Pharmacy
The University of Alaska offers three medical plans (Premium, Basic, and HDHP). Pharmacy is automatically included with the medical benefit. If an employee enrolls in medical, they are enrolled in the corresponding pharmacy benefit.
Benefit-eligible Employees
Benefit-eligible employees who will be working a minimum of 20 hours per week.
Temporary Employees / Sikuliaq Employees
Check with your HR Coordinator and visit the temporary employee webpage.
Dependents
Dependents (spouse/FIP and child(ren)) can only be enrolled in the same plan as the
employee. Review the drop down for additional information on dependents.
The University of Alaska requires evidence of eligibility for all enrolled dependents. Supporting documents include birth certificate, marriage license, final adoption paperwork, tax returns showing claimed dependents, qualified medical child support orders, legal guardianship papers, etc.
If an employee enrolls in a medical plan, the following dependents are eligible for coverage, as well.
Spouse
The lawful spouse of an employee unless legally separated.
Financially Interdependent Partner (FIP)
Wherever “spouse” is stated in the health care plan, a FIP would also be included
(provided all requirements are met as specified by the University of Alaska).
Health care deductions for FIPs are post-tax.
- FIP Explanation Document
- Statement of Financial Interdependence
- View FIP Tax Rates to see how covering a FIP affects income tax.
Child(ren)
- Under 26 years of age
- Natural offspring of either/both employee or employee's spouse
- Legally adopted of either/both employee or employee's spouse
- Granted court-appointed legal guardianship
- Signed court order granting guardianship to employee or employee's spouse of the employee as of a specific date.
- When the court order terminates or expires, the child is no longer an eligible child.
- Domestic relations order to provide medical benefits as directed by a divorce decree, a medical child support order, or other court-ordered dependent coverage
- Foster child living with the employee
- Signed court order (or other order) signed by judge or state agency which grants guardianship to the employee or employee's spouse as of a specific date.
- When the court order terminates or expires, the child is no longer an eligible child.
- Placed for the purpose of legal adoption in accordance with state law
- Placed for adoption means assumption and retention by the employee of a legal obligation for total or partial support of a child in anticipation of adoption of such child.
Life Event Webpage
Review the Life Event Webpage to understand how this life event affects benefits.
Due Dates
If an employee is welcoming a new family member and would like to enroll their newborn
in coverage, the form must be submitted within 60 days of birth.
SSN and Birth Certificate
Do not wait for the social security number or official birth certificate before submitting
the Life Event Changes Form.
Submitting the Form
When completing the Life Event Changes Form submit
- the temporary birth certificate from the hospital, and
- use 0's for placeholders for the SSN.
Once the SSN is received, please reach out to us at ua-benefits@alaska.edu for instructions on how to add the SSN. Do not send any SSNs through email.
Automatically Provided with Medical Plan
If an employee is enrolled in a medical plan, they are automatically enrolled in the
corresponding pharmacy plan.
New Benefit-eligible Employees
Review the New Employee webpage for more information on enrolling in coverage. Employees have 30 days from their
hire date to enroll in coverage otherwise employees will be defaulted into Basic medical,
Basic dental, and vision for employee-only coverage.
Current Benefit-eligible Employees - Life Event
Please review the qualifying life events page to understand life events and their deadlines. Late forms will not be accepted.
Temporary Employees / Sikuliaq Employees
Check with your HR Coordinator and visit the temporary employee webpage.
Premera
UA's prescription drug program is coordinated through Premera. Information on benefits,
coverage, and list of in-network pharmacies is available online at premera.com or by calling the customer care number on the back of the Premera ID card.
Prescription Costs
Prescription costs are determined by the tier assigned to the prescription drug and
whether or not an in-network or out-of-network pharmacy is used. Prescriptions are
either (1) Generic Preventive, (2) Preferred Generic, (3) Preferred Brand Name, (4)
Specialty Drugs, or (5) Non-Preferred.
| Premium Plan | Basic Plan | HDHP with Optional HSA | |
|---|---|---|---|
| Out of Pocket Maximum |
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Pharmacy charges on the HDHP are included in the medical deductible and the medical out of pocket maximums. |
| Retail Prescription Tiers |
In-Network
Out-of-Network |
In-Network
Out-of-Network |
Pharmacy charges are the responsibility of the employee until the medical deductible is met. Once the medical deductible is met, the employee will then pay a 20% cost share of the medications until the medical out of pocket maximum is met. |
| Mail Order Prescriptions Tiers |
In-Network
Out-of-Network |
In-Network
Out-of-Network |
Pharmacy charges are the responsibility of the employee until the medical deductible is met. Once the medical deductible is met, the employee will then pay a 20% cost share of the medications until the medical out of pocket maximum is met. Mail order prescriptions are not covered in out-of network pharmacies. |
Preventive Medications Covered at No Cost
Preventive drugs are covered at no cost to to the employee on all plans. For more
information on alternatives for non-preferred or excluded drugs, please visit Premera's website.
Maintenance Medications
This is a medication prescribed on a regular basis to control or treat an ongoing
or chronic condition.
Retail Pharmacy
Maintenance medications can be filled at a retail pharmacy twice. After this, all
brand name maintenance medications must be ordered through the mail-order pharmacy.
If a retail pharmacy is used after the first two fills then the regular copay will
be doubled for a 30 day supply. Find out which medications make the list of Maintenance Medications and view the Maintenance Medication Exemptions to find exceptions.
Mail Order Pharmacy
Premera partners with Express-Scripts for mail-order prescriptions.
How to Enroll
To change prescriptions to mail order, log into the Premera portal and click on "prescriptions"
in the tool bar at the top and "manage prescriptions" in the drop down. On the next
page under "Express Scripts" click on the link "order and refill" and follow the directions
to change prescriptions to mail order.
Specialty Medications Dispensed from Accredo
All specialty medications must be dispensed from the specialty pharmacy, Accredo Health
Group.
Specialty Medications Copays
The Premium and the Basic medical plans have a $100 copay for up to a 30 days supply.
The HDHP does not have a copay but is subject to the deductible. Visit the Specialty Pharmacy Program page on Premera's website to find out how to order and to see various Specialty Medications
lists.
SaveonSP Specialty Coupon Program
Express-Scripts’ program, SaveonSP, helps members save money on certain specialty
medications. Participation in the program is voluntary and, if participating, SaveonSP
will monitor the account to ensure employees have no cost ($0).
Filled with Accredo
Prescriptions will still be filled through Accredo, the existing specialty mail pharmacy.
Copay Covered
If participating in this program, the copay will be covered under SaveonSP for the
specialty medications that are included in the program. This will result in no out-of-pocket
costs to participants.
How to Participate
To participate, call SaveonSP at 1-800-683-1074 prior to filling a specialty prescription.
The program cannot be retroactively applied to a previously filled prescription. If
not to participating, SaveonSP will not be able to monitor the account and employees
will be responsible for the copay.
Out of Pocket Maximum
The prescription drugs included in the SaveonSP program are classified as Non-Essential
Health Benefits under the Affordable Care Act. This means that payments will not
apply toward out of pocket costs. The medications and associated copays included in
this program are subject to plan clinical rules and subject to change.
Chart of Pay Periods
Review the chart of pay periods to understand the deadlines and when coverage will end.
Unsure? Email ua-benefits@alaska.edu
To confirm when coverage begins or ends, please email ua-benefits@alaska.edu.
New Employees - First Day Coverage
Coverage can begin on the first day of employment. To qualify for first-day coverage,
a new employee must submit their form by 5:00pm on the Thursday prior to the end of
their first pay period.
Current Employee - Day of Life Event
Coverage can begin on the day of the life event. To qualify for day of event coverage,
the form must be submitted on or before the day of the event.
Other Coverage Begin Dates
If a form is submitted after the deadlines above, but within the 30 day requirement (60 for birth), coverage will begin on the day the form is submitted.
Coverage End Dates
Coverage ends at the end of the pay period in which coverage is terminated via a life
event, open enrollment, or by separating from the university.
UA has several resources available to employees who need assistance. When in doubt, please email ua-benefits@alaska.edu and we will be sure to direct the questions appropriately.
UA Benefits Team | ua-benefits@alaska.edu or Meet with Us
- Need help submitting a form or providing documentation for a dependent?
- Want confirmation of your coverage begin and end dates?
- Want to set up a quick zoom for some basic questions?
Premera | Call the number on the back of the Premera ID card
- Having issues logging into the premera portal?
- Wanting to confirm prior authorization for a certain service?
- Want to enroll in electronic Explanation of Benefits (eEOBs)?
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