University of Minnesota
Office of Human Resources
http://www.umn.edu/ohr
612-625-2016

Medical Plan Descriptions

Medica is the plan administrator for your medical plan options. Contact Medica Customer Service at 952-992-1814, 877-252-5558, or at 800-855-2880 for TTY users. Visit the Medica website for more information to help you select a medical plan.

PlanContact

Medica Elect/Essential

Base plan for Twin Cities area and Duluth

It is a combination of two networks, each of which includes major care systems. Each care system includes a comprehensive network of physicians, specialists and other types of care providers, clinics, and hospitals.

You have the lowest biweekly rates and out-of-pocket costs with the base plan. The out-of-network benefit and in-network travel benefit give you additional flexibility in selecting a provider.

You will need to select a primary care clinic when you enroll in this plan. Family members may select their own primary care clinics. You and your family members can choose separate primary care clinics from care systems in either the Elect or Essential networks.

Clinics can be changed monthly. When you contact Medica's member services by the 20th of the month, the change will go into effect the first of the following month.

Your primary care clinic will work with you to coordinate your care including, when appropriate, referral to specialists. Each care system establishes its own access procedures for seeing specialists. Some require a referral from your primary care clinic; others allow you to directly access a specialist affiliated with your care system. You must follow your care system's access procedures to receive the highest level of benefits. To be referred to an out-of-network provider and obtain the highest level of benefits, you also need Medica's approval.

952-992-1814
877-252-5558

800--855-2880 (TTY)

Medica website

Medica Choice Regional

Base plan for Greater Minnesota, including Morris, Crookston, and Rochester

It is an open access plan that uses the statewide Medica Choice network.

You have the lowest biweekly rates and out-of-pocket costs with the base plan. The out-of-network benefit and in-network travel benefit give you additional flexibility in selecting a provider.

You have access to any provider who is part of the network, and you do not need to select a primary care clinic when you enroll. You can see any specialist within the plan network without getting a referral from your primary care doctor.

952-992-1814
877-252-5558

800--855-2880 (TTY)

Medica website

Medica ACO Plan

Twin Cities only

Medica ACO Plan is available to you if you live in the 11-county, Twin Cities metro area. In an ACO, Medica and the network of primary care and specialty providers work together to deliver coordinated health care and support to the member. You will have benefits that are slightly higher and biweekly rates that are slightly lower than the base plan.

Your ACO options include Fairview & North Memorial Vantage Plan with Medica (including Boynton and UMP); Inspiration Health by HealthEast with Medica; Park Nicollet First with Medica; and Ridgeview Connect with Medica. You need to select one ACO for your entire family. ACO enrollments are for a full year, so mid-year changes cannot be made. You don't need a referral to see any primary care provider or specialist within the network. The out-of-network benefits and in-network travel benefit give you additional flexibility.

952-992-1814
877-252-5558

800--855-2880 (TTY)

Medica website

Medica Choice National

It is an open access plan with a statewide network with over 13,000 physicians and more than 200 hospitals. You also have national coverage access to more than 600,000 physicians and health care providers through United Healthcare Options PPO network when traveling or working outside the service area.

You have access to any provider in the network without a referral, and you do not need to select a primary care clinic when you enroll. The out-of-network benefit gives you additional flexibility in selecting a provider.

952-992-1814
877-252-5558

800-855-2880 (TTY)

Medica website

Medica HSA - For Current Employees

It is a high deductible plan that allows you to make decisions about how you spend your health care dollars. This plan also uses the Medica Choice statewide network and the United Healthcare Options PPO national network with the same provider access described in Medica Choice National.

The University will contribute a set amount of benefit dollars to your HSA account. When enrolling mid-year, the HSA amount will be prorated monthly; however, the deductible amount is not pro-rated. The amount you receive depends on when your coverage becomes effective and is contributed over the number of pay periods remaining in the year. While the HSA amount is tax-sheltered from federal and state taxes in most states (including Minnesota), for federal reporting purposes the amount the University contributes to your HSA will be shown on your pay statement.

Enrollment in Medica HSA means that you are not eligible to fully participate in a health care flexible spending account. You may only use the pre-tax FSA plan to cover out-of-pocket costs for eligible dental and vision expenses.

You will have a special debit card to spend HSA dollars for pharmacy or medical expenses. You pay the doctor or pharmacy until the annual deductible is met, and then you can be reimbursed from the benefit account as funds are available. After the deductible is satisfied, Medica pays 90 percent. You own the HSA contributions and can decide whether to use them for current medical expenses or save them for future expenses when you retire.

You can also make your own pre-tax contributions to the HSA and invest them in options from Wells Fargo. If you leave the University the account balances are portable.

Due to federal law, if you have any other medical coverage, including any part of Medicare, you are not eligible to enroll in Medica HSA. However if you are age 65 or older and delay taking Social Security benefits and Medicare Part A, you remain eligible for Medica HSA.

952-992-1814
877-252-5558

800-855-2880 (TTY)

Medica website

Medica HSA - For Retirees Under Age 65

It is a high deductible plan that allows you to make decisions about how you spend your health care dollars. This plan also uses the Medica Choice statewide network and the United Healthcare Options PPO national network with the same provider access described in Medica Choice National.

The University does not make a direct contribution to your HSA; instead the rates are adjusted to account for that. You have the option to make your own pre-tax contributions to the HSA and invest them in options from Wells Fargo. If you do, you will have a special debit card to spend HSA dollars for pharmacy or medical expenses.

You pay the doctor or pharmacy until the annual deductible is met, and you will get reimbursed from the benefit account as funds are available. After the deductible is satisfied, Medica pays 90 percent. You own the HSA contributions and can decide whether to use them for current expenses or save them for future expenses.

After leaving the University any balance in the account can remain with Wells Fargo, or you can move the funds to a personal HSA.

Due to federal law, if you have any other medical coverage, including any part of Medicare, you are not eligible to enroll in Medica HSA. However if you are age 65 or older and delay taking Social Security benefits and Medicare Part A, you remain eligible for Medica HSA.

952-992-1814
877-252-5558

800-855-2880 (TTY)

Medica website