any remaining money in your FSA account. You may only start, stop, or change FSA elections during Open Enrollment or if you have a qualified life event. 
    • The full FSA contribution amount you choose for the year is available as soon as the account is open. Payroll deductions for the FSA would continue through the remainder of the year.
    • Current maximum contribution amounts are $2,500 for Full FSA and Limited FSA, and $5,000 for Dependent Care Reimbursement FSA
    • For additional information about FSA accounts and resources, visit the FSA 2023 webpage, and learn more about a Limited Flexible Spending Account.

    Supplemental Benefit Credit - For lower-wage full- or part-time, benefits-eligible Academic Division employees, the Supplemental Benefit Credit program helps offset employee benefit costs. The program offers a $550 annual supplemental benefit credit to employees earning $42,000 or less. 

    • The number of months you work per year and the frequency of your pay affect how much money you receive in a specific paycheck
    • The credit is automatically applied to your benefit deductions and appears on your payslip
    • The credit is applied toward the amount needed for benefit deductions in any given pay period
    • If benefit deductions do not exceed the supplemental benefit credit in any given pay period, the extra supplemental benefit credit funds cannot be received as income
    • For additional information about Supplemental Benefit Credit accounts, visit the Supplemental Benefit Credit 2023 webpage.
  • Retirement

    UVA's retirement plans help ensure you have enough income to live comfortably after you retire.

    While your initial retirement plan is established when you first begin your career at UVA, additional investment and retirement benefit options can be modified throughout the year, not just during Open Enrollment. Changes to your 403(b) and 457 are anytime changes and are not exclusive to Open Enrollment.

    HOWEVER:

    • VRS participants enrolled in the Hybrid Plan: for members who are not already contributing 4% in voluntary contributions to the 457 Deferred Compensation Plan, you will see an auto-escalation to your voluntary contribution amount by 0.5% until it reaches the maximum of 4%. You can "opt out" of the auto-escalation from September 16 - December 15. Watch for a postcard from VRS at your home in early October for further information and instructions.

    For more information and to make changes to your retirement options, visit the Retirement 2023 webpage.

  • Life Insurance

    If you are enrolled in a UVA retirement plan (VRSORP, or MCRP), if you are Housestaff, or if you are a Postdoctoral Fellow, you already have basic life insurance coverage at no cost to you while working at UVA. 

    VRS members are enrolled in the VRS Basic Group Life Insurance Program. If you would like additional life insurance (for yourself, your spouse, and dependents), you can purchase Optional Group Life Insurance at any time, not specifically during Open Enrollment.

    HOWEVER:

    • VRS participants have the option to increase supplemental life insurance (up to the guaranteed amount) without medical "evidence of insurability" but not inside Workday; see the Life Insurance webpage for details. ​

    ORP members, MCRP members, and Housestaff are enrolled in Group Term Life Insurance with Accidental Death & Dismemberment through The Standard. You can secure additional life insurance by purchasing Supplemental Life with Accidental Death & Dismemberment at any time, not specifically during Open Enrollment.

    Changes to Supplemental Life Insurance are anytime changes, and are not exclusive to Open Enrollment. 

    HOWEVER:

    • ORP and MCRP participants enrolled with The Standard have the opportunity only during Open Enrollment and in Workday to apply for additional Life and AD&D insurance up the "Guarantee Issue Amount" without providing medical evidence of insurability
      • If you are insured for an amount less than the Guarantee Issue Amount, medical evidence of insurability will be waived if you apply for an increase in your life insurance by no more than one Annual Earnings increment, up to the Guarantee Issue Amount.
      • All amounts over the Guarantee Issue Amount are subject to medical evidence of insurability. (For example, if you are currently insured for 1x Annual Earnings, you may only elect up to 2x Annual Earnings without medical evidence of insurability, up to the Guarantee Issue Amount.)
      • For more information:

    For additional information and to make changes to your life insurance, visit the Life Insurance 2023 webpage.

  • COBRA

    UnifyHR manages the Open Enrollment process for all COBRA participants. The Open Enrollment process for all other employee categories are managed through UVA. 

    If you are a COBRA participant, you can get started by:

    • Visiting the Resources 2023 webpage, where you’ll find tools to help you choose your 2022 benefits. Complete benefit summaries, plan comparisons, required annual notices, and rates are available on the Chard Snyder website.
    • Visiting the UnifyHR web portal to:
      • Review comprehensive plan information to help you make informed decisions
      • Access plan comparison charts and premium rates for each plan and coverage level
      • Modify dependent information to ensure accuracy for your coverage needs this coming year
      • Finalize your enrollment
    • Contacting UnifyHR at benefitssupport@ascensus.com or 888.878.6175 with questions.

    For additional information specific to COBRA participants, visit the COBRA 2023 webpage.

  • Postdoctoral Fellows

    The Open Enrollment process for all Postdoctoral Fellows (non-UVA employees) is managed through UVA Human Resources.

    If you are a Postdoctoral Fellow, you can get started by:

    • Visiting the Resources 2023 webpage, where you’ll find tools to help you choose your 2023 benefits. Complete benefit summaries, plan comparisons, required annual notices, and rates are available on the this webpage.
    • Reviewing your email from the UVA Benefits Administration team:
      • Modify your plans
      • Modify dependent information to ensure accuracy for your coverage needs this coming year
      • Finalize your enrollment
    • Contacting UVA HR with any questions

    For additional information specific to Postdoctoral Fellows, contact Nic Miceli at nb5bk@virginia.edu.

FAQs - Health Plan

  • Can married UVA employees share a health plan?

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

    Employees' non-UVA spouses who have access to health benefits that meet affordability and minimum value standards as defined by the Affordable Care Act are not eligible for enrollment in UVA's health plans except in the following circumstances:

    • Spouses whose remote employer offers affordable health care that provides minimum value, but none of their health options has in-network coverage at the spouse’s residence, are eligible to be a dependent on the UVA employee’s health coverage.​

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

    Try our health care AI tool, Picwell, 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.

    You can map out what you’ll need from your benefits in 2023 by reviewing how you’ve used them in 2022 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 2023:

    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 Plan (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.

    How will I know if I am benefits eligible? 

    You will receive a Workday inbox task during Open Enrollment. Allowing you to choose benefits. 

  • 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 2023 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 2023 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 2023 webpage)
    • Children of eligible UVA employees - children (as defined on the Eligibility 2023 webpage) are eligible through their birthday at age 26, or longer if documented to have mental or physical disabilities (see the Eligibility 2023 webpage for more details)

    The Basic Health option has some additional requirements; please visit the Eligibility 2023 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 Medical Scenarios webpage, or call Aetna for customized scenarios based on your preferred health plan option and potential future health care expenses.

    UVA Health Plan and how Aetna shares costs

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

    UVA employees and their dependents over age 18 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.

    Those under 18 can receive their vaccines through the medical benefit through their Primary Care Physician or at one of the pharmacies in Aetna's Expanded Vaccine Network. The pharmacies should be reminded to bill Aetna instead of AetnaRx so your medical benefit covers the vaccine. 

    Flu vaccines are covered at no cost, as a preventive service through the UVA 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 Announcement 

  • Tell me more about the spousal eligibility rule

    Has the eligibility for spouses of UVA employees to enroll as a dependent on the UVA Health Plan changed?

    Yes. Effective January 1, 2022, if the spouse’s employer offers affordable health care that provides minimum value as defined by the Affordable Care Act but ALL his/her employer’s health options are HMOs and the spouse lives outside the HMOs’ defined service area, the spouse is eligible to be a dependent on the UVA Health Plan.

    My spouse lives in Charlottesville and work for a company headquartered in Fairfax, VA who offers affordable, minimum value group health coverage. The employer offers a PPO with a provider network across the entire United States. My spouse’s preferred PCP is 30 miles from home and his/her preferred specialists are 6 and 42 miles from home. Is my spouse eligible to be a dependent on my UVA Health Plan coverage?

    No, your spouse is not eligible to be a dependent on your health coverage. Your spouse’s employer offers a PPO with a service area that covers the entire United States. Your spouse has access to in-network coverage at his/her residence in the Charlottesville area.

    My spouse lives in Louisa, VA and works for a company headquartered in Williamsburg, VA who offers affordable, minimum value group health coverage. The employer offers an HMO administered by Anthem BC/BS with a service area that covers the Commonwealth of Virginia. My spouse doesn’t want to use the providers in the HMO. Is my spouse eligible to be a dependent on my UVA Health Plan coverage?

    No, your spouse is not eligible to be a dependent on your coverage. Your spouse’s employer offers an HMO with a service area that covers Virginia. Your spouse has access to in-network coverage at his/her residence in the Louisa area. It’s your spouse’s choice whether the in-network providers to which he/she has access are used or not.

    My spouse lives in Crozet, VA and works for a company headquartered in San Francisco, CA who offers affordable, minimum value group health coverage. The employer offers two HMOs. One has a service area that covers San Francisco and San Mateo counties. The other has a service area that covers the state of California. Is my spouse eligible to be a dependent on my UVA Health Plan coverage?

    Yes, your spouse is eligible to be a dependent on your coverage. Your spouse’s employer offers two HMOs but neither one includes Virginia in their service area. Your spouse does not have access to in-network coverage at his/her residence in the Crozet area.

    My spouse lives in Lovingston, VA and works for a company headquartered in Ann Arbor, MI who offers affordable, minimum value group health coverage. The employer offers one PPO administered by BC/BS of Michigan with a service area that covers the entire United States and one HMO administered by BC/BS of Michigan with a service area that covers southeast Michigan. Is my spouse eligible to be a dependent on my UVA Health Plan coverage?

    No, your spouse is not eligible to be a dependent on your coverage. Your spouse’s employer offers more than one insurance option. One of those options is a PPO with a service area that covers the entire United States. Your spouse has access to in-network coverage at his/her residence in the Lovingston area.

FAQs - Health Plan and Medicare

  • Can I sign up for the Basic Health option or the 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 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 2023 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.

  • Can I sign up for Basic Health option or the 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 insurance, 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 UVA's Basic Health option. 

FAQs - Health Plan and J Visa

FAQs - Prescription Drug Program

  • How do my deductible, coinsurance, and min/max drug 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 preferred brand and non-preferred brand retail drugs. You must pay for covered prescriptions up to your deductible amount before the UVA Health Plan begins to pay for preferred brand, non-preferred brand retail prescriptions and specialty prescriptions. Generic medications are not subject to the deductible.

    The table below shows 2023 costs for retail pharmacy outside of UVA pharmacies (such as CVS, Kroger, etc.); this excludes specialty prescriptions and mail order prescriptions.

    Drug Tier Choice Value Basic

     

    Generic, low cost

    $6 co-pay

    30-day supply

    $6 co-pay

    30-day supply

    Deductible + 20% for up to 30-day supply

     

    Preferred Brand

    Deductible + 20%

    $34 min/$200 max

    30-day supply

    Deductible + 20%

    $34 min/$200 max

    30-day supply

    Deductible + 20% for up to 30-day supply

     

    Non-Preferred Brand

    Deductible + 20%

    $68 min/$275 max

    30-day supply

    Deductible + 20%

    $68 min/$275 max

    30-day supply

    Deductible + 20% for up to 30-day supply
  • Where can I find more information about prescription coverage?

    You can find information on our Prescription Drug Program 2023 webpage.

    If you need additional details, contact Aetna for assistance.

    AETNA CUSTOMER SERVICE

    Phone: 800.987.9072

    Hours of Operation:

    • Monday through Friday: 9 am - 9 pm, EST
    • Saturday: 8 am - 4:30 pm, EST

    Claims Mailing Address: P.O. Box 981106, El Paso, TX 79998-1106

    AETNA MEDICAL/PHARMACY PRE-CERTIFICATION DEPARTMENT

    Phone: 855.240.0535

    Hours of Operation:

  • 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.

  • Can I get a cost estimate for my prescription?

    Yes, by using Aetna's Digital Care Tool. This tool provides drug cost estimates based on the selected UVA Health Plan option. Use the links below to compare prices between the UVA Health Plan options

    1. Enter the name of the drug
    2. Click "search" to view the estimate and plan details.

    When using the Digital Care Tool, review the Aetna formulary list, as your drug may be listed as the generic name within the tool. The Digital Care Tool are cost estimates and based on Aetna's 2022 formulary and pricing. 

FAQs - HSAs and FSAs

  • Help me understand the Health Savings Account and Flexible Spending Account

    Health Savings Account (HSA) - For Basic Health participants only; use pre-tax dollars for health care, dental, and vision expenses. Funds in these accounts roll over each year and are yours to keep for future health care costs.

    Flexible Spending Account (FSA) - For all Health Plan participants as follows:

    • FULL Flexible Spending Account - for Value and Choice participants; use pre-tax dollars for out-of-pocket health care, dental, vision, and some medication expenses. Funds in these account do NOT roll over each year. Use or lose before the end of the calendar year.
    • LIMITED Flexible Spending Account - for Basic Health participants only; use pre-tax dollars for out-of-pocket dental and vision care expenses. Funds in these account do NOT roll over each year. Use or lose before the end of the calendar year.

    Dependent Care Reimbursement Account - For all Health Plan participants with covered dependents under the age of 13; use pre-tax dollars for daycare expenses.

    Here are resources to help you learn more:

  • When will I receive my HSA funds after selecting Basic Health for the first time?

    After moving to Basic Health, you must complete banking forms that will go to Fidelity, the company that administers UVA’s HSAs, FSAs, and Dependent Care Reimbursement Accounts beginning 1/1/2023. Contributions are accepted into new HSAs the month after the account is opened by Fidelity. Sometimes Fidelity may request more information to open an account. Be sure to follow up on any requests to get your HSA opened in a timely manner.

    • UVA contributes either $1,000 (employee only) or $1,500 (employee plus) once your account is opened, and the funds will show up in your Fidelity account and on the your second payslip in January 2023.
    • If you were hired in December, you may not have your HSA funds available until February 2023.
    • There are two ways to spend those funds for eligible expenses:
      1. Use your prepaid benefits card, the Benefits Card, at the time of purchase for eligible expenses.
      2. Submit claims or make payments from your accounts online through the Fidelity website.
  • How much should I contribute to my HSA?

    If you are enrolled in the Basic Health option with HSA, you should contribute as much as you can afford, up to the annual maximum, since the HSA offers several tax advantages that make it an excellent long-term savings vehicle.

    At the very minimum, you should contribute enough to cover the average out-of-pocket costs that you will likely incur over the course of the year. This strategy makes it more likely that you’ll have the funds on hand to cover the medical care you will need. And, as bonus, if you end up with extra funds at the end of the year, you get to keep that money to cover future medical expenses – including in retirement. 

    Current maximum contribution amounts are $3,850 for an employee and $7,750 for employee + dependents. (employee maximum contribution limits include employer seed funds, these will remain the same)

    • Those age 55 and older may make an additional catch-up contribution of up to $1,000 per year.
  • Why do my HSA contributions have to be split over the 2023 pay cycles; am I able to front load my HSA?

    UVA does not allow the front loading of employee contributions to the HSA. If you elect the HSA, then your seed funds will load at the beginning of the year, and your employee contributions will be evenly deducted over your paydays in 2023.

     

  • Does the HSA contribution amount include the employer contribution?

    Depending on your employee type, UVA may contribute money to your HSA to help offset the higher deductible.

    You may choose to contribute to your HSA, though you are not required to do so. Employee contributions made by payroll are deducted before taxes. Each year, the IRS sets a contribution limit. This limit includes employer and employee contributions and is per household.

  • Why is a physical address needed to open my HSA?

    Anyone with a PO Box as their home address in Workday will have their request to open a health savings account rejected by Fidelity. It is a Patriot Act requirement to have a physical address on file before the HSA can be opened.

    Please verify your contact information contains your physical address within Workday during Open Enrollment.

  • What happens if I do not sign and complete the HSA Terms & Conditions authorization form?

    If your HSA Terms & Conditions authorization form is not completed within the Open Enrollment timeframe, you will not be able to open your HSA account with Fidelity, will not receive the employer contribution, and will not be able to contribute to your HSA. 

    If you were not enrolled in the Basic Heath plan option in 2022 and you elected Basic Health for 2023, you must complete your HSA Terms & Conditions authorization form during the Open Enrollment timeframe, or you will be defaulted into the Value Health plan option.

    For more information regarding the Health Savings Account, please see the Health Savings Account webpage.

    If you have any questions, or need our help submitting your form, please contact us at 434.243.3344.

  • Can my spouse and I both have an HSA?

    Yes, both spouses can have their own individual HSA, whether they work for the same employer or different employers. However, the IRS maximum contribution is a household maximum, so the combined contribution of both spouses, along with any employer contribution, cannot exceed $7750. If each spouse has employee only coverage, each spouse cannot contribute more than $3,850 each, including employer contributions. 

  • Can my spouse and I both have a FSA?

    Both spouses can each have a Healthcare FSA whether they work for the same employer or different employers and both can contribute the maximum amount to each account.

    Dependent care Accounts, however, have a household limit of $5,000 so if you and your spouse both have a DCA, your combined annual contribution cannot exceed $5,000. 

  • I am turning 65 this year. Can I have an HSA?

    If you will be enrolled in Medicare Part A or B at any time during the year, you should not enroll in Basic Health since you cannot contribute to an HSA while on Medicare (employer contributions are included in this).

  • What happens to the money in my Chard Snyder HSA after January 1, 2023?

    During Open Enrollment, you must complete the HSA Terms & Conditions form that opens your HSA account with Fidelity, and an Electronic Consent form that consents to the bulk transfer. The Electronic Consent form will be available from November 28, 2022 to January 13, 2023. When you participate in the bulk transfer, your account will be subject to a 15-day blackout period starting in mid-February thru March 3. The blackout period is needed to settle the pending transactions. Blackout is only for those that are doing the bulk transfer. Funds will move electronically via FedWire and will not have any tax consequences.

    If you do not want to participate in the bulk transfer, you may initiate an individual transfer from Chard Snyder to Fidelity at any time. You may also elect to leave funds at Chard Snyder. Accounts that remain at Chard Snyder will be subject to the $4 monthly fee beginning in mid-April, and employer contributions to your HSA will not go into a Chard Snyder account.

    Additional details about the bulk transfer will be forthcoming at the close of Open Enrollment.

    Your HSA account belongs to YOU, and you have agency to continue your HSA at Chard Snyder, transfer it to Fidelity, or transfer it to another HSA provider. All 2023 employee and employer contributions will go to Fidelity.

FAQs - Open Enrollment Presentations

FAQs - Picwell

  • What is Picwell and how does it work?

    Picwell is a decision support tool that combines big data, artificial intelligence, and economic models to help you find the health insurance plan that's right for you and your family.

    • Picwell asks basic questions about you and your past medical care use
    • Picwell algorithms generate a personalized risk assessment for the Basic, Value, and Choice Health options, based on actual medical use by millions of people in its database that share your medical care needs and are similar in age and gender
    • Picwell asks you questions about your preference for risk protection versus cost savings
    • Picwell scores each of the health plan options to show you how they meet your needs based on both personalized health risk predictions and your risk preferences
    • Picwell now has a consolidated profile page that allows users to navigate vertically by scrolling through the stages. Questions have been reordered by question type. Picwell also now offers a side-by-side comparison of plan options, and a “Build-a-plan” to compare a non-company sponsored plan (i.e. spouse or partner's plan) against the UVA plan options. 
  • What information does Picwell need from me, and is it protected?

    Picwell protects the privacy of all participants, and will never ask for personally identifiable information. Picwell asks you information about:

    • Age and gender for each member of your household covered under your health plan
    • Household income, to determine what potential tax benefits you may qualify for based on different health plan options (such as pre-tax dollars in the HSA or FSA)
    • Healthcare utilization over the last 12 months, to refine predictions about future health care costs
    • Prescription drugs, to also predict future health care spending
    • Risk tolerance, to contribute to scoring each health plan option based on both your health care needs and your risk tolerance
    • Your ability to pay for unexpected medical care, to determine if a high-deductible plan option meets both your risk tolerance, medical care needs, AND budget
  • What is the Picwell score and what does that mean for me?

    The Picwell Score measures how well each of UVA's health plan options matches your individual needs and preferences. It takes into account:

    • Plan premiums and design
    • Your health risk and preferences

    The health plan option with the highest score best matches your responses, and is the best match and best value for you.

  • Is the Basic Health option always going to be the top ranked plan?

    While the Basic Health option has the lowest premiums, this is not always the best match for everyone. Picwell will sometimes recommend Value or Choice Health to people with higher health risks or stronger preferences for risk protection.

    The total cost of health care is defined as the annual premium plus your medical expenses. You may find that the combined cost of lower premium for Basic Health plus your total medical expenses comes out lower than choosing the more expensive plan up front. This often happens because the higher premiums for Value or Choice may offset any savings you would realize when using medical care.

    If you change your survey answers, you may see your estimated costs and scores changing while the rankings stay the same. This typically happens when Basic Health appears to be a particularly good deal relative to Value or Choice. Modifying your risk preference might change the relative score for each of the health plans, but may not change the fact that there is a clear best value available.

    Sometimes when Picwell evaluates health plans, one option always has the highest score. Economists call this a "Dominant Option," which means that regardless of the health care you end up using, you will always be better off under a specific plan. This typically occurs when employees have the opportunity to enroll in a low-premium, high-deductible plan and their employers makes HSA contributions. If the combined premium savings plus the employer HSA contribution is high enough, the higher deductible plan can end up being less expensive even in worst-case scenarios where you need a lot of high-cost medical care.

    Picwell is 100% objective and solely focused on finding the ideal health plan for you, not your employer and not your insurance company.

  • Does having an HSA impact the Picwell score?

    Yes. When a plan is HSA eligible, Picwell assumes that you will use an HSA to help pay for eligible out-of-pocket costs. Since HSA contributions are tax-free, using them to cover your medical expenses provides an additional benefit that is accounted for in the Picwell score. For example, if you have a 22% marginal tax rate and you contribute $1,000 to an HSA, that saves you $220 in taxes, and is included as an extra value in Picwell's calculations. 

    When UVA makes your Basic Plan HSA contribution, Picwell includes that in the Picwell score, Total Estimated Cost estimate, and your recommended HSA contribution. For example, if we predict that you will spend $1,000 out-of-pocket, but UVA contributes $500 to your HSA, we would use the UVA contribution to offset the costs that you would incur by reducing the Total Estimated Cost estimate by this amount. We would also recommend that you personally save $500 in your HSA account to make up for the estimated out-of-pocket costs that would not be covered by UVA’s contribution. The lower costs are also reflected in the plan’s Picwell score. 

You all did an excellent job of promoting Open Enrollment and making staff aware of the options, deadlines, etc. Margaret Edwards, LPC, Program Director for Counseling and Wellness Services, Maxine Platzer Lynn Women's Center

Having trouble finding what you’re looking for?

We strive to make the information on every webpage clear and easy to find. For benefits questions or concerns, or questions about Open Enrollment, please contact the HR Solution Center by phone at 434.243.3344, or by email at AskHR@virginia.edu.

Please let the HR Communications team know if you're having trouble finding what you're looking for on these webpages, so we can improve your experience on this page in the future. 

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