Insurance Basics

Health Care: The Union Difference

Before UE-COGS, the University’s only graduate employee health care plan was SHIP (Student Health Insurance Plan), offering meager catastrophic coverage and no preventive care. Since 1997, our union contract has made GradCare available to TAs and RAs and their families. GradCare is an affordable, comprehensive health and prescription drug plan. Our contract guarantees that the UI will cover 90% of the premium cost for single employees, and 70% of the premium cost for domestic partners, spouses, children, and families (see below). For a more detailed description of coverages and co-pays, go to http://www.cogs.org/contract.htm#AppendixA

Plan Highlights

Grad Care Coverage

(Guarantee under union contract)

SHIP Coverage

(“Student Health Insurance Plan”)

Routine Physical Exams
Free
Free
Prescription Drugs (including contraceptives)
You pay $7 or 25%, whichever is greater
3-Tier Plan: 25% Generics, 30-50% Name Brands
Routine Vision and Hearing Exams

You pay $10 copayment

(free at UIHC)

Not Covered
Immunizations
Free
Free
Office Calls
$10 copayment
You pay $10-30 depending on provider
Hospitalization and Surgeries
You pay 10% after $125 daily deductible for room and 10% for all other services up to $1200/yr (thereafter you pay $0)
You pay 10% after $300 deductible (or 20% after $600 deductible if non-select provider) up to $1,000 per hospital stay
Allergy Treatments and Chiropractic
You pay $10 copayment
You pay $10-30 depending on provider; coverage limited to $1500/yr
Lab Tests and X-rays
You pay 10%
Covers diagnostics only; you pay $10; coverage limited to $1,500/yr
Emergency Services
You pay 10% after $50 copayment
You pay $50
Annual Out-of-Pocket Maximum
Annual cost to you capped at: $1,200 single/ $1,800 family; same rate for prescription drugs
No cap on annual costs to you
Monthly Cost to Employee

Employee Only: $24.20

Employee + Partner: $161.10

Employee + Children: $432.90

Employee + Family: $339.60

Employee Only: $13.00

Employee + Partner: $162.00

Employee + Children: $192.00

Employee + Family: $358.80

Dental Care: The Union Difference

Another benefit made possible by our union is dental insurance. Our contract requires the UI to pay 85% of the premium cost for employees who sign up for dental coverage. For graduate employees with dependents, the UI is required to pay 70% of the premium cost for dependent and family plans.

Plan Highlights

Delta Dental Coverage

2013-14 Monthly Cost to Employee

Employee $3.15

Employee + spouse/partner $14.40

Employee + children $11.70

Employee + family $21.00

Checkups; Diagnostic & Preventive Services
Free
Cavity Fillings, Oral Surgery, & Emergency Pain Treatment
You pay 20% after $25 deductible ($75 deductible for family plans)
Crowns, Inlays, Bridges, or Dentures
You pay 50% after $25 deductible ($75 deductible for family plans)
Maximum annual benefit (exclusive of accident care covered under UI GradCare plan)
$1000 per person

Enrolling for Health and Dental Coverage

Insurance coverage for new RAs/TAs with academic year appointments begins September 1 (August 1 for fiscal year appointments). New employees must submit a Health Insurance Application to the UI Benefits Office (120 USB) by September 6, 2013 in order to receive coverage retroactive to September 1. You should receive a benefits booklet, including this form from the university at your home or campus address. If you do not receive on by September 1, you can request a form from the Benefits Office by phoning 335-2676 or website. Forms and assistance are also available from your COGS Steward and at the COGS Office (phone 337-5074).

International Students: International students are routinely auto-enrolled in the Student Health Insurance Plan (SHIP). If you are an international student hired for an assistantship of 25% or more, you have the right to switch to UI GradCare, which provides much better coverage for a slightly greater monthly cost for RAs, TAs, and family members. To change coverage, circle UI GradCare on the Health Insurance Application.

Dental Care: To sign up for dental coverage, circle “Dental” on the Graduate Employee Health Insurance Application. You must sign up for dental care during an open enrollment period (September, January, or June). **NOTE*: The Dental option is not printed on the Graduate Student Health Insurance Application, so if using one of these forms, you must write and circle “Dental” next to UI GradCare.

Selecting a Primary Care Manager: For the first time, primary care physicans are available throughout the UIHC system for anyone on UIGradCare. This includes physicians in the Family Practice and Internal Medicine Clinics at UIHC, the Community Medical Service Clinics, and Student Health Service. Student Health Services director Dr. Mary Kowassah is automatically identified as the care manager for all graduate employees. Employees are, however, encouraged to develop a relationship with a physician at any of these clinics adn to request her/him by name when calling for appointments. Information on Student Health Physicians on staff is available at http://www.uiowa.edu/~shs/general_info/staff.shtml. Assistance in selecting another physican in the UIHC system can be found through UI Health Access http://www.uihealthcare.com/depts/uihealthaccess/index.html). Female employees may designate a co-care manager from UIHC OB/Gyn; spouses, partners, and children must designate a primary care manager from UIHC Family Practice, Internal Medicine, or Pediatrics (lists available inside UI Benefits Booklet).