High Deductible Health Plan

The High Deductible 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.  800-207-3172

Plan Deductible:

Tier I  - $1,600 individual / $3,200 family deductible

Tier II - $1,750 individual / $3,500 family deductible

Preventative visits covered 100%.

Out of pocket maximum:

Tier I  - $1,600 individual / $3,200 family for the plan year (in-network)

Tier II $3,000 individual / $6,000 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.

Once the deductible is reached, copays are $35 primary office visits or $45 for secondary office visits.

Prescription: $20 generic Rx, 30% ($250 max); Preferred Rx, 50% ($350 max) Non-preferred Rx, or unique specialty medications. 
- Prescription Benefits Information 

Health Savings Account (HSA)

For the 2024 calendar year the HSA has a $4,150/$8,300 annual contribution limit (EE + ER). Those 55 and older can contribute an additional $1,000 as a catch-up contribution.

For the 2025 calendar year the HSA has a $4,300/$8,550 annual contribution limit (EE + ER). Those 55 and older can contribute an additional $1,000 as a catch-up contribution.

Funds in the HSA roll over each year if unused and are portable, all funds deposited into the HSA go with the employee if they leave SUU employment.

• Optum Bank - Health Savings Account Card (Customer Service 866-234-8913)
• Optum Bank - Excess Contribution/Deposit Correction
• HSA Plan Highlights 
• HSA Qualified Expenses (pages 5-17)

Health Reimbursement Account (HRA)

Special enrollment is available for employees with HDHP who are not eligible for HSA. Employer contribution only.

• HRA Plan Highlights 
• HRA Enrollment Form

UMR Website

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.

1. Cedar Orthopedic Surgery
2. Cedar Orthopedic Surgery Center (C.O.S.C.)
3. Southern Utah MRI  (SUMRI)
4. Southern Utah Physical Therapy  (SUPT)
5. Coral Desert - Revere Health Orthopedics
6. St. George Surgical Center
7. St. George Endoscopy

Resources

• HDHP Plan Summary
• Telemed
• Summary of Benefits and Coverage
• Ongoing Condition Care Guide
• Maternity Care Guide
• HSA Contribution Change Form
• Member Claim Submission Form
• University Benchmark
• One Pass Select Flyer
• One Pass Select Member Experience Demo
  

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.