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Medical Insurance

Medical

University Health offers a comprehensive medical plan called the University Family Care Plan. This plan includes two networks:

• University Health Family Network
• First Health Network

CategorySemi-monthly Premium
Employee$49.21
Employee + Spouse/Domestic Partner$90.67
Employee + Child(ren)$89.24
Employee + Family$153.24

Schedule of Benefits [PDF] – A summary of covered services and fees.

Summary of Benefits [PDF] – A overview of benefits.

Summary of Benefits Expanded Network [PDF]An overview of benefits under the Expanded Network.

UFCP Prior Authorization List [PDF]This list contains information regarding authorization requirements and is applicable to the University Family Care Plan product line.

Summary of Benefits and Coverage – Employees Only [PDF] – A summary of covered benefits for employees only.

Summary of Benefits and Coverage – Employee & Spouse [PDF] – A summary of covered benefits for employee and spouse.

Summary of Benefits and Coverage – Employee & Children [PDF] – A summary of covered benefits for employee and their children.

Summary of Benefits and Coverage – Employee & Family [PDF] – A summary of covered benefits for employee and their family.

Benefit Election Form [PDF] – For qualifying events. Submit to Human Resources within 31 days from the event date.

Dependent Verification [PDF] – A list of acceptable documentation to be submitted for any dependents that will be added to your benefits.

University Family Care Plan Provider Directory (UFCP) – A list of available providers.

First Health Network Provider Directory – A list of available providers.

RX & Go Program – Access the prescription-filling service for University Family Care Plan members. No co-pays for new prescriptions and refills at University Health pharmacies.

Prescription Plan Overview [PDF] (Spanish [PDF]) – An overview of the copays for employees filling a prescription at a non-University Health Pharmacy.

RX Medications & Vaccines List [PDF] – A overview of medications, vaccines, quantity limits and medication instructions.

Notices

Community First Notice of Privacy Practices [PDF](Spanish [PDF])