Health & Wellness

Pharmacy Plan

The University of Alaska partners with Premera to provide UA employees with a pharmacy plan. Each medical plan (Premium, Basic, and HDHP) as a corresponding pharmacy plan. There is no additional enrollment or biweekly premium to access the pharmacy plans. 


Pharmacy Plan Enrollment

    • Benefit-eligible employees working a minimum of 20 hours per week
    • Temporary employees who meet the hours worked requirement (check with HR Coordinator or visit the temporary employee webpage)
    • Dependents (spouse/Financially Interdependent Partner (FIP) and child(ren)). Dependents can only be enrolled in the same plan as the employee.
    • The University of Alaska requires evidence of eligibility for all enrolled dependents
    • Supporting documents include birth certificate, marriage license, final adoption paperwork, tax returns showing claimed dependents, qualified medical child support orders, legal guardianship papers, etc. 

​If an employee enrolls in a medical plan, the following dependents are eligible for coverage, as well. 

Spouse
The lawful spouse of an employee unless legally separated.

Financially Interdependent Partner (FIP)
Wherever “spouse” is stated in the health care plan, a FIP would also be included (provided all requirements are met as specified by the University of Alaska).

Health care deductions for FIPs are post-tax. 

Child(ren)

    • Under 26 years of age 
    • Natural offspring of either/both employee or employee's spouse
    • Legally adopted of either/both employee or employee's spouse
    • Granted court-appointed legal guardianship
      • Signed court order  granting guardianship to employee or employee's spouse of the employee as of a specific date.
      • When the court order terminates or expires, the child is no longer an eligible child.
    • Domestic relations order to provide medical benefits as directed by a divorce decree, a medical child support order, or other court-ordered dependent coverage
    • Foster child living with the employee
      • Signed court order (or other order) signed by judge or state agency which grants guardianship to the employee or employee's spouse as of a specific date.
      • When the court order terminates or expires, the child is no longer an eligible child.
    • Placed for the purpose of legal adoption in accordance with state law
      • Placed for adoption means assumption and retention by the employee of a legal obligation for total or partial support of a child in anticipation of adoption of such child.

Life Event Webpage
Review the Life Event Webpage to understand how this life event affects benefits.

Due Dates
If an employee is welcoming a new family member and would like to enroll their newborn in coverage, the form must be submitted within 60 days of birth.

SSN and Birth Certificate 
Do not wait for the social security number or official birth certificate before submitting the life event form.

Submitting the Form
When completing the life event form, submit

    • the temporary birth certificate from the hospital, and
    • use 0's for placeholders for the SSN.

Once the SSN is received, please reach out to us at ua-benefits@alaska.edu for instructions on how to add the SSN. Do not send any SSNs through email. 

New Benefit-eligible Employees 

    • Review the new employee webpage
    • 30 day deadline from hire date to enroll or opt out
    • If no form submitted, defaulted into Basic medical, Basic dental, and vision for employee-only coverage

Current Benefit-eligible Employees - Life Event

Temporary Employees


The pharmacy plan is included with the corresponding medical plan. There is no additional enrollment or biweekly premium. 

Coverage Begin Dates

New Employees - First Day Coverage
      • Submit form by 5:00pm on the Thursday prior to the end of their first pay period 
      • If submitted later but within the 30 day requirement, coverage begins on the first day of the pay period the form is submitted
Current Employee - Day of Life Event
      • Submit form on or before the day of the event
      • If submitted after the day of the event but within the 30 day requirement (60 for birth/adoption), coverage begins on the day the forms is submitted

Coverage End Dates

End of the Pay Period
      • Coverage will end at the end of the pay period in which an employee (1) separates from the University or (2) ends coverage due to a life event

 

      • Every employee is on a 26 pay period (12 month) deduction schedule for their benefits
      • Employees who work less than 26 pay periods in a fiscal year (9, 10, and 11-month employees) will accrue arrears on missed deductions during the time they are off-contract or otherwise experiencing leave without pay
      • Review the FAQ below to understand what arrears are and how they apply

Viewing the Arrears Balance
Employees can view arrears balance at any time on UAOnline by clicking on "Employee Service" > "Benefits & Deductions" > "Arrears Balance."

Arrears are missed deductions. 

For example: An employee who is off-contract and not receiving pay will not have deductions collected from their $0.00 paycheck. When an employee returns to work and begins receiving pay again, the deductions will restart and the arrears balance will begin to be repaid in the specific amounts listed in the "how are arrears repaid" drop down menu below. 

Arrears apply to any employee who has active deductions that require arrears and that employee experiences a pay period where they do not receive pay.

Employees who are off contract
Employees who are in an off contract status are not receiving pay. This will generate arrears for their missed deductions during the pay periods where an employee was off contract. When an employee returns back to an on contract status, they will begin paying for their deductions again, including any arrears that need to be paid off.

Leave without pay
Employees who experience leave without pay in excess of 10 days must reach out to ua-benefits@alaska.edu to discuss the potential for Family Medical Leave (FML), Short-term Disability (STD), and other benefits that might apply to a specific situation. Some cases - such as an approved Leave of Absence - will be a COBRA event. Specific situations can be reviewed with individual employees. 

  1. Premium health care
  2. Basic health care
  3. HDHP
  4. Premium dental
  5. Basic dental
  6. Vision
  7. Health Care Flexible Spending Account (HC FSA)
  8. Corestream Voluntary Benefits
  9. Supplemental life - employee
  10. Supplemental life - spouse
  11. Supplemental life - child
  12. Accidental Death & Dismemberment - employee
  13. Accidental Death & Dismemberment - family
  1. HSAs
  2. FSA dependent care accounts
  3. Pet insurance (Pet insurance payments are made directly with ASPCA and are not included in payroll deduction. Employees are responsible for these premiums.)

There are two repayment schedules for arrears: 100% and 40%.​

This repayment schedule is for:

  1. Health Care Flexible Spending Account (HC FSA)
  2. Corestream Voluntary Benefits

100% Schedule
Arrears will be paid biweekly when the employee returns to work at a rate of 100% of the current deduction(s) until the arrears balance is paid.

This means that the employee will pay 200% of the biweekly deduction until the arrears balance is paid off.

Example
An employee is currently contributing to a HC FSA at $100 per pay period.

This employee goes off contract for 4 pay periods. This means that the employee has missed $100 x 4 ($400) deductions for their HC FSA.

When the employee returns to work, the employee will pay $100 for their deduction and $100 toward the arrears balance ($200 deduction in total).

The arrears balance will be paid off in 4 pay periods. At that time, the deduction will return to $100 per pay period.

This repayment schedule is for:

  1. Premium health care
  2. Basic health care
  3. HDHP
  4. Premium dental
  5. Basic dental
  6. Vision
  7. Supplemental life - employee
  8. Supplemental life - spouse
  9. Supplemental life - child
  10. Accidental Death & Dismemberment - employee
  11. Accidental Death & Dismemberment - family

40% schedule
Arrears will be paid biweekly when the employee returns to work at a rate of 40% of the current deduction(s) until the arrears balance is paid.

This means that the employee will pay 140% of the biweekly deduction until the arrears balance is paid off.

Example
An employee is currently enrolled in premium medical, premium dental, and vision for employee, spouse, and 2 dependent children. The employees current biweekly deduction for these coverages is:

  • $361.47 Premium medical family
  • $25.94 Premium dental family
  • $1.90 Vision family
  • $389.31 total per pay period

This employee goes off contract for 4 pay periods. This means that the employee has missed $389.31 x 4 ($1,557.24) deductions for their coverages.

When the employee returns to work, the employee will pay $389.31 for their deductions and 40% of each of their deductions toward the arrears balance:

  • $144.59 Premium medical family
  • $10.38 Premium dental family
  • $.76 Vision family
  • $155.73 total arrears per pay period

This means the employee would pay:

  • $389.31 total per pay period for deductions
  • $155.73 total arrears per pay period
  • $545.04 total

The arrears balance will be paid off in 10 pay periods. At that time, the deduction will return to $389.31 per pay period.

 

Pharmacy Plan Basics

Premera Premium Pharmacy Plan

Biweekly premiums are included in the medical plan premium.

Out of Pocket Maximum

Individual: $1,000
Family: $1,700 

Retail Prescription Tiers

In-Network
$0 Generic Preventive 
$10 Preferred Generic
$30 Preferred Brand Name
$100 Specialty
30% Non-preferred

Out-of-Network
Specialty medications not covered.

Mail Order Prescription Tiers

In-Network
$0 Generic Preventive 
$20 Preferred Generic
$60 Preferred Brand Name
$110 Specialty

Out-of-Network
Mail-order not covered.

Premera Basic Pharmacy Plan

Biweekly premiums are included in the medical plan premium.

Out of Pocket Maximum

Individual: $1,000 
Family: $1,700 

Retail Prescription Tiers

In-Network
$0 Generic Preventive 
$10 Preferred Generic
$30 Preferred Brand Name
$100 Specialty
30% Non-preferred

Out-of-Network
Specialty medications not covered.

Mail Order Prescription Tiers

In-Network
$0 Generic Preventive 
$20 Preferred Generic
$60 Preferred Brand Name
$110 Specialty

Out-of-Network
Mail-order not covered.

Premera HDHP Pharmacy Plan

Biweekly premiums are included in the medical plan premium.

Out of Pocket Maximum

Pharmacy charges on the HDHP are included in the medical deductible and the medical out of pocket maximums. 

Retail Prescription Tiers

Pharmacy charges are the responsibility of the employee until the medical deductible is met.
Once the medical deductible is met, the employee will then pay a 20% cost share of the medications until the medical out of pocket maximum is met.

Mail Order Prescription Tiers

Mail order prescriptions are not covered in out-of network pharmacies.

Included with Medical Premiums

There are no additional premiums for the pharmacy plan. Employees are automatically enrolled in the pharmacy plan that corresponds to their medical plan enrollment.

Premera 

1-800-722-1471 |  Sign into Premera portal and send a secure email

  • Preventive Medications
  • Maintenance Medications

Accredo and SavonSP

Accredo (Express-Scripts) | 1-800-689-6592
SaveonSP | 1-800-683-1074

  •  Specialty Medications

TouchCare

1-866-486-8242 | assist@touchcare.com

  • Comparing UA plans for the best option medically/financially
  • Price comparisons for services (like an x-ray)
  • Assistance with medical billing - general questions on bills, advocacy with Premera on incorrect bills, etc.

UA Benefits Team


Pharmacy Plan Details

Covered at No Cost on All Plans

Provided through ExpressScripts

Retail Pharmacy

  • Maintenance medications can be filled at a retail pharmacy twice (2x).
  • After this, brand name maintenance medications must be ordered through the mail-order pharmacy.

Mail Order Pharmacy

  • Premera partners with Express-Scripts for mail-order prescriptions.
  • Log into the Premera portal and click on "prescriptions" in the tool bar at the top and "manage prescriptions" in the drop down.
  • On the next page under "Express Scripts" click on the link "order and refill" and follow the directions to change prescriptions to mail order.

Specialty Medications List

List of SaveOn SP Medications

Accredo Specialty Medications Pharmacy

All specialty medications must be dispensed from the specialty pharmacy, Accredo Health Group.

Specialty Medication Copays

  • Premium and Basic medical plans have a $100 copay for up to a 30 days supply.
  • HDHP does not have a copay but is subject to the deductible.
  • Visit the Specialty Pharmacy Program page on Premera's website to find out how to order and to see various Specialty Medications lists. 

SaveonSP Specialty Coupon Program 

  • SavonSP is an Express-Scripts’ program.
  • Helps members save money on certain specialty medications.
  • Participation in the program is voluntary.
  • If participating, SaveonSP will monitor the account to ensure employees have no cost ($0). 

Filled with Accredo
Prescriptions will still be filled through Accredo, the existing specialty mail pharmacy.    

Copay Covered
If participating in this program, the copay will be covered under SaveonSP for the specialty medications that are included in the program. This will result in no out-of-pocket costs to participants. 

How to Participate

  • Call SaveonSP at 1-800-683-1074 prior to filling a specialty prescription.
  • The program cannot be retroactively applied to a previously filled prescription.
  • If not to participating, SaveonSP will not be able to monitor the account and employees will be responsible for the copay.

Not Applied to Out of Pocket Maximum

  • The prescription drugs included in the SaveonSP program are classified as Non-Essential Health Benefits under the Affordable Care Act. 
  • Payments on prescriptions in the SavonSP program will not apply toward out of pocket costs.
  • The medications and associated copays included in this program are subject to plan clinical rules and subject to change. 


FORMS 

Premera Forms

 


RESOURCES

COBRA

External Resources