Medical Plans
Butler University provides three medical plan options, PPO Plus, PPO Core and HDHP, which are administered through Anthem. Click on the links below to find out more about each plan Butler offers.
Plan benefits run through your first day of hire through December 31. Open Enrollment is held each fall for benefits effective January 1 of the next calendar year.
Legally married spouses and dependents, under the age of 26 or legally dependent due to a physical or mental disability, can be covered under your Butler plan. Dependent coverage ends when your coverage ends or on the last day of the month in which they turn 26.
Summary of Benefits and Coverages
High Deductible Health Plan (HDHP) (PDF)
PPO Core (PDF)
PPO Plus (PDF)
The HDHP plan has a higher deductible than a traditional PPO insurance plan. The per pay premium is lower, but you pay more health care costs initially before the insurance company starts to pay its share. The amount you are responsible for before the plan begins to pay is your deductible. The HDHP plan can be combined with a health savings account (HSA), allowing you to pay for certain medical expenses with money free from federal taxes.
Health Savings Account (HSA)
A health savings account is a tax-advantaged checking account that gives you the ability to save for future medical expenses or pay current ones. It is individually owned; however, you may elect to designate an authorized signer who may also withdraw funds and be issued a debit card.
To be eligible for an HSA you:
- Must be currently enrolled in an HSA-qualified health plan
- May not be enrolled in any other non-HSA qualified health plan
- May not be claimed as a dependent on another person’s tax return
- May not be enrolled in Medicare, Medicaid, or Tricare
- Must not have used VA medical benefits in the past 3 months, with the exception of preventative services or treatment for a service-connected disability
You cannot have an HSA account if your spouse has a general-purpose health care FSA through their employer under which money can be reimbursed for your eligible healthcare expenses.
Medicare
If you are enrolled in a Medicare plan, you are not eligible to contribute to an HSA. However, premiums for Medicare Part A, B, C, and D can be reimbursed from an HSA. Medicare supplement insurance is not eligible for reimbursement. For more information regarding Medicare and Health Savings Accounts please visit, Flexible Spending/Health Savings.
The Preferred Provider Organization (PPO) Core plan is a type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost.
The PPO Core plan has a higher deductible and co-pays than the PPO Plus plan, but your per pay premium is lower.
If you are covered under a PPO plan you are eligible to enroll in a Flexible Spending Account (FSA), however, you may not be also enrolled in a Health Savings Account.
The Preferred Provider Organization (PPO) Plus plan is a type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost.
The PPO Plus plan has a lowest deductible and co-pays available, but your per pay premium is higher than the PPO Core or HDHP plans.
If you are covered under a PPO plan you are eligible to enroll in a Flexible Spending Account (FSA), however, you may not be also enrolled in a Health Savings Account.
Insurance Eligibility and Dependent Changes
Due to IRS regulations, once you have made your elections for the plan year, you cannot change your benefits until the next annual open enrollment. The only exception is if you experience a qualifying life event. Elections changes must be requested within 30 days of the event date.
Examples of a Qualifying Life Event includes, but are not limited to:
- Marriage, divorce, or legal separation
- Birth, adoption or place for adoption or foster care
- Death of a dependent or spouse
- Change in your spouse’s employment status
- Change in coverage under your spouse’s plan
- A loss of eligibility for other health coverage
- Termination of eligibility for Medicaid or a state Children’s Health Insurance Program (CHIP)
- Becoming eligible for a premium assistance subsidy under Medicaid or a state CHIP
Please notify the Benefits & Wellness team at benefits@butler.edu of your qualifying life event within 30 days of the event date. Once supporting documentation is received, an enrollment event will be opened for you to login to my.butler.edu to update your coverage elections.
Affordable Care Act (ACA) Compliance
The following statements are included in compliance with the Affordable Care Act (ACA) and refer to medical insurance offered by Butler University as an employer.
Does this Coverage Provide Minimum Essential Coverage?
The Affordable Care Act requires most people to have health care coverage that qualifies as “minimum essential coverage.” This plan or policy does provide minimum essential coverage.
Does this Coverage Meet the Minimum Value Standard?
The Affordable Care Act establishes a minimum value standard of benefits of a health plan. The minimum value standard is 60% (actuarial value). This health coverage does meet the minimum value standard for the benefits it provides.