MEDICAL BENEFITS
Villanova University is proud to offer employees three medical plan options, which include prescription and vision coverage, to help you care for your and your family's medical needs. Spending accounts and dental insurance are also available.
PLANS
For additional details on all of the plans, please visit:
KEYSTONE HEALTH PLAN EAST HEALTH MAINTANENCE ORGANIZATION (HMO)
An HMO is a managed care program that provides a wide range of healthcare services through an organized network of physicians and hospitals. You are required to select a primary care physician (PCP), from the Keystone network to guide your care. Referrals from the PCP are required for specialist visits.
Under the HMO plan, most services are paid at 100% with no deductibles or 100% after a small co-payment for physician visits. Referrals from the PCP are required for specialist visits.
If you will be traveling out of the area for at least 90 days, please learn more about the HMO Guest Membership.
PREFERRED PROVIDER ORGANIZATION (PPO)
The PPO plan provides you in and out of network benefits and allows you to select your own doctors and hospitals. You do not need to select a Primary Care Physician and referrals are not required. By staying in the Blue Cross network you will maximize your benefits. However, if you choose to see an out-of-network provider, you will incur higher out-of pocket costs. Premium costs in the PPO plan will be higher than the HMO but network flexibility will be greater.
CONSUMER DRIVEN HEALTH PLAN (CDHP)
The CDHP plan is similar to the PPO plan in that it provides you in and out of network benefits and allows you to select your own doctors and hospitals. You do not need to select a Primary Care Physician and referrals are not required. By staying in the Blue Cross network you will maximize your benefits. However, if you choose to see an out-of-network provider, you will incur higher out-of pocket costs. The CDHP with Health Savings Account (HSA) is a different approach to how you pay for today’s health care and save for your future. It is a lower-premium, high-deductible health insurance plan, which means you pay less out of your paycheck for premiums and more out of pocket at the point of service—before the plan pays for services that are not considered preventive. Villanova’s CDHP meets the minimum federal requirements that allow an enrollee to also qualify for a tax-advantaged HSA.
Eligibility
All full-time employees are eligible for coverage under the University’s medical, dental and life insurance programs beginning on the first day of the month following the first day of work. Registration in these plans is NOT automatic. No participation can begin without completion of the required enrollment materials, either during your New Employee Orientation, during the annual Open Enrollment Period (generally in April with choices in effect June 1-May 31) or within 31 days of a Life Status Change.
Important Note: The open enrollment period is the only time during the year when you can enroll, cancel coverage, add or remove dependents, and change supplemental or dependent life insurance. The only exception to this is if you have a “Qualified Life Status Change,” which is further described in the Pathways brochure.
**All supporting documentation for a Qualified Life Status Change must be uploaded to the benefit enrollment system and not emailed to HR.
The Internal Revenue Service defines a Life Status Change as a change in coverage due to the following:
- Marriage or divorce
- Birth or adoption of a child
- Death of a spouse or child
- Change in employment status of you or your spouse
- Open Enrollment period for your spouse or certain other changes that impact coverage
- Change in full-time student status of your unmarried dependent child
- Judgment, decree or order
- Medicare entitlement
- Termination of Medicaid or CHIP coverage (notification must be made within 60 days)
- Eligibility for Premium Assistance under Medicaid or CHIP (notification must be made within 60 days)
Any benefit change must be consistent with a life status change. You must notify Human Resources within 31 days of the life status change except as indicated above. After this grace period, you will not be able to make any changes in your coverage until the next Annual Open Enrollment.
Dependent children are eligible to be covered until age 26 (except for dependent life which provides coverage until age 25 for full time students). When a dependent is no longer eligible for benefits, it is the employee’s responsibility to contact Human Resources for continuation of coverage for dependents under COBRA provisions.
Faculty and staff who participate receive $150 off annual medical plan contribution. In addition, spouses that are enrolled in the University medical plans qualify for a $75 annual medical plan contribution if they complete the physician health screening form as well. If you are enrolled in either the HMO or PPO plans, this contribution will be applied as a premium discount. If you are enrolled in the CDHP plan, this contribution will be made into your HSA account.