To assist Kent State University employees and families, Medical Mutual has provided a website dedicated to Kent State. Once there, you can search for in-network providers and view videos regarding Medical Mutual online tools and resources. If you need to see a doctor while travelling or if your care provider is outside the state of Ohio, your coverage will be through Cigna. Follow this link to learn more about Cigna.
Have other insurance? What is Opting Out?
Sometimes employees have other insurance through their parents or a spouse/domestic partner. If you are not covered under Kent State's insurance, you can receive $50 per pay ($100 per month) in your pay for opting out. Opting out means that you chose not to receive the medical, vision, prescription, and dental benefits through Kent State. To receive the cash incentive, you will need to submit an affidavit of alternate coverage. Note: The Opt-Out election must be completed each year in the Open Enrollment portal, and a current signed affidavit must be on file to receive the incentive.
If I Opt-Out, then lose insurance, what then?
If you opted out and later lost insurance coverage, you can enroll in Kent State's plans under a Qualifying Event. A qualifying event is a major life event such as loss of insurance coverage, birth, adoption, marriage, and/or divorce. Qualifying life events may make you eligible to enroll in benefits or make changes to your benefits outside of the annual open enrollment period. Just contact us at email@example.com within 31 days of the qualifying event to enroll or make any necessary changes to your benefits.
How do I avoid "Default Coverage"?
Simply put, TAKE ACTION!! Review your benefits offerings and actively select a plan that works for you and your family. New Employees have 31 days to enroll from their date of hire.
What are the coverage highlights with the 85/60 PPO plan?
As with all our medical plans, your medical premium includes prescription and vision benefits. Unlike traditional medical plans, preventive services are covered at 100% with in-network providers at NO COST to you. Examples of preventive care services are annual exams, immunizations, and preventive screenings. Also, if you choose the 85/60 plan, you can enroll in Flexible Spending Accounts, such as the Healthcare Flexible Spending Account or the Dependent Care Flexible Spending Account. Healthcare FSAs allow you to use pre-tax dollars to pay for eligible healthcare expenses incurred by you or your eligible dependents. Dependent Care FSAs allow you to use pre-tax dollars to pay for DAYCARE expenses for dependents up to the age of 13 or for elderly care. Visit our FSA and HSA web pages for more information.
Deductible for in-network providers: $300 for single coverage and $600 for family coverage.
Coinsurance for in-network providers: 15%
Office co-pays for non-preventive healthcare services: $15 for primary care doctors and $30 for specialists. *Co-pays do not go toward meeting your deductible.
Out of Pocket Maximum for in-network providers: $1,500 for single coverage and $3,000 for family coverage.
Out of Pocket Maximum for in-network providers for FACULTY: $1,200 for single coverage and $2,400 for family coverage.
What are the highlights of the HDHP (High Deductible Health Plan)?
The High Deductible Health Plan (HDHP) is an option for all full-time benefits-eligible employees, including the bargaining units. Also with the election of an HDHP, a Health Savings Account (HSA) can be created for you in which Kent State will contribute to your HSA $1,300 for single plans or $2,000 for family plans at the start of 2023. To increase your savings in your HSA, you can elect to contribute to the HSA at any time throughout the year. You can also increase or decrease your contributions throughout the year. Another great thing about an HSA is that it allows you to use your pre-tax dollars to pay for eligible healthcare expenses incurred by you or your eligible dependents. Got Dependents? No problem! You can enroll in the Dependent Care FSA that allows you to use pre-tax dollars to pay for DAYCARE expenses for dependents up to the age of 13 or for elderly care; however, be aware that you cannot increase or decrease your elections to your FSA during the plan year. Visit our FSA and HSA web pages for more information.
As with all medical plans that Kent State offers, your medical premium includes your prescription and vision benefits. Preventive services are also covered at 100% with in-network providers at NO COST to you. Examples of preventive care services are annual exams, immunizations, and preventive screenings.
Deductible for in-network providers: $3,000 for single coverage and $5,400 for family coverage.
Coinsurance for in-network providers: $0.00
Office Co-pays: $0.00
Out of Pocket Maximum for in-network providers: $3,000 for single coverage and $5,400 for family coverage.
Employer contribution to your health savings account (HSA) of $1,300 for single coverage and $2,000 for family coverage effective at the first of the year!
Preventive Services for Medical Mutual High Deductible Health Plan and 85/60 PPO plan (PDF)
How does my prescription coverage work when enrolled in a High Deductible Health Plan?
When enrolled in the High Deductible Health Plan, you can expect to pay the negotiated price for your prescriptions, that are not on the Preventative Drug List, until your HDHP annual deductible is met. The cost of these prescriptions will go towards meeting your annual deductible. Once your deductible is met, your prescription co-insurance will apply (see below) and the maximum you would pay for your prescription will be $60. For more information about your prescription coverage, visit our CVS/Caremark prescription webpage.
To get pricing information for prescriptions under the HDHP plan, you can contact CVS/Caremark at 1-888-202-1654.
10% coinsurance of the negotiated price for generic medications
20% coinsurance of the negotiated price for brand-name prescriptions when a generic equivalent is not available
40% coinsurance of the negotiated price for brand-name prescriptions when a generic equivalent is available
*If you or your dependents are taking prescriptions appearing on the Preventive Therapy Drug List (PDF), the cost of that drug is not subject to your deductible. However, co-insurance will apply as stated above and the co-insurance amount will be applied to your combined medical/prescription maximum out-of-pocket deductible.
Dependent Eligibility and Verification Form (pdf)
Medical Mutual Plan Booklet - HDHP (pdf)
Medical Mutual Plan Booklet - 85/60 - Staff (pdf)
Medical Mutual Plan Booklet - 85/60 - Faculty (pdf)
Affidavit of Working Spouse/Domestic Partner Insurance Status (pdf)