There are two versions of the Custom Network Plan for benefit-eligible faculty and staff: one for those who live and/or work in the Columbia area (coverage map ) and another for those who live and/or work in the St. Louis area (coverage map ). See the eligibility section of this webpage for details. Retirees are not eligible for the Custom Network Plan.
Visit the health and wellness tools and discounts webpage to maximize your convenience and savings.
If you are a benefit-eligible faculty or staff member with an home address or official business unit in an eligible region around Columbia or St. Louis, the Custom Network Plan is available to you. Counties are different for the Columbia and St. Louis plans, as follows:
Columbia: Audrain, Boone, Callaway, Cole, Cooper, Howard, Moniteau, Osage, and Randolph. See the coverage map .
St. Louis: There are eligible counties in both Missouri and Illinois. In Missouri: Franklin, Gasconade, Jefferson, Lincoln, Montgomery, Pike, St. Charles, St. Francois, St. Louis, St. Louis City, Ste. Genevieve, Warren, and Washington. In Illinois: Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Pike, Randolph, and St. Clair. See the coverage map
You may be eligible for both the Custom Network Plan in Columbia and the Custom Network Plan in St. Louis (i.e., your official business unit is located in an eligible Columbia-only county but your home address is in an eligible St. Louis-area county, or vice versa). In this case, you will have the option to enroll in either of the two insurance plans. Please note, however, that these plans have access to different networks of medical care providers. You will only have in-network access to those providers associated with the particular plan in which you choose to enroll.
Custom Network Plan- Monthly premiums for active employees, 2020
|Coverage level||Employee cost|
|Self and spouse||$231|
|Self and child(ren)||$200|
|Self, spouse, and child(ren)||$365|
The Custom Network Plan has two deductibles: one for medical and a second for prescription drug costs.
Custom Network Plan- Annual deductibles, 2020
|Medical||$0/self*; $0/family*||$500/self*; $1,500/family*|
|Rx||Retail: $50/person; Mail-order: $0/person|
* Considerations for “self” and “family” are different for the Custom Network Plan and PPO Plan than the Healthy Savings Plan. Visit the glossary for details.
The Custom Network Plan has two out-of-pocket limits: one for medical and a second for prescription drug costs.
Custom Network Plan- Annual out-of-pocket limits, 2020
|Medical||$3,500/self*; $7,000/family*||$10,500 or more/self*; $21,000 or more/family*|
|Rx||$4,650/self coverage; $9,300/family coverage|
* Considerations for “self” and “family” are different for the Custom Network Plan and PPO Plan than the Healthy Savings Plan . Visit the glossary for details.
**Please refer to the Summary Plan Description (SPD) for additional details on allowable/eligible expenses when using an out-of-network provider.
To estimate prescription costs, visit Express Script's prescription cost estimator tool (exit UM System site) for UM System medical plans. Select the plan year and health plan you wish to review; then, select "price a medicine" and type in the medicine's name. You will be prompted to select the strength, form, quantity and frequency for the prescription to estimate the cost covered by the plan and the cost to you.
Custom Network Plan- Prescription drug out-of-pocket costs, 2020
|Retail ($50 deductible)||In-network: Greater of (after Rx deductible):||Out-of-network|
|Formulary generic||$7 copay or 20% coinsurance||$30 copay or 50% network costs or more after deductible**|
|Formulary brand||$15 copay or 25% coinsurance|
|Non-formulary brand||$30 copay or 50% coinsurance|
|Mail-order ($0 deductible)*||In-network: Greater of:||Out-of-network|
|Formulary generic||$15 or 20% coinsurance||$30 copay or 50% network costs or more after deductible**|
|Formulary brand||$30 or 25% coinsurance|
|Non-formulary brand||$60 or 50% coinsurance|
* 90-day fill/refill at Mizzou pharmacies at same cost as mail-order.
** Member will pay difference between the non-participating and participating pharmacy charge.
You may choose to visit either in-network or out-of-network doctors and other providers. Your costs will be lower, however, when you select in-network providers. Provider directories may be accessed on the plan contacts webpage.
Virtual visits are also available to you. Virtual visits let you see and talk to a doctor from your mobile device or computer without an appointment, any time. Visit the virtual visits webpage to learn more.
Many health plans include preventive care services, such as various screenings, vaccinations, and well-woman visits, at no out-of pocket cost. Read about women's preventive healthcare or learn more about UHC's preventive care guidelines (exit UM System site).
Consider a Flexible Spending Account
If you enroll in the Custom Network plan, you may also want to consider enrolling in a Health Care Flexible Spending Account (FSA), an account that allows you to set aside pre-tax dollars to pay for out-of-pocket medical expenses. Visit the Understanding your flexible spending account webpage to learn more.
- 2020 Custom Network Plan Summary of Benefits and Coverage
- 2020 Custom Network Plan Summary Plan Description (SPD) View all available SPDs.
- Custom Network Coverage Maps: Columbia and St. Louis
- Medical claim form (UHC)
- 2020 preferred prescription drug formulary
- 2020 specialty drug list
- Prescription FAQs
- Special health topics (such as behavioral health, diabetes and preventive care)
- Full list of forms and guides about medical insurance
* In the event of a difference between this webpage and the plan document or summary plan description, the plan document and plan description prevail.