Meeting Your Health Care Needs

UVA Retiree Health Benefits Program


Eligibility for health insurance after retirement:

  • You have worked at UVA for at least five (5) consecutive years directly prior to your retirement;
  • You are eligible for a monthly annuity from VRS and you start receiving your retirement benefit immediately upon retirement, or participating in the MCRP or ORP programs and meet the age and service requirements for an immediate retirement benefit under the VRS plan that you would have been eligible for on your date of hire had you not elected ORP or MCRP; and
  • You were eligible for enrollment in UVA’s active employee health plan on your last day as an active state employee; OR
  • You were approved for long-term disability through VSDP, MCRP, or ORP and have applied for social security disability.

How to enroll:

  • Contact the UVA HR Solution Center at least three months before you retire so you have plenty of time for the enrollment process
  • Review the Enrollment Kit you receive from UVA’s partner, Mercer Marketplace 365+ Retiree; contact Mercer to enroll in a pre-Medicare health plan or a Medicare supplement.
  • If you are Medicare eligible, you can also enroll in the state’s Medicare supplement, Advantage65. You must have continuous pre-Medicare health coverage through the UVA Retiree Health Benefits Program since your retirement in order to enroll in Advantage65 when you become Medicare eligible.
  • You must enroll in your insurance plan prior to your retirement date. No retroactive coverage is available.

Plan options and monthly premium ranges for single coverage:

  • Pre-Medicare Medical Plans through Mercer Marketplace 365+
    • $661 - $1,249 without any federal subsidies
    • Depending on your income, you may have access to federal premium and cost-sharing subsidies which will lower the cost of your plan.
  • Medicare Supplement Medical Plans through Mercer Marketplace 365+
    • Beginning at $0
  • Advantage65 Medicare supplement options through the Commonwealth of Virginia
    • $170-$273

Health credit for retirees:

  • Retirees with at least 15 years of creditable State service when they retire are eligible for a health insurance credit of $4 per month for each year of creditable service.
  • Disability retirees usually receive a health credit of $120 per month.
  • Retirees eligible for health insurance credit must complete a Retiree Health Insurance Attestation Form after their initial enrollment in a Mercer Marketplace health plan and return it to the UVA HR Solution Center. This form contains information needed to complete the VRS health insurance credit form.
  • Retirees must update VRS regarding future changes to their health premiums.

How to change retiree health insurance coverage:

  • Retirees can reduce membership or cancel coverage prospectively (going forward) at any time, but retirees who cancel coverage may not re-enroll in the future.
  • Membership can only be increased prospectively due to a qualified life event. Changes must be made within 30 days of the event date.
  • Retirees enrolled in a Mercer Marketplace plan can change their health insurance during the annual open enrollment period, typically November 1st through December 15th, with changes effective the following January 1st.

Additional details can be found in the UVA Retiree Health Benefits Program document.

The Retiree Health Insurance Attestation Form should be submitted by new retirees to their UVA Benefits Counselor after completing their initial enrollment in the UVA Retiree Health Benefits Program. It should also be used by retirees already in the program who become eligible for Medicare and want to enroll in the state’s Advantage65 Medicare supplement plan.

Contact information for Mercer Marketplace 365+ Retiree can be found here. You can also visit Mercer online at http://retiree.mercermarketplace.com/UVA

 

Participating Providers

Currently, the plans available on the Mercer Marketplace 365+ exchange for retirees living in central Virginia are issued by Anthem HealthKeepers, Inc., Piedmont Community HealthCare HMO, Inc., and Optima Health Plan.

The UVA Hospital is a participating provider with all three insurance companies. If you look at the Plan Details for each insurance plan and choose Doctor Lookup, you will find that the insurance companies use different names when describing the UVA Hospital. It is called the UVA Health Sciences Center by Anthem HealthKeepers, the University of Virginia Medical Center by Optima Health Plan, and the Rector and Visitors of the University of Virginia d/b/a University of Virginia Medical Center by Piedmont Community Healthcare. 

Most physicians practicing at UVA locations are UPG (University of Virginia Physicians Group) physicians. UPG has contracted all of its physicians to be participating providers with all three insurance companies. The physicians are usually listed by name but may be also listed as the University of Virginia Physicians Group. Some providers are not listed by name but, instead, are listed by their group such as “UVA Physicians Group – Audiology” or “University of Virginia Physicians Group (PT/OT/ST)”.  

Physicians who practice at UVA Northridge Internal Medicine are not UPG physicians; they are Community Medicine Physicians. They participate with Anthem HealthKeepers, Inc. and Optima Health Plan but do not participate with Piedmont Community HealthCare HMO.

When looking for Optima Providers in the OptimaFit plans under “Doctor Lookup”, choose “OptimaFit Direct” as the plan name and “Individual & Family” as the plan type.

Residents and interns practicing at UVA locations are not listed as participating providers because they are working under the direction of a supervisor and do not bill professional services using their own name. Search for their supervising provider as the listed participating physician when using the “Doctor Lookup.”

 

Resources to Support You

  • ON-DEMAND WEBINAR

    Located online, this webinar will discuss the transition and your insurance choices. View it on the Mercer Marketplace website. From the home page, click on “Webinar” in the navigation bar at the top and follow the instructions for viewing the webinar. 

  • PLAN COMPARISONS

    To shop and compare individual plan options through Mercer Marketplace 365+ Retiree, access the Mercer Marketplace website. Through this site, you will be able to review individual insurance plan information and compare your options.

    Plan shopping is easy when you follow these steps: 

    1. On the main landing page, scroll down to “PRE-MEDICARE” and select “Shop and Compare Pre-Medicare Plans.”   

    2. Once you are ready to review your options, click “Get Started” toward the bottom of the page. 

    3. Click on the “START SHOPPING” button and you will then be asked to select from a list of options as to why you are seeking coverage. Click on the “Lost Coverage” option. 

    4. You will be asked to enter your zip code and the date of birth for yourself as well as any other pre-Medicare dependents in your household.  

    5. If you are interested in seeing if you qualify for tax credits, you can select the size of your household and your projected household income.

    NOTE: Enter the information for the person in your household who has retired from UVA if he or she is pre-Medicare; otherwise, enter the information of the member of your household who is pre-Medicare.  

    You will use this information to access the plan-shopping site until you are prompted to create an account using your email address and a password of your choice. After creating your account, you will use your email address and password to log in moving forward. 

  • MERCER MARKETPLACE BENEFITS COUNSELORS

    Schedule an appointment to speak with one of the Mercer benefits counselors by calling 1.855.429.8822.

  • UVA BENEFITS COUNSELORS

    You may call UVA Human Resources at 434.243.3344 and ask to speak with a UVA benefits counselor about the transition to Mercer 365 Exchange.

Frequently Asked Questions

  • What is Mercer Marketplace?

    What is Mercer Marketplace

    Mercer Marketplace 365+SM* Retiree, a partner of the UVA Retiree Health Benefits Program, provides access to affordable, comprehensive medical plan options for pre-Medicare and Medicare-eligible retirees. Within the new Mercer Marketplace 365+ structure, you can choose from a comprehensive menu of individual insurance plans across the country, and you can enjoy the comfort and familiarity of well-known insurance carriers that provide a variety of options.

    Mercer is dedicated to simplifying healthcare insurance options and helping you feel confident that your choice meets your unique needs and budget. In the marketplace, you'll find a comprehensive menu of individual insurance plans across the country, providing you with the comfort and familiarity of well-known insurance carriers that provide a variety of options.

    You can choose from:

    • Medicare Supplement Plans
    • Medicare Advantage Plans
    • Pre-Medicare Individual Plans
    • Prescription Drug Plans
    • Dental
    • Vision
  • How you Benefit when using Mercer Marketplace

    If you choose to contact Mercer Marketplace 365+ Retiree, you will have:

    • Access to one-on-one help from a licensed Mercer Marketplace 365+ Retiree benefits counselor
    • The opportunity to enroll in medical, prescription drug, dental, and vision benefits
    • Multiple options to choose from and you may choose coverage that best meets your individual health needs• Access to Mercer Marketplace 365+ Retiree benefits counselors year-round to answer any benefit questions
    • The potential to reduce your health insurance costs
    • The ability to review your health insurance coverage annually through Mercer Marketplace 365+ Retiree
    • A team of benefits counselors who will serve as your ongoing advocates.
  • How Does the Mercer Marketplace Differ from the Affordable Care Act Exchange?

    The ACA (Affordable Care Act) Exchange is a state-based or federal government-sponsored exchange that offers health care plans from a variety of insurance carriers who are contracted with the either a state or the federal government. These plans are considered ‘On-Exchange’ plans.

    Some insurance carriers offer other plans that are not offered through a state-based or the federal ACA Exchange. These plans are referred to as Off-Exchange plans.

    Mercer Marketplace 365+ Retiree is a private exchange that offers Off-exchange health care plans through a variety of insurance carriers who are contracted directly with Mercer Marketplace 365+ Retiree. By working through Mercer Marketplace 365+ Retiree private exchange, individuals have the opportunity to shop and compare both On- and Off-exchange health care plans through a variety of insurance carriers. If the individuals elects to enroll in an Off-exchange plan through Mercer Marketplace 365+ Retiree, the Mercer benefits counselor will be able to assist the individual with completing the Enrollment process. If the individual elects to enroll in an On-exchange plan, in many cases the Mercer benefits counselor will be able to assist the individual with completing the enrollment process. In instances where the Mercer benefits counselor is unable to assist the individual in completing the enrollment process, the Mercer benefits counselor will be able to provide direction on what the individual will need to do to complete the enrollment process on their own.

  • WHAT IS MY DEADLINE TO ENROLL IN A NEW PLAN THROUGH MERCER MARKETPLACE 365+ RETIREE?

    To avoid a gap in coverage, you must enroll in your new Mercer Marketplace plan before your current coverage ends. You will not be able to enroll retroactively in coverage.

  • HOW CAN I OBTAIN HELP ENROLLING IN MY NEW HEALTH INSURANCE?

    To help you find the plan that best fits your needs and budget, the University of Virginia has contracted with Mercer Marketplace 365+ Retiree to guide you through the process of enrolling in your new coverage from beginning to end. Mercer Marketplace 365+ Retiree will be your single point of contact for healthcare insurance issues — before, during and after the transition to your new healthcare plan.

  • WILL I BE REQUIRED TO CHOOSE A NEW DOCTOR?

    It depends on the health insurance strategy that you choose. Individual healthcare plans offer narrower provider networks. Your Mercer Marketplace 365+ Retiree benefits counselor will review the plans you have available in your zip code and determine if your doctor(s) are included in the provider networks. You may also call your doctor to confirm the plans in which they are a participating provider.

  • HOW DO I ENROLL IN MY NEW HEALTH INSURANCE?

    You will receive an enrollment kit in the mail from Mercer Marketplace 365” Retiree. It will detail the process you should use to schedule a one-on-one consultation with a Mercer benefits counselor who will walk you through the entire decision-making process and help you choose the coverage that best meets your needs and budget. The kit will also provide you with ways to prepare for your consultation.

  • HOW LONG WILL THE APPOINTMENT WITH MY MERCER BENEFITS COUNSELOR LAST?

    In general, you’ll spend about 60 to 90 minutes on the phone speaking with your Mercer benefits counselor. The length of the call will depend on whether you enroll that day or want to include a family member or caregiver, or a power of attorney on the call. The length of your appointment will also depend on how much preparation you wish to do in advance.

    Remember, your Mercer benefits counselor is an excellent resource and will take as much time on the phone or in a future conversation as you need to feel comfortable with your enrollment decision. If you go online to the Mercer Marketplace 365+ Retiree website prior to your consultation to enter your prescription drugs, your appointment could be much shorter. See the checklist in this Enrollment Guide for details on how to prepare for your call.

  • IF I NEED ASSISTANCE WITH ENROLLING, CAN SOMEONE SPEAK WITH MY MERCER BENEFITS COUNSELOR ON MY BEHALF?

    If you complete and sign a Personal Information Authorization form, anyone listed on the form can assist you with your plan information and/or selections. However, a durable Power of Attorney (POA) document must be on file at Mercer Marketplace 365+ Retiree for anyone but the policy holder to enroll in healthcare coverage. Anyone who is listed on the durable POA can act on behalf of the retiree in all insurance capacities; this form must be in place prior to your consultation. A Mercer benefits counselor can mail or email you the Personal Information Authorization form upon request.

  • WHAT HEALTHCARE PLANS WILL BE AVAILABLE?

    The individual healthcare insurance market has the following metal tier plans: Bronze, Silver, Gold, and Platinum. Plans in these categories differ based on how you and the plan share the costs of your care. Bronze plans will have lower premiums but higher out-of-pocket expense when going to a doctor. Gold plans will have higher premiums but will have lower out of pocket expenses when going to a doctor. The categories have nothing to do with the amount or quality of care you receive.

  • WHAT BENEFITS WILL BE COVERED UNDER MY PLAN?

    All individual healthcare plans provide the same essential health benefits, cover pre-existing conditions, and offer free preventive services. However, many plans will offer additional benefits which your benefits counselor can review.

  • WHAT ARE “ESSENTIAL HEALTH BENEFITS?”

    Essential health benefits are included in all individual healthcare plans. There are ten categories of essential health benefits including: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

  • IF I DON'T LIKE THE PLAN IN WHICH I'M ENROLLED, WHEN CAN I CHANGE?

    Outside of the annual Open Enrollment Period—typically November 1st through December 15th—the only way you can obtain or change your health insurance is through one of two ways: (1) Qualify for a special enrollment period if you lose job-based coverage, have a baby, get married, or have certain other life changes, or (2) Qualify for Medicaid or the Children's Health Insurance Program (CHIP). Your Mercer benefits counselor can answer any questions you may have about changing your plan during your consultation or at any point throughout the year.

  • How will I know if I’m eligible for federal tax credits including federal premium and cost-sharing subsidies?

    During your consultation, Mercer’s benefit counselors will discuss these subsidies with you if you are eligible. If you’d prefer, you can shop online using the Mercer Marketplace website and enter your income information to determine if you’re eligible for subsidies..

    You can also use the Kaiser Family Foundation tax subsidy estimator to gain additional information and estimate Health Insurance Premiums and Subsidies for Health Insurance Coverage through Marketplaces

  • WHAT IF I DON'T LIKE THE HEALTH PLANS THAT ARE AVAILABLE THROUGH THE MERCER EXCHANGE?

    During your consultation with Mercer, the Mercer benefits counselor will seek to understand the needs of the retiree, i.e. are their current physicians on any of the plans that are offered on the Mercer exchange, does the retiree travel, what coverage options are they looking for, etc. Once the benefits counselor understands what is most important to the retiree, the benefits counselor will initially look at the plans that are available on the Mercer Marketplace 365+ Retiree exchange. If there are no plans that fit the needs of the retiree, then the benefits counselor will look outside of the Mercer exchange for other plan options. This might include looking on the healthcare.gov exchange or a State-Based Exchange (SBE). They will be able to assist the retiree in shopping for other plan options as they compare and contrast physician networks, coverages, out of pocket costs and premium costs and enrolling in the retiree’s preferred plan.

  • WILL I BE ABLE TO ENROLL IN THE STATE’S ADVANTAGE65 MEDICARE PLAN WHEN I BECOME MEDICARE ELIGIBLE IF I ENROLL IN A PRE-MEDICARE MERCER HEALTH INSURANCE PLAN?

    Yes. Your eligibility for enrollment in Advantage65 is maintained if you have continuous health coverage through the UVA Retiree Health Benefits Program after retiring from UVA. 90 days prior to becoming Medicare eligible, complete the Retiree Health Insurance Attestation Form and submit it along with a copy of your insurance ID card to the UVA Solution Center at AskHR@virginia.edu. The form can be found on the UVA HR webpage or can be requested from the UVA Solution Center. A UVA benefits counselor will contact you regarding your Advantage65 enrollment once the completed form and ID card are received at UVA.