American Family Children's Hospital
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Comprehensive Health and Supplemental Dental and Vision Benefits

Please Note

This information refers to benefits and compensation for UW Hospital and Clinics residents and fellows. For information about Family Medicine residency and fellowship benefits and compensation, go to the UW Department of Family Medicine and Community Health site.

Health Insurance

 

ACGME Residents and fellows of UW Hospital and Clinics may choose from a variety of comprehensive health plans, including fee-for-service plans and HMOs.

For more information to assist in choosing a health plan, please see:

Unity Health Insurance

 

When you choose Unity Health Insurance, you receive quality care, consistent services and convenient access to a large network of local providers, including the doctors of UW Health.

  • Unity Health Insurance is rated 4.5 out of 5 among NCQA's Private Health Insurance Plan Ratings in 2015-2016 and was among the nation's top 50 private HMO and POS plans for 10 years from 2005-2015.
  • Guaranteed access to UW Hospital, rated the No. 1 hospital in Wisconsin four consecutive years by U.S. News and World Report.
  • Guaranteed access to the pediatricians and pediatric specialists at American Family Children’s Hospital.
  • A broad network of local providers.
  • Fast, friendly and accurate customer service. Contact Unity Customer Service through the message center in MyChart, online chat or by telephone weekdays from 7am to 7pm.
  • Wellness rewards for participation in Well Wisconsin, Fitness First & More, Health First and 9 Months and more wellness programs.
  • High overall member satisfaction

Visit Unity Health for more information

 

All HMO plans include:

  • Choice of single or family coverage
  • Coverage for spouse/domestic partner and eligible dependents to age 26 available. Tax implications may apply.
  • Routine and Preventive Services covered at 100%
    • Includes physical examinations and well baby-care
  • Illness or injury related services covered at 90% after annual deductible: $250 individual/$500 family
    • Employee responsible for 10% coinsurance
    • Out-of-pocket limit (OOPL) expense: $1,250 individual/$2,500 family
  • Emergency room copayment: $75
    • Copayment waived if admitted to the hospital
    • All services accumulated covered at 90% after annual deductible
    • Employee 10% coinsurance will accumulate towards the OOPL
  • Vision Services: Includes one routine eye exam per year after $25 copayment
  • Prescription drugs
    • Prescription costs include $5 copays for generic drugs and coinsurance for non-generic drugs as determined by the plans formulary list (pdf)
  • Includes basic dental coverage
  • Monthly premiums for health plans offered with and without basic dental coverage
Insurance Type Coverage Level With Dental* Without Dental*
It's Your Choice (IYC) Health Plan Single  $44.50 $41.50
  Family $112.50 $104.50
IYC Access Health Plan Single $128.00 $125.00
  Family $320.00 $312.00

 

Premium dollar amounts are current for 2016 and are subject to change each year

 

Federal Health Insurance Marketplace

 

As your employer, UW Hospital and Clinics is required to provide all employees with a Notice of the availability of the Health Insurance Marketplace.

 

Beginning in 2014, the Affordable Care Act (ACA) requires most everyone to obtain health insurance for themselves and their dependents or pay a penalty when filing their tax returns. The Health Insurance Marketplace (also known as the Exchange) is a new option for people to obtain health insurance.

 

If you have or will have State Group Life Insurance coverage through your UW Hospital and Clinics employment, you do not need to enroll through the Marketplace or take action, unless you choose to do so.

 

If you have questions about your eligibility for health insurance through your employment at UW Hospital and Clinics, please call (608) 263-6500 or email uwhcbenefits@uwhealth.org.

 

Additional Resources

Supplemental Delta Dental Insurance

 

Delta Dental provides supplemental dental coverage with a $25-$50 annual deductible that offers a benefit maximum of $1,000 per person per year. Coverage begins on the first of the month following 30 days of employment.

Coverage includes:

  • 100% coverage for diagnostic and preventive services
  • 80% coverage for of basic services, including fillings, emergency treatment or sealants
  • 50% coverage for major services, including crowns, bridges or dentures
  • 50% coverage for orthodontics to age 19 (Lifetime Maximum of $1,250 per dependent)

Additional benefit information can be found in the Supplemental Delta Dental Summary (pdf).

 

Supplemental Vision Insurance

 

The VSP Vision Insurance plan provides supplemental vision coverage for eye exams, lenses, frames and contact lenses. Coverage begins on the first of the month following 30 days of employment.

Coverage includes:

  • 100% coverage on a comprehensive vision examination by a network optometrist or ophthalmologist every calendar year after $10 co-pay
  • 100% coverage on single vision, lined bifocal and lined trifocal lenses and scratch-resistant coating every calendar year after $25 co-pay
  • Coverage on frames (up to $130 allowance) every 24 months after $25 co-pay. If frames and lenses are purchased in the same year, only one $25 co-pay applies.
  • Coverage on contact lenses (up to $105 allowance for contact and the contact lens exam) every calendar year only if electing contact lenses instead of lenses or frames
  • Out-of-network reimbursement is available in the below amounts (contact VSP at 1-800-400-4569 before seeing a non-VSP provider):
    • Contact lenses up to $105
    • Eye exam up to $40
    • Single vision lenses up to $33
    • Lined bifocal lenses up to $50
    • Lined trifocal lenses up to $66
    • Frames up to $45
  • Discounted rates on laser vision correction available from contracted facilities
  • Additional discounts for prescription glasses, sunglasses and contacts at VSP participating providers

EPIC Benefits+

Major Medical and Dental - Supplemental

 

EPIC Insurance provides excess health, supplemental dental and Accidental Death and Dismemberment (AD&D) benefits. EPIC Insurance is intended to supplement, not replace, the primary health coverage.

Includes:

  • Hospital and Surgery Benefit: Provides Inpatient hospital and/or Outpatient surgery indemnity benefits.
  • Dental services not covered or partially covered by the primary health insurance.
  • Accidental Death & Dismemberment: Provides a lump sum benefit for accidental death or specific life-altering injuries of the employee, employee's spouse or children.

Employee Reimbursement Account (ERA)

 

The employee reimbursement account allows employees to pay for medical and child care expenses with pre-tax income. Residents and Fellows have a 30-day deadline to enroll in this benefit. The plan is based on expenses incurred during the calendar year.

Medical Reimbursement includes medically necessary expenses not covered by health, dental or vision insurance, such as:

  • Prescription co-pays
  • Major dental expenses
  • Glasses or contacts
  • Refractive surgery

The Dependent Reimbursement account is for child or dependent care up to $5,000 per year, and up to $2,500 for non-covered medical and dental expenses. The minimum annual contribution is $100. Expenses for daycare, as well as before- and after-school care of children may be reimbursed.