2021 Medical Insurance

MEDICAL MUTUAL CUSTOMER CARE CENTER:  800-382-5729

www.medmutual.com

 

To assist Kent State University employees and families, Medical Mutual has provided a website that is dedicated to Kent State.  Once there, you can search for in-network providers and view videos regarding Medical Mutual online tools and resources.  Although we are approaching a new year, there are no medical plan benefit changes for 2021. 

Have other insurance?  What is Opting Out?

Sometimes employees have other insurances through their parents or a spouse/domestic partner.  If you are not covered under Kent State's insurance, you can receive $50 per pay ($100 per month) in your pay for opting out.  Opting out means that you will be opting out of medical, vision, prescription, and dental benefits at Kent State.  To receive the cash incentive, you will need to enter the OE portal, elect the Opt-Out option, and complete all related questions for 2021.   Note:  The Opt-Out election must be completed each year.

If I Opt Out and lose insurance, what then?

If you opted out and lost insurance coverage, you can enroll in Kent State's plans under a Qualifying Event.  A qualifying event is a major life event such as loss of insurance coverage, birth, adoption, marriage and/or divorce. Qualifying life events may make you eligible to enroll in benefits or make changes to your benefits outside of the annual open enrollment period.  Just contact us at benefits@kent.edu within 30 days of the loss of insurance and we can get you and your dependents enrolled.

What plans are available in 2021?

As a full-time, benefits-eligible employee you will have a choice of the Medical Mutual 85/60 or the High Deductible Health Plan (HDHP).  To assist you in making the right choice for you and your family, please view the video "Choosing an HDHP or Copay Plan" and the Healthcare Modeler.

What are the coverage highlights of the 85/60 PPO plan?

As with all our medical plans, your medical premium includes prescription and vision benefits.  Unlike traditional medical plans, preventive services are covered at 100% with in-network providers at NO COST to you.  Examples of preventive care services are annual exams, immunizations, and preventive screenings.  Also, if you choose the 85/60 plan, you can enroll in the Flexible Spending Accounts such as the Healthcare Flexible Spending Account or the Dependent Care Flexible Spending Account.  Healthcare FSAs allow you to use pre-tax dollars to pay for eligible healthcare expenses incurred by you or your eligible dependents.  Dependent Care FSAs allow you to use pre-tax dollars to pay for DAYCARE expenses for dependents up to the age of 13 or for elderly care.  Visit our FSA and HSA web pages for more information.

  • Deductible for in-network providers:  $300 for single coverage and $600 for family coverage.
  • Coinsurance for in-network providers: 15%
  • Office co-pays for non-preventive healthcare services: $15 for primary care doctors and $30 for specialists. *Co-pays do not go toward meeting your deductible.
  • Out of Pocket Maximum for in-network providers:  $1,500 for single coverage and $3,000 for family coverage.
  • Out of Pocket Maximum for in-network providers for FACULTY:  $1,200 for single coverage and $2,400 for family coverage.
  • Preventive Services for 2021 Medical Mutual 85/60 and HDHP (PDF)
  • Preventive Therapy Drug List (PDF)  

What are the highlights of the HDHP (High Deductible Health Plan)?

The High Deductible Health Plan (HDHP) is an option for all full-time benefits-eligible employees, including the bargaining units.  Also with the election of an HDHP, a Health Savings Account (HSA) can be created for you in which Kent State will contribute to your HSA $1,100 for single plans or $2,000 for family plans at the start of the 2020 year.  To increase your savings in your HSA, you can elect to contribute to the HSA at any time throughout the year.  You can also increase or decrease your contributions throughout the year.  Another great thing about an HSA it allows you to use your pre-tax dollars to pay for eligible health care expenses incurred by you or your eligible dependents.  Got Dependents?  No problem! You can enroll in the Dependent Care FSA that allows you to use pre-tax dollars to pay for DAYCARE expenses for dependents up to the age of 13 or for elderly care; however, you cannot increase or decrease your elections to your FSA during the plan year.  Visit our FSA and HSA web pages for more information. 

As with all medical plans that Kent State offers, your medical premium includes your prescription and vision benefits.  Preventive services are also covered at 100% with in-network providers at NO COST to you.  Examples of preventive care services are annual exams, immunizations, and preventive screenings.   

How does my prescription coverage work when enrolled in a High Deductible Health Plan?

When enrolled in the High Deductible Health Plan, you can expect to pay the negotiated price for your prescriptions until your HDHP deductible is met.  After your deductible is met, your prescription co-insurance will apply and the maximum you would pay for your prescription will be $60.   For more information about your prescription coverage, visit our prescription webpage.  

*Prescription co-insurances:

  • 10% coinsurance of the negotiated price for generic medications
  • 20% coinsurance of the negotiated price for brand-name prescriptions when a generic equivalent is not available
  • 40% coinsurance of the negotiated price for brand-name prescriptions when a generic equivalent is available

*If a prescription you or your dependent(s) is taking appears on the PREVENTIVE THERAPY DRUG LIST, the cost of that drug is not subject to your deductible.  However, co-insurance will apply as stated above and the co-insurance amount will be applied toward your annual deductible.

www.medmutual.com

Dependent Eligibility and Verification Form

2021 Medical Mutual Plan Booklet - HDHP

2021 Medical Mutual Plan Booklet - 85/60 - Staff

2021 Medical Mutual Plan Booklet - 85/60 - Faculty