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I won’t be 62 when I retire; can I continue to work for the university after retirement?

Those who retire before age 62 must execute a “bona fide” termination, consistent with IRS standards. If you are younger than age 62 at retirement, you must complete all the necessary paperwork to apply for and initiate your retirement. You are not eligible to return to work unless certain criteria are met.

The following measures are in place to ensure a “bona fide” termination took place:

  • The employee and the employer did not engage in discussions regarding reemployment before the employee’s effective date of retirement/separation from service (i.e., your official retirement date). Therefore, for employees who have not reached 62, discussions about reemployment are prohibited.
  • The break in service before reemployment is at least 90 days from the effective date of retirement/separation, unless the rehire is part of a competitive hiring process, which generally includes posting of the position, receipt of applications, and interviewing candidates.
  • In order to ensure that there is not an understanding or agreement to rehire prior to effective date of retirement, the employee may not apply for a position until after the effective date of the employee’s retirement/separation.

If these criteria are met, then at the discretion of the department and University, you may return to work. However, in order to continue receiving pension benefits, you may only work on a non-benefit eligible basis (less than 75% FTE). Please note, the “less than 75% FTE” threshold measurement includes all appointments you may hold at any given time.

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I’m in the step therapy program. Why couldn’t I fill my prescription at the pharmacy?

The first time you submit a prescription that isn’t for a front-line drug, your pharmacist should inform you that with step therapy you need to first try a front-line drug if you’d rather not pay full price for your prescription drug.

To receive a front-line drug:

  • Ask your pharmacist to call your doctor and request a new prescription.

OR

  • Contact your doctor to get a new prescription.

Only your doctor can change your current prescription to a first-step drug covered by your program.

 

If you have more questions, you can log in and go to www.StepTherapyFacts.com to watch informative videos or call the Express Scripts Pharmacy at the number on your ID card. (This FAQ answer provided by ExpressScripts.)

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What if I need more than the Employee Assistance Program’s short-term counseling sessions?

The Employee Assistance Program (EAP) is designed help university employees with personal or work-related problems by providing short-term counseling (up to 5 sessions).  EAP practitioners are trained in assessment. If it is determined that more than five sessions are needed, the practitioner will provide employees with a referral within the community. EAP practitioners attempt to ensure sure all referrals are covered by insurance, or if money is a concern, to help employees locate counseling services that are offered at a sliding fee or reduced rate. Visit the Employee Assistance Program webpage for more information.

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What’s the difference between generic and brand-name prescription drugs?

FDA-approved generic drugs must meet the same U.S. Food and Drug Administration (FDA) standards of quality and purity as brand-name drugs. FDA-approved generic versions have the same active ingredients as their brand-name counterparts are equal in strength and dosage. Sometimes drug manufacturers use different inactive ingredients in generic versions, which may affect its shape, color, size or taste.

(This FAQ answer provided by Express Scripts.)

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Whom should I contact with questions about the Wellness Portal hosted by Cerner Health?

For all Healthy for Life Wellness Portal technical questions, if you cannot find your answer among these FAQs, please contact Cerner tech support at (888) 252-8150.

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How can I find out if my doctor or other provider participates in Medicare?

To find out if your provider participates in Medicare, you can ask your provider or can visit the Medicare.gov website at www.medicare.gov/physiciancompare/search.html to search for your doctor. You can find additional information about Medicare, including the CMS “Medicare and You” brochure, on the Medicare.gov website at www.mymedicare.gov or by calling Medicare at 1-800-MEDICARE. TTY users should call 1-877-486-2048, 24 hours a day, seven days a week.

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What can FMLA leave be used for?

There are two types of FMLA leave, as described below:

General (12 weeks within a 12-month period) can be taken for: Covered Service Member Leave (26 weeks in a 12-month period) can be taken for:
  • Birth of an employee's child(ren), adoption of a child, or official placement of a child with the employee for foster care (leaves for birth/adoption must be taken within 12 months of the event).
  • A qualifying exigency** due to a call to active duty in the Reserves or National Guard by an employee’s spouse, son, daughter, or parents who has been notified of an impending call or order to active duty in the Reserves or National Guard.
  • Care of a son, daughter, spouse, or parent (not parent-in-law) having a serious health** condition*.
  • Incapacity of an employee as a result of a serious health condition. 

* Leave for the care of an adult son or daughter (at least 18 years old) is not covered unless required as a result of "mental or physical disability" as defined under the Americans with Disabilities Act. 

**Learn more about what constitutes a qualifying exigency or a serious health condition on the FMLA page Q&A page.

  • Care of a service member who is recovering from a serious illness or injury sustained in the line of duty on active duty and is actively receiving medical treatment.*

* Employee must be the spouse, son, daughter, parent, or nearest blood relative of a covered service member to be eligible.

*Employee must promptly advise their supervisor of the date and probable length of the absence.

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Why must covered dependents be tobacco free? What if only one dependent isn’t tobacco-free?

All dependents covered by the employee’s medical insurance plan must be tobacco free. The goal of this discount program is to encourage healthier living with a reduced risk of cancer and other conditions associated with tobacco use. Also, the university is seeking to reduce the costs of medical insurance for all employees. These goals can best be achieved by encouraging a family-wide cessation of tobacco use – especially because smoking is one of the most common forms of tobacco use and secondhand smoke has health risks just like smoking does. (See the Health Effects of Secondhand Smoke from the Centers for Disease Control and Prevention).

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Can I take FMLA leave if I am on a leave of absence for a work-related injury or illness?

Yes. Either you or the university may choose to have the your FMLA 12-week leave entitlement run concurrently with a Workers’ Compensation absence when your injury is one that meets the criteria for a serious health condition. However, if you have elected to receive worker’s compensation benefits, the university cannot require you to substitute any paid vacation or other leave.

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How can I find out if my doctor or other provider is a member of the UHC Group PPO Network?

To find out if your provider participates in the UHC Group PPO Network, you can ask your provider if they are a UHC Medicare Advantage Provider, or you can also call UHC’s university-dedicated toll-free number at 1-866-899-5903, TTY 711, from 8:00 a.m. – 8:00 p.m. in your local U.S. time zone, seven days a week.

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Is there a specific set of job codes that fall into teaching academics?

There is some work being done on academic titles, so it may be possible in the future, but at this time there is no consistent way to distinguish a teaching academic from a non‐teaching academic by title alone. The same title has been used for both teaching and non‐teaching roles, as well as for both fully benefit-eligible and non‐benefit-eligible positions.

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Can I take intermittent FMLA leave?

Yes. You can take intermittent leave in blocks of time or by reducing your weekly or daily schedule. FMLA leave may be taken intermittently whenever it is medically necessary to care for a seriously ill family member or because you are seriously ill and unable to work a full schedule. Intermittent leave may also be taken for a qualifying exigency or for covered service member leave. If you take such leave, you must make a reasonable effort to schedule such leave so as not to unduly disrupt university operations.

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What happens if I am traveling overseas and need care?

The university-sponsored UHC Group Medicare Advantage plans include worldwide coverage for emergency or urgently needed services, when medical services are needed right away because of an illness, injury, or condition that you did not expect or anticipate, and you can’t wait until you are back in the United States to address it. If you incur expenses for emergent or urgently needed care while traveling outside of the United States, you will have to personally submit your claims to UHC for reimbursement.

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Do I have to prove the necessity of medical leave?

In the case of general FMLA leave, the university requires the health care provider to certify the necessity. In the case of covered service member FMLA leave, the university requires medical certification from the military to certify that the service member is recovering from a serious illness or injury sustained in the line of duty on active duty and is actively receiving medical treatment. Medical leave will be limited to the duration of the serious health condition, as defined by FMLA.

The university may, with a HIPAA compliant authorization, contact your health care provider* to clarify information provided, but not to seek additional information beyond the inquiries permitted on the form. However, your direct supervisor may not contact the health care provider. If the university has reason to doubt the validity of a physician's certification, the university may require you to obtain a second medical opinion at the university’s expense.

* FMLA defines "health care provider" as a doctor of medicine or osteopathy who is authorized to practice medicine or surgery by the state in which the doctor practices; or any other person determined by the Secretary of Labor to be capable of providing health care services.

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Is leave under the FMLA paid or unpaid?

Both. Accrued vacation and personal days must be used when appropriate for any FMLA qualifying purpose. In addition, family sick leave (up to 12 days per year) must be used for a seriously ill immediate family member or service member and accrued sick leave must be used for the employee's own serious health condition. Once this time is exhausted, the employee reverts to unpaid status for the remainder of the FMLA leave. Employees with accrued compensatory leave may not be required to substitute such leave for FMLA leave.

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What info is needed for me to be enrolled in one of the new UHC Group Medicare Advantage plans?

There is certain information you must provide and actions you must take before you can be enrolled in the new university-sponsored Medicare Advantage plans. Although sponsored by the university, because this coverage replaces your current Medicare Part A and Part B coverage, your enrollment must be approved by the Centers for Medicare and Medicaid (CMS) – the federal agency that is responsible for the administration of Medicare Advantage plans – before coverage becomes effective. CMS will approve enrollment into a Medicare Advantage plan if an individual: 

  • Is enrolled in Medicare Parts A and B,
  • Provides a Health Insurance Claim Number (HICN)/Medicare Claim Number,
  • Has a permanent U.S. street address (no P.O. Box) on file, and
  • Is not within the 30-month coordination period for end-stage renal disease.

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Why is “full-time equivalency (FTE)” not an accurate way to determine medical eligibility?

While full-time equivalency (FTE) is currently reported in job data, using FTE does not meet one of the safe harbor methods for tracking hours. The three safe harbor methods are (a) track actual hours, (b) days worked equivalency – credit eight hours worked for any day in which the employee works one hour, or (c) weeks worked equivalency – credit 40 hours worked for any week in which the employee works one hour. Using FTE for teaching academics is appropriate because it is based on an agreed upon documented methodology which is being applied consistently as allowed by the regulations.

Visit the Patient Protection and Affordable Care Act (PPACA) page for more information.

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Why do I need to provide my HICN/Medicare Claim Number and street address when I enroll?

This is a critical step in continuing your university retiree medical coverage. If you have already provided your HICN/Medicare Claim Number to the university and have a current permanent U.S. street address on file with the university, you will not need to provide this information again. For most individuals, the university has the information.

Under CMS rules, individuals must provide the following information before CMS will approve their enrollment in a Medicare Advantage plan such as the university-sponsored UHC Group Medicare Advantage plans:

  • Health Insurance Claim Number (HICN)/Medicare Claim Number
  • Street Address (other than a P.O. Box)

To facilitate the collection of this information, the university will be contacting those Medicareeligible retirees and their covered Medicare-eligible dependents who do not have HICNs/Medicare Claim Numbers and/or street addresses on file with instructions on how to provide that information.

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Will I still receive benefits and accrue vacation and sick leave while on FMLA leave?

The university will continue benefit programs in which you were enrolled at the time of your leave. However, you are responsible for your portion of the cost. 

Vacation and sick leave continue to accrue during any paid leave status of at least 75 percent FTE, but you are not eligible to use accrual until you return to work. Personal days accumulate regardless of paid or unpaid leave status, and are lost at the anniversary date if you are on a leave of absence at that time.

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How can I check if the university has my Health Insurance Claim Number (HICN)/Medicare Claim Number?

The university will send out a letter requesting this information from those retirees or their eligible dependents who do not already have HICNs on file with the university.

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If I go on FMLA leave, do I have to continue to contribute to my retirement?

No. Your contributions to the university’s plan will not be required for periods for which no salary is paid. However, contributions will be required if your leave of absence is recognized as service credit under the plan for which partial or full salary is paid.

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What happens when I return to work from FMLA leave?

Your department will return you to the same position you had before the leave (or an equivalent position). You’ll receive the same level of benefits and seniority as you had before you went on FMLA leave.

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What if I don’t enroll in Medicare Parts A and B?

The Centers for Medicare and Medicaid Services (CMS) require you to be enrolled in Medicare Parts A and B, and that you continue to pay your Part B premium (as you do today if you are already enrolled in Medicare), to participate in a Medicare Advantage plan such as the new university-sponsored UHC Group Medicare Advantage plans. Therefore, to remain eligible for your university retiree medical coverage, you must remain enrolled in Medicare Parts A and B. If you are a pre-1990 university retiree, or retired from the Federal Civil Service or the Missouri State Retirement System and have not previously enrolled in Medicare or are not eligible to enroll in Medicare, please contact that the university to discuss your plan options.

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How do departments ensure time entered by variable-hour, exempt, non-teaching employees is accurate?

Reports are being provided to departments to allow reconciliation of the full-time equivalency (FTE) in the PeopleSoft HR system with the time recorded by variable-hour exempt employees in the time reporting system.

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If I am already enrolled in a Medigap plan, can I still enroll in the Medicare Advantage plan?

Medigap (Medicare Supplement) plans are intended to supplement Medicare parts A&B. Since the university-sponsored Medicare Advantage plans replace Medicare, you would not receive any benefits from your Medigap (Medicare Supplement). Therefore, there may be no value in continuing your Medigap (Medicare Supplement) plan.

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What if I don’t return to work after FMLA leave?

If you don’t return to work, or if you don’t remain at work for at least 30 days, you will have to reimburse the university for the cost of benefits coverage during the leave. If you don’t return due to a continuing serious health condition (your own or a family member’s), or because of other circumstances beyond your control, the reimbursement clause does not apply to you.

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How do I apply for FMLA leave?

If you are interested in applying for Family and Medical Leave, visit the FMLA page. Please note that the university requires a 30-day notice if the leave is foreseeable. For unforeseen circumstances, the university requires as much notice as is practicable.

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If I am enrolled in another Medicare Advantage plan, can I enroll in the university-sponsored plan?

No. CMS does not allow retirees to enroll in two Medicare Advantage plans. You will need to choose between your current plan and the university-sponsored UHC Group Medicare Advantage plans; you cannot be covered under both. 

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How are the Healthy Savings, Custom Network, and PPO plans different?

The Healthy Savings Plan is an IRS-qualified high-deductible health care plan that offers a lower premium with a higher deductible. Because it is qualified by the IRS, it can be paired with a Health Savings Account (HSA) to offset your higher deductible. Plus, the university contributes to your HSA (if you are an active employee) to help pay the higher deductible and eligible out-of-pocket medical, dental, and vision expenses. You may choose to contribute to your HSA, too, up to the IRS maximums, but you do not have to do so to earn the university contribution.

The Custom Network Plan and the PPO Plan are similar to one another in how they are structured. The Custom Network Plan is offered only in specific regions, however. See the Custom Network Plan webpage for information on eligibility. The Custom Network offers a network that is specially selected to keep costs low and offers the mid-level of monthly premiums if you are comparing against the other two plans, but the lowest deductible ($0 for in-network services). The PPO Plan has the same nationwide network as the Healthy Savings Plan and has the highest premium but a lower deductible.

Generally speaking, with both the Custom Network and the PPO Plan, you will pay less per medical service than with the Healthy Savings Plan until you meet the respective deductibles. The Custom Network Plan and the PPO Plan have a higher out-of-pocket maximum than the Healthy Savings Plan.

The Custom Network Plan and PPO Plan can be paired with a Health Care Flexible Spending Account (FSA) to offset out-of-pocket expenses. Any plan can be paired with a Dependent Care FSA.

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I am an LTD recipient enrolled in Medicare, will I need to enroll in the university-sponsored plans?

Long Term Disability (LTD) recipients will not enroll in the University-sponsored UHC Group Medicare Advantage plans for 2017. They will continue to be eligible to remain enrolled in the medical plans offered to active employees: the PPO Plan, Custom Network Plan, and Healthy Savings Plan.

Plan options for LTD recipients in 2018 will be different; stay tuned for more Annual Enrollment information.

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If I miss work due to work-related illness/injury, will my leave be unpaid?

If you accrue an absence due to work-related illness or injury, on the day of the accident or first medical attention, you will be excused from work without loss of pay. This time will not count against vacation time or sick leave. If you are able to return to work, you will continue to be paid during the period of time required to obtain medical attention related to the injury or illness. If unable to return to work, a regular administrative, service, and support staff employee will be granted an unpaid leave of absence.

If attending a Worker’s Compensation conference or hearing, you will be excused from work without loss of pay, vacation time, or sick leave.

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Is women’s preventative health care covered by my insurance plan?

Yes, preventive health care—such as mammograms, screenings for cervical cancer, prenatal care, and other services—is covered at no cost to the employee if you are enrolled in a university medical insurance plan and the visit to your health care provider is not part of a preexisting condition diagnosis or treatment.

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What is ERIP

ERIP stands for Employee Retirement Investment Plan. Learn more on the ERIP webpage.

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What is Healthy for Life?

Healthy for Life is a wellness program that lets you take charge of your health. The program offers a variety of resources to help you achieve the best possible health and wellness.

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What is RDD?

RDD stands for Retirement, Disability and Death Benefit Plan. Learn more about RDD.

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What is the University of Missouri System Wellness Incentive?

The University of Missouri System (UM) offers a Wellness Incentive to promote improved employee wellness. Active employees who are primary subscribers to university medical plans can earn incentive money by taking steps to live a healthier lifestyle, such as completing a wellness pledge, brief personal health assessment, or physical activity class.

Incentive earnings are taxed and voluntary retirement earnings are deducted, just like any other university earnings. The amount of taxes deducted will differ depending on the individual. It is sponsored by the University of Missouri System Total Rewards Department and the Tiger Institute (a partnership between UM and Cerner). The online health management component of the program is delivered through Cerner Health.

To learn more about the Wellness Incentive, visit the Wellness Incentive webpage.

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Does the “90-day break” apply to retirees moving from one appointment to another?

No. If an employee has been rehired after retirement in a manner consistent with the standards discussed here, there is no requirement for a break in service before moving from one appointment to another.

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How are large discount stores able to offer generic prescription drugs for $4.00?

Nationwide discount stores often offer “in the door” pricing which allows them to offer lower costs on certain drugs to promote shopping at their location. You have the option of considering purchasing your prescriptions at different locations. Finding out what the price is at multiple locations is a great way to check that you are getting the best price, but don’t forget to factor in the cost of driving to multiple locations versus getting your prescriptions all one place or through mail order.

(This FAQ answer provided by Express Scripts.)

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How do I know which front-line drug my doctor should prescribe for my ExpressScripts Step Therapy?

Only your doctor can make that decision. Go to Express-Scripts.com for a list of your plan’s front-line drugs. Give this drug list to your doctor so he or she will know which drugs are covered.

 

If you have more questions, you can call the Express Scripts Pharmacy at the number on your ID card. (This FAQ answer provided by ExpressScripts.)

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What if I don’t know my employee ID number to establish my Wellness Portal account?

Your employee identification number is the unique 8-digit number given to all employees. There are several places you can find your employee ID number if you do not know it:

  • On your medical insurance card: on the line that reads “MEMBER NUMBER”, if you remove the very first number, then the next 8 numbers are your employee id number.
  • From the HR Service Center. Their phone number is 573-882-2146 and their email address is hrservicecenter@umsystem.edu.
  • From a recent paystub. Your employee ID number can be found in the “General” section, underneath your name.
  • Log into www.myhr.umsystem.edu and find your employee ID under “Self Service.” Once logged into myHR, click on “Main Menu”, then on “Self Service”. Under the section “Payroll and Compensation”, you can click on “View Paycheck”. Choose any of the paystubs available, and after clicking on it, you will see your 8-digit employee id number underneath your name.

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For an unpaid leave of absence, do I still accumulate seniority, paid leave, and retirement credit?

Yes. While on an unpaid leave of absence, you will continue to accumulate seniority, retirement credit, vacation, personal days, and sick leave (for a period of one year).

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How long does an unpaid leave of absence due to work-related injury or illness last?

Unpaid leaves of absence due to work-related injury or illness can last up to, but will not exceed, one year.

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Who is eligible for the Wellness Incentive?

Any university faculty and staff member may participate in Wellness Incentive activities, but only employees who meet the following conditions at the time of payout can earn incentive money:

  • The employee's primary status is active.
  • The employee is at least .75 FTE and pays premiums for a University of Missouri System medical insurance plan (i.e., the employee is a primary subscriber).
  • To earn the Tier 2 payout, the employee must have completed and submitted Tier 1 by April 30.

To learn more about the Wellness Incentive, visit the Wellness Incentive webpage.

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Will I still need two ID cards to see healthcare services?

No. When receiving care under your university-sponsored UHC Group Medicare Advantage plan, you will only need to use one medical ID card – your Medicare Advantage ID card – instead of two – your Medicare ID card and the ID card for your university-sponsored plan. Beginning in 2017, you will only need to present your new Medicare Advantage ID card when you receive medical services. You will not need to show your original Medicare ID card, although you should keep it in a safe place for your records. Note that you will still need to use your Express Scripts prescription ID card to obtain prescriptions.

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How does the deductible and out-of-pocket maximum work with the Healthy Savings Plan?

The deductible is the total amount members are required to pay each year before the plan begins to pay a benefit. Under the Healthy Savings Plan, if you have individual coverage, you must satisfy the individual deductible before any benefit will be paid. If you have family coverage (two or more are covered), you and/or your dependents must satisfy the family deductible before any benefits will be paid for any member.

Both medical and pharmacy (prescription drug claims) expenses combined accumulate toward a single Healthy Savings Plan deductible and maximum out-of-pocket amount, which is different than the other two insurance plans--the PPO Plan and Custom Network Plan have separate medical and pharmacy deductibles and out-of-pocket limits.

See the Healthy Savings Plan webpage for details about specific deductibles for a given calendar year.

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What do I receive for participating in the Wellness Incentive?

Active, primary subscribers to the University of Missouri System medical plans can earn $450* on their paycheck by completing two tiers. Tier 1 is worth $50*, which you can earn by simply completing and submitting the Health Risk Assessment on the Cerner Wellness Portal and reading the Cerner User Guide in the Cerner Wellness Portal by April 30.  Tier 1 will be paid out in May. Tier 2 is worth $400*, which you can earn by completing and submitting at least 400 points from Activities that will earn you points for Tier 2. The $400* will be paid out in October.

Incentive earnings are taxed and voluntary retirement earnings are deducted, just like any other university earnings. The amount of taxes deducted will differ depending on the individual.

To learn more about the Wellness Incentive, visit the Wellness Incentive webpage.

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Will I have the same ID card as my covered eligible dependent?

No. You each will receive your own university-sponsored Medicare Advantage ID card – with your own unique ID number – from UHC in December.

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What are the options available under the new university-sponsored UHC Group Medicare Advantage Plan?
  • The university-sponsored Medicare Advantage Base Plan, or
  • The university-sponsored Medicare Advantage Enhanced Plan.

Both plans offer the same flexibility to see providers in or out of network at the same cost, $0 deductible, no requirement to select a primary care provider, and a referral is not necessary to see a specialist. The university-sponsored Medicare Advantage Base Plan is primarily a co-payment plan, while the university-sponsored Medicare Advantage Enhanced Plan has no member out-of-pocket expense for covered services. However, you do pay an additional premium cost for the Enhanced Plan.

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Who is eligible to receive paid time off to vote?

Any employee who is eligible to vote in an election (local, state, or national) held within the state of Missouri can receive paid time off to vote. However, if your working hours are such that you are not on duty for three successive hours between the opening and closing of the polls, you are not eligible for any paid time off for the purpose of voting.

If you commute from another state, you will receive the same considerations as a Missouri voter for national elections and the proceeding primaries, but you will not be granted time to vote in local or state elections. If you commute, you should arrange to cast an absentee ballot if you are unable to reach and return from your voting place within the three successive hours granted.

You must request your absence prior to Election Day. It is within a supervisor's right to specify the time an employee may be absent to vote. 

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Will this year’s Wellness Incentive be taxable?

Yes, incentive payments are taxable to the employee. The amount of taxes deducted will differ depending on the individual. This year’s incentive will be directly deposited into your bank account.

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