Medical Plan Options for 2021

The Arizona Department of Administration (ADOA) provides medical insurance to state employees and determines changes to these plans. In 2021, there will be changes to your medical plan options. Review the information below carefully for details on your options.

 

Learn more about the 2021 medical plans.
View the 2021 Benefits Guide (PDF)

Email HR Solutions


Introduction

Medical Plan Options

2020 Options

Exclusive Provider Organization (EPO)

Preferred Provider Organization (PPO)

High-deductible Health Plan (HDHP)

 

2021 Options New

Triple Choice Plan (TCP)

High-deductible Health Plan (HDHP)

The new TCP combines features of the former EPO and PPO plans, with one premium.

The HDHP continues to be offered in 2021, but with a new HSA administrator, Optum Bank. If you have funds with the former provider, Payflex, you will receive information about options to transfer your account in February 2021.

Insurance Carriers

2020 Carriers

Blue Cross Blue Shield

UnitedHealthcare

Aetna

Cigna

2021 Carriers New

Blue Cross Blue Shield

UnitedHealthcare

If Cigna or Aetna is your current insurance carrier for medical insurance, you will have to choose a new insurance carrier when you elect a medical plan for 2021.

If you are currently undergoing treatment or are in a disease management program with Aetna or Cigna, please see the FAQs for additional information about transitioning care.

Definitions

Premium: The amount you pay each month for coverage. Premiums are automatically deducted from your paycheck twice each month.

Deductible: The amount you must pay each year before insurance begins covering costs.

Copay: The set amount you pay for each healthcare service you receive.

Coinsurance: A percentage of the provider’s bill that you are responsible for paying. For example, if the provider bills $200, and you have 10% coinsurance, you pay $20.

Out-of-pocket maximum: The most you will pay each year. Once you have paid this amount, your insurance will pay 100%.

Quick Facts About 2021 Medical Plan Options

Preventive care (e.g., physicals, immunizations, screenings): Both plans cover preventive care at $0 cost.

Specialist referrals: You do not need to designate a primary care physician or receive referrals for specialist services in either plan.

Covered Benefits: Both plans cover the same services. Your cost of these services could differ between plans.

Nationwide coverage: Both plans offer networks with nationwide coverage.

Pharmacy coverage: Pharmacy is included with whichever plan you choose and offered through MedImpact.
 
 

Steps and Considerations
When Choosing a Medical Plan

 view the 2021 Benefits Guide (PDF)
Click for a full overview of the 2021 options.
 

Step 1: Compare Medical Plan Options

Triple Choice Plan (TCP)
 

Watch this short video about the TCP

 

The TCP is a single plan for which you pay one premium.

In the TCP, you have access to two tiers of in-network providers plus the option to go out-of-network with a third tier. If you visit an in-network provider, you pay copays for service; out-of-network you pay 50% coinsurance.

The provider you choose determines your deductible. If your provider is in Tier 1, your deductible is lower than if you choose a Tier 2 or Tier 3 provider.

You are responsible for the cost of services until you meet the deductible. Once the deductible is met, you will pay copays for services until you reach the out-of-pocket maximum. Once you reach the out-of-pocket maximum, you pay nothing.

All preventive services are free and do not count toward the deductible.
 
 

Summary of Benefits and Coverage - TCP (PDF)

High-Deductible Health Plan (HDHP)
With Health Savings Account (HSA)

Watch this short video about the HDHP with HSA

 

The HDHP has lower premiums and is paired with an HSA.

You are responsible for the cost of services until you meet the deductible. Once you meet the deductible, you pay 10% (coinsurance) and the plan pays 90% until you reach the out-of-pocket maximum. Once you reach the out-of-pocket maximum, you pay nothing. 

With the HDHP, the University contributes to your HSA every pay period and you may choose to as well for additional tax savings. Your HSA monies can be used towards your deductible, coinsurance, or other qualified medical expenses. The University contribution to your HSA is $30 per pay period for employee-only and $60 per pay period for family.

All preventive services are free and do not count toward the deductible.
 

  You are ineligible for the HDHP if you have a Health Reimbursement Account, or have coverage through Medicare or TRICARE. You also cannot be claimed as a dependent on another person’s tax return.

Summary of Benefits and Coverage - HDHP (PDF)

Employees enrolling a domestic partner are eligible for the University’s Alternative Plan.
Click here for information on that plan

Deductibles, copays, coinsurance, out-of-pocket maximums

View the Comparison (PDF)

Full Premium Charts - 12-month employees

View the 12-Month Charts (PDF)

Full Premium Charts - 9-month employees

View the 9-Month Charts (PDF)


Step 2: Search for Your Providers

  Important: The provider networks may differ between the two insurance carriers. Search for your providers with both carriers to help determine the best choice for you.

 

Watch this short video about how to find Tier 1 and Tier 2 providers in the TCP.

 

 

Blue Cross Blue Shield of Arizona

Find network doctors and facilities

  • Visit www.azblue.com/stateofaz.
  • Click the "Find A Doctor" tab.
  • Choose a medical plan to search.
  • Type in the doctor or facility name.

 

For the TCP:
Look for the Tier 1 ribbon for lower costs. Providers without the ribbon are Tier 2. Providers not listed are Tier 3.

BCBC Tier 1

For the HDHP:
Look for the Total Care icon. These providers can result in lower coinsurance costs.
 

BCBS Total Care

Note: Tier 1 providers are only located in Arizona. Outside of Arizona, in-network providers will always be Tier 2.

UnitedHealthcare

Find network doctors and facilities

  • Visit www.whyuhc.com/stateofaz.
  • Click the "Search for a Provider" tab.
  • Choose a medical plan to search.
  • Type in the doctor or facility name.

 

For the TCP:
Look for the Tier 1 dot for lower costs. Providers without the dot are Tier 2. Providers not listed are out-of-network and Tier 3.

UHC Tier 1

For the HDHP:
Look for the Premium Care heart. These providers can result in lower coinsurance costs.
 

UHC Premium Care

Note: Tier 1 providers are located in Arizona and also outside of Arizona.


Step 3: Consider the Following

Triple Choice Plan (TCP)
 

  • This plan has higher premiums and lower deductibles.
     
  • For the lowest deductible of $200 (single) or $400 (family), you must visit only Tier 1 providers. If you visit Tier 2 providers, your deductible will increase to $1,000 (single) or $2,000 (family).
     
  • You may have to change your provider to achieve the lowest out-of-pocket expenses.
     
  • This plan has fixed copays and more predictable costs at the time of service. Because you pay a fixed copay rather than coinsurance, this could mean lower out-of-pocket costs if you see specialists frequently, have ongoing healthcare needs, or experience unexpected medical expenses.

High-Deductible Health Plan (HDHP)
With Health Savings Account (HSA)

  • This plan has higher deductibles of $1,500 (single) or $3,000 (family), but much lower premiums.
     
  • If you are generally healthy and receive mostly preventive and routine care, your out-of-pocket costs may be less.
     
  • If you have unexpected medical expenses, you may experience higher out-of-pocket costs. This is because you will have to meet the deductible and then pay 10% of all services (coinsurance) until reaching the out-of-pocket maximum of $3,500 (single) or $7,000 (family).
     
  • The University contributes to an HSA account each pay period to help you cover the deductible, coinsurance, or other qualified medical expenses. Annually, this contribution is $720 (single) or $1,440 (family) - about half of the deductible.
     
  • You may make pre-tax contributions to the HSA through payroll deduction, allowing you to build tax-free savings to pay for healthcare. You also do not pay taxes when you withdraw the money to pay for your medical expenses.
     
  • All funds in the HSA belong to you. There is no use-it-or-lose-it requirement, and you keep your HSA even if you leave the University.