FY26 Open Enrollment
Plan Changes & Participation Requirements - Sent on 3/4/2025
Plan Changes
The FY26 plan year will bring about a few changes. These changes include (1) replacing
the Basic medical plan with the Copay plan and (2) updating plan premiums, deductibles,
and out-of-pocket maximums. Below are the highlights of each change.
(1) NEW PLAN! The Copay Plan
Beginning on July 1, 2025, there will be a new plan to select: the Copay Plan. This plan will replace the Basic medical plan and provide a new option for UA employees to engage with their medical benefits. To understand the new Copay medical plan, it is important to understand the difference between 鈥渃oinsurance鈥 and 鈥渃opay鈥 as it relates to your medical plan.
(1) Coinsurance
This is a percentage that you pay toward a service - typically 20%. Our Premium medical
and HDHP have coinsurance. This requires you to meet your deductible first and pay
for all services up to the deductible amount for your plan before coinsurance begins
to pay. Once you meet your deductible, then you will cover 20% of all services and
your insurance will cover 80%. This continues until you reach the out-of-pocket maximum
for the year or when the plan year starts over.
(2) Copay
This is a flat amount that is paid up front for specific services. You do not need
to meet your deductible to access Copays; however, Copays do not count toward your
deductible, either.
The new Copay medical plan has three levels of Copays for medical services:
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- $40 flat payment to see a primary care physician (PCP)
- $60 flat payment to see a Specialist
- $75 flat payment to go to Urgent Care
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Compatibility of the Copay Medical Plan
The Copay plan is compatible with the premium dental, basic dental, and our vision plans. It is also compatible with the Health Care and Dependent Care Flexible Spending Accounts (FSA)s.
It is not compatible for contributions to the Health Savings Account (HSA) or the Limited Purpose FSA. To contribute to the HSA you must be enrolled in an IRS qualifying plan. At UA, our qualifying plan is the HDHP. To contribute to a Limited Purpose FSA, you must be enrolled in and contributing to the HSA. Even though you cannot contribute to the HSA if you are on a non-qualifying plan, you can always use funds that have already been deposited in your HSA for medical expenses.
TouchCare
If you're unsure if the Copay plan is the right move for you, please contact TouchCare. They are our patient advocacy partner and are here to help you make the best plan choice for you and your family. TouchCare will be able to help with Open Enrollment specific questions beginning on April 1, 2025.
Preventive Visits
As always, preventive visits and medications are covered in full at no cost to you! Be sure to get your annual wellness visit each year.
What's not changing this year?
The dental and vision plans remain the same as they were last year.
(2) Updates to Premiums, Deductibles, and Out-of-pocket Maximums
There are updates to the Premium medical and HDHP premiums, deductibles, and out-of-pocket maximums.
Premium Plan
Biweekly premium:
- $137.85 employee
- $297.82 employee+spouse
- $213.05 employee+children
- $385.01 employee+family
Coinsurance:
- 20% after the deductible is met
Deductible:
- $800 individual
- $2,400 family
Out-of-pocket Maximum:
- $4,250 individual
- $9,250 family
Pharmacy Benefits:
Out-of-pocket Maximum:
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- $1,000 individual
- $1,700 family
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Retail Prescriptions - IN NETWORK:
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- $0 Generic Preventive
- $10 Preferred Generic
- $30 Preferred Brand Name
- $100 Specialty
- 30% Non-preferred
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Mail Order Prescriptions - IN NETWORK:
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- $0 Generic Preventive
- $20 Preferred Generic
- $60 Preferred Brand Name
- $110 Specialty
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Biweekly Premium
- $150.61 employee
- $325.40 employee+spouse
- $232.78 employee+children
- $420.66 employee+family
Coinsurance:
- 20% after the deductible is met
Deductible:
- $1,400 individual
- $4,200 family
Out-of-pocket Maximum:
- $5,000 individual
- $10,000 family
Pharmacy Benefits:
Out-of-pocket Maximum:
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- $1,000 individual
- $1,700 family
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Retail Prescriptions - IN NETWORK:
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- $0 Generic Preventive
- $10 Preferred Generic
- $30 Preferred Brand Name
- $100 Specialty
- 30% Non-preferred
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Mail Order Prescriptions - IN NETWORK:
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- $0 Generic Preventive
- $20 Preferred Generic
- $60 Preferred Brand Name
- $110 Specialty
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NEW! Copay plan
Biweekly Premium
- $54.38 employee
- $116.02 employee+spouse
- $80.34 employee+children
- $146.27 employee+family
Copays:
Copays do not count toward the deductible.
- $40 to see a primary care physician (PCP)
- $60 to see a specialist
- $75 to go to urgent care
Coinsurance:
Coinsurance is applied to all services outside the Copay services listed above.
- 20% after the deductible is met
Deductible:
- $4,000 individual
- $8,000 family
Out-of-pocket Maximum:
- $6,000 individual
- $12,000 family
Pharmacy Benefits:
Out-of-pocket Maximum
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- $1,000 individual
- $1,700 family
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Retail Prescriptions - IN NETWORK
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-
- $0 Generic Preventive
- $10 Preferred Generic
- $30 Preferred Brand Name
- $100 Specialty
- 30% Non-preferred
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Mail Order Prescriptions - IN NETWORK
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-
- $0 Generic Preventive
- $20 Preferred Generic
- $60 Preferred Brand Name
- $110 Specialty
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HDHP
Biweekly premium:
- $64.39 employee
- $135.82 employee+spouse
- $91.93 employee+children
- $166.43 employee+family
Coinsurance:
- 20% after the deductible is met
Deductible:
- $1,600 individual
- $3,200 family
Out-of-pocket Maximum:
- $5,000 individual
- $6,850 family
Pharmacy Benefits:
- Medical deductible and then 20%
Biweekly Premium
- $72.19 employee
- $152.28 employee+spouse
- $103.07 employee+children
- $186.59 employee+family
Coinsurance:
- 20% after the deductible is met
Deductible:
- $2,200 individual
- $4,400 family
Out-of-pocket Maximum:
- $6,000 individual
- $8,150 family
Pharmacy Benefits:
- Medical deductible and then 20%
Participation Requirements - Who must do a form this year?
There are three groups that must participate in Open Enrollment this year. Please
read below to see if you fall in one or more of the three (3) categories that will
require you to submit a form.
(1) Employees Currently Enrolled in Basic Medical
Any employee currently enrolled in the Basic medical plan will be required to do an Open Enrollment form this year to select a new plan. The Basic medical plan will no longer be available after June 30, 2025.
Confirm your Plan
To confirm if you are in Basic medical, login to and click on Employee (Upgraded) > Benefits > Current Summary > Select
The Default
If you are enrolled in Basic medical and you do not submit a form, UA Benefits will
take the following actions on your behalf:
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- Enroll you and your currently covered dependents in the Copay plan. (No dependents will be added or removed during this process.)
- Dental and vision coverages and dependents will not be touched.
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(2) Employees Wanting to Enroll in any Flexible Spending Accounts (FSAs)
If you are wanting to enroll in a Health Care, Dependent Care, or Limited Purpose FSA, you must submit an Open Enrollment form each year you would like the FSA. These benefits are only enrolled in for the specific plan year and will not automatically continue into the next plan year unless an active election is made by you.
(3) Employees Wanting to Update Plan Coverage or Dependents
In addition to the FSA requirement, an Open Enrollment form must be completed if any of the following conditions apply:
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- You want to enroll, update, or stop your medical, dental, or vision plan(s)
- You want to enroll, update, remove currently covered dependents on your medical, dental, or vision plan(s)
- You want to enroll, update, or stop Supplemental Life Insurance (including employee, spouse/FIP, and child coverage)
If you are currently enrolled in one of our supplemental coverages with Corestream and/or MASA, these changes are made during Open Enrollment but they are made directly with each vendor - not on the Open Enrollment form. More information on how to enroll, update, or stop these benefits will be on our Open Enrollment website which will be released later this month.
No Form Required
If you鈥
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- Are not in Basic medical (to confirm if you are in Basic medical, login to and click on Employee (Upgraded) > Benefits > Current Summary > Select)
- Do not want to enroll/update/stop your current medical, dental, or vision plan(s)
- Do not want to enroll/update/remove currently covered dependents on your medical, dental, or vision plan(s)
- Do not want a Flexible Spending Account (FSA)
- Do not want to update any Supplemental Life coverages (employee, spouse/FIP, child(ren))
Then you do not need to do an Open Enrollment form.
Stay tuned for more information on Open Enrollment. Our dedicated Open Enrollment website is schedule to go live by early April!
Mark your calendars! - Sent 2/18/2025
Open Enrollment will run from April 15 - May 2, 2025. Open Enrollment allows employees to make any changes needed to their coverages - switching plans, opting out, adding/removing dependents, etc.
Flexible Spending Account Reminders
As a reminder, all Flexible Spending Accounts (FSAs) must be re-enrolled each year. If an employee currently has a Health Care FSA, Dependent
Care FSA, or Limited Purpose FSA, these will expire on June 30, 2025. To continue coverage for July 1, 2025 and beyond, an Open Enrollment
form electing the FSA coverage must be submitted before the May 2nd deadline.
As we move closer to Open Enrollment, more information will be posted in this article.
Stay tuned!
Emailed via benefits newsletter on 2/18/2025, 3/4/2025.
Contact Benefits: (907) 450-8242 | ua-benefits@alaska.edu | schedule one-on-one time