NKU offers 3 plan choices for medical plans. Starting January 1, 2024 UMR/United HealthCare will be our provider. The charts below have information on copays, deductible and co-insurance amounts, payroll deductions, etc.
New Hires: 1st of the month after 30 days of employment.
Annual Enrollment: January 1st of next calendar year.
Coverage may not be changed during a calendar year unless you have a qualified status change.
| Network | Cincinnati/Northern KY HMO | National POS Open Access | |
|---|---|---|---|
| Option | HMO | POS | HDHP 2500 |
| Preventive Care | $0 | $0 | $0 |
Office Visit Copayments Primary care Specialist |
$25 $55 |
$25 $40 |
100% before deductible; 15% after deductible to OOP |
| Emergency Room | $250/visit | $200/visit | 100% before deductible; 15% after deductible to OOP |
| Annual Deductible | $2,000 individual $4,000 family |
$1,000 individual $2,000 family |
$2,500 individual $5,000 family |
| Coinsurance | 20% | 20% | 15% |
| Annual Out Of Pocket Maximum | $4,500 individual $9,000 family |
$4,000 individual $8,000 family |
$3,425 employee only $6,850 employee + one or more |
Health Savings Account Employee only Employee +1 or more |
Not applicable | Not applicable |
$625/year $1,250/year |
| HMO and POS | HDHP 2500/5000 | ||
|---|---|---|---|
Retail (30 day supply) |
Mail Order (90 day supply) |
Retail or Mail Order | |
| Level 1 | $10 copayment | $25 copayment | 100% before deductible; 15% after deductible to OOP Specifically listed preventive drugs 15% coinsurance up to deductible |
| Level 2 | $35 copayment | $87.50 copayment | |
| Level 3 | $55 copayment | $137.50 copayment | |
| Level 4 | 25% of required payment limited to $300 per prescription filled | ||
| POS | HMO | HDHP | |
| Option Out of Pocket Maximum |
$4,000 individual $8,000 family |
$4,500 individual $9,000 family |
Prescription drug deductible combined with medical deductible employee only or employee plus 1 or more |
| Option/Level | HMO | POS | HDHP 2500/5000 |
|---|---|---|---|
| Employee only | 58.00 | 130.00 | 32.00 |
| Employee + Spouse | 219.00 | 465.00 | 120.00 |
| Employee + Child(ren) | 196.00 | 426.00 | 99.00 |
| Employee + Family | 345.00 | 810.00 | 187.00 |
| NKU Spouses – Employee + Spouse* | 99.00 | 221.00 | 55.00 |
| NKU Spouses – Employee + Family* | 216.00 | 473.00 | 112.00 |
| Employee + Spouse w/Surcharge** | 254.00 | 500.00 | 155.00 |
| Employee + Family w/Surcharge** | 380.00 | 845.00 | 222.00 |
*Spouse who works at NKU in a benefit eligible position
**Spouse with coverage available from own employment
