Effective January 1, 2008
Medical Insurance
Medical coverage is provided through Optimum Choice, Inc. with Health Maintenance Organization HMO coverage or MAMSI Life and Health Insurance Co. for Preferred Provider Organization (PPO). Information is available on their website at
http://www.mamsiunitedhealthcare.com.
If you elect the Optimum Choice HMO coverage you must choose an OCI-participating PCP who is open for new patients and be sure this PCP is noted on your card. These visits incur a $20 copayment. Failure to select an OCI PCP will result in claims being denied. You must obtain PCP referrals for specialist visits. If properly referred, you will incur a $40 copayment (no referral needed for OB/GYN or eye refraction services). In addition, if your UVa PCP refers you to another UVa provider, no formal referral is necessary. Services provided by non-network providers are not covered except in emergency. There is a 24/7 Member Services Hotline you can contact at 800-331-2102.
If you elect the MAMSI Life and Health Insurance Co. PPO plan, you must use the MAMSI PPO network of participating providers. PCPs and referrals to specialists are not required. Deductibles are waived for services rendered in a Primary, Wellness or Emergency setting and Primary Care Services covered incur a $30 copayment. Covered services rendered by non-network providers are adjudicated under the Non-Preferred Option after deductible. Separate contract year deductibles apply for care rendered under Preferred ($500) and Non-Preferred ($1000) settings. There is a 24/7 Member Service Hotline you can contact at 800-331-2102.
HMO copayments and coinsurances are waived when you utilize healthcare services from the UVA Medical Center and UVA Physicians. This waiver does not include prescription copayments. PPO copayments and coinsurances are waived when you utilize healthcare services from the UVA Medical Center and UVA Physicians. This waiver does not include prescription copayments. You are responsible for paying deductibles no matter what provider is used.
Well Being
Optimum Choice, Inc. and MAMSI Life and Health customers now have access to a no-cost well-being program at the Optimum Choice/MAMSI website
(www.mamsiunitedhealthcare.com). This program, called Health AtoZ offers a number of enhanced capabilities including a health assessment, online health coaching and a live nurse chat. New members can do an easy one time registration to learn more about HealthAtoZ simply by visiting the site.
Premium Costs:
HMO requires no monthly premium payment. The PPO requires payment of a monthly premium as follows:
- $53.09 single coverage
- $111.48 employee + 1 coverage
- $150.24 family coverage
Enrollment:
Enrollment in the housestaff health plan must occur within 31 days of your date of hire. Additions, subtractions, changes to coverage can be undertaken during Open Enrollment or within 31 days of a "Life Status" Change such as Birth, Death, Loss of coverage, Marriage or Divorce.
Enrollment applications must be submitted to the University Human Resources Benefits Division, 914 Emmet St. Charlottesville, VA 22904; fax (434) 924-4486.
Do not submit any Optimum Choice or MAMSI health plan applications directly to Optimum Choice/MAMSI.
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