Traditional Health Insurance
The Traditional Health Plan is one of two medical plans employees can choose from. All qualified employees, their spouses, and their children under the age of 26 are provided with medical benefits through UMR.
Call UMR Plan Advisor for help understanding your benefits, claims and providers. 1-800-207-3172
| Type of Coverage | Employer Premium | Employee Premium |
|---|---|---|
| Single | $287.06 | $77.15 |
| Two-Party | $645.82 | $175.00 |
| Family | $926.06 | $251.65 |
Plan Deductible:
Tier I and Tier II - $1000 individual / $1,500 family deductible.
Preventative visits covered 100%.
Out of pocket maximum:
Tier I $2,500 individual / $5,000 family for the plan year (in-network)
Tier II $3,500 individual / $7,000 family for the plan year (in-network)
Copays not subject to deductible are: $35 primary office visits or $45 for secondary office visits, $45 for instacare/urgent care; $300 for ER visit
Prescription:
$50 deductible, generic Rx $10; preferred Rx 30% ($250 max); non-preferred Rx or unique specialty medications 50% ($350 max)
- Prescription Benefits Information
Flexible Spending Account
FSA funds must be used during the plan year or are forfeited at the end of the plan year grace period.
For the 2024 calendar year the FSA has a $3,200 annual contribution limit.
For the 2025 calendar year the FSA has a $3,300 annual contribution limit.
National Benefit Services - Flexible Spending Accounts (Customer Service 800-274-0503)
Frequently Asked Questions
Q: When can I start using my medical benefits?
A: Eligible employees can begin using their benefits on day 1 of their hire.
Q: Is my yearly preventative eye exam covered under my medical or vision coverage?
A: Your yearly eye exam is covered under your medical coverage. Vision is reimbursement for hardware only.
UMR Member Support: 1-800-207-3172
What is Tier I pricing?
The largest cost-driver in our SUU plan is outpatient surgery.
You can still use any of the providers in the network, but the much more affordable Surgical Centers were previously not available to SUU employees, as they were not on the EMI provider list.
With the change to UMR we now have access to these surgical centers.
As an incentive for employees to choose the less expensive surgical centers, we have given a lesser deductible to services performed at these centers.
The Tier I list will continue to grow, but at this time the following surgical centers will bill under Tier I.
- Cedar Orthopedic Surgery
- Cedar Orthopedic Surgery Center (C.O.S.C.)
- Southern Utah MRI (SUMRI)
- Southern Utah Physical Therapy (SUPT)
- Coral Desert - Revere Health Orthopedics
- St. George Surgical Center
- St. George Endoscopy
Resources
- Traditional Plan Summary
- FSA Plan Highlights
- Summary of Benefits and Coverage
- Member Claim Submission Form
- Ongoing Condition Care Guide
- Maternity Care Guide
- University Benchmark
- One Pass Select Flyer
- One Pass Select Member Experience Demo