Medical Coverage


Overview

The State of Rhode Island offers eligible active employees two medical plans—the Choice Plus Plan with HSA and the 2014 Active Plan. Both plans are administered by UnitedHealthcare (UHC). Coverage for participating employees is effective on the first day of state employment.

Click on the tabs below to learn more about your medical coverage options. See Prescription Coverage if you want more information on the prescription coverage that accompanies your medical coverage.

Coverage Details

Which Medical Plans are Available to Me?

You can enroll in either the Choice Plus Plan with HSA or the 2014 Active Plan. For a brief outline of the plans, see the respective Summary of Benefits and Coverage (SBC) below. For a complete descriptions regarding the terms of coverage, including exclusions and limitations, see the respective Summary Plan Description (SPD).

Did You Know?
  • Both plans offer identical health coverage; they only differ in the cost-sharing structure
  • Both plans cover certain preventive care services at 100%. See the UHC Preventive Care Guidelines for a full list of qualifying services. (Certain preventive prescriptions and products are also covered at 100%; see Prescription Coverage for more information.)

Choice Plus Plan with HSA

2014 Active Plan

  • Higher premium
  • Lower deductible/out-of-pocket maximum (OOPM)
  • Not eligible to open an HSA, which causes you to miss out on an opportunity to receive State contributions towards your health savings and to save for medical expenses for the long run
  • Prescriptions: You only pay co-pays for your medications regardless of whether you have reached the annual deductible
  • Summary of Benefits and Coverage (SBC)
  • Summary Plan Description (SPD)
  • FAQ
Need Help Choosing Your Plan?

Visit the Decision Support page for tools such as our Health Plans Comparison and ALEX® that can help you better understand your plan options and make the best choice for you and your family.

Any State employee that satisfies all of the following criteria is eligible to enroll:

The following dependents are also eligible for enrollment:

  • Spouse
  • Domestic partner
  • Children (Up to the end of the month in which they reach age 26. At that time, COBRA continuation coverage will be offered.)
Enrollment Periods

Employees may enroll in medical coverage during one of the following periods*:

* If you are enrolled in the Choice Plus Plan with HSA, you may make changes to your HSA contribution at anytime during the year.

Enrollment Process

Step 1: Required forms
Complete and submit the following form(s) to the OEB:

Choice Plus Plan with HSA

Step 2: Required supporting documentation
Supporting documentation must also be submitted with the Health Coverage Enrollment/Status Change Form for the following circumstances:

  • Spouses
    • Dual state-employed spouses
      If two spouses are both state employees—i.e., an employee answers “Yes” in section 7 of the Health Coverage Enrollment/Status Change Form, they must also complete and attach the Dual State-Employed Spouses Declaration Form.
    • Divorce
      Per statute, the State employee health plan cannot provide coverage to a non-state-employee former spouse. For all divorces occurring subsequent to December 31, 2013, employees must report the divorce as a status change on the Health Coverage Enrollment/Status Change Form; the non-state-employee former spouse will be dropped from coverage and offered COBRA.
  • Domestic partnerships
    • Employees must attach completed copies of the Affidavit of Domestic Partnership and the Domestic Partner Dependent Declaration Form with supporting evidentiary documentation in order to enroll a domestic partner in medical and prescription coverage.
    • Note: The fair market value of the state’s contribution towards the cost of health coverage for a domestic partner is considered imputed income to the employee, and must be reported as taxable income on the employee’s bi-weekly paycheck unless the domestic partner qualifies as a dependent of the employee under the IRS rules and regulations for health plans.
  • Children
    • Employees must attach a copy of their child’s birth certificate to the Health Coverage Enrollment/Status Change Form in order to enroll a child for medical and prescription coverage.
Medical Coverage Waiver

Employees may elect to waive the state medical and prescription coverage if they have other coverage by completing the Waiver of Medical/Prescription Coverage Form (please still submit the Health Coverage Enrollment/Status Change Form even if you are waving medical coverage, as the OEB needs your dental and vision election information). Waiver elections and changes can only occur at the time of hire or during the annual open enrollment period unless a status change occurs during the year.

The annual waiver checks issued in early December of each year will be pro-rated at an accrual rate of $38.50 per biweekly pay period, up to the $1,001 maximum per year.

Note: If two state employed spouses are hired into state service on or after June 29, 2014, and both are eligible for health insurance, the health co-share rates will be based on the income of the higher earning spouse and the other spouse will not receive any waiver payment. Completion of the Dual State-Employed Spouses Declaration Form will be required of any state employee applying for the waiver if their spouse is also a state employee.

See below for 2018 premium rates—i.e., your co-share—for your medical & prescription coverage.

A co-share is the amount you must pay each pay period for health insurance. Co-shares vary by individual vs. family coverage, as well as by annual salary and full-time/part-time status. Co-shares listed here are for classified and unclassified State employees only. College employees should refer to their college/university website (URI, RIC, CCRI) for their co-shares.


Individual coverage

Full-time employees
Bi-Weekly Co-Shares Annual Co-Shares
Annual Base Salary Percentage* Choice Plus with HSA 2014 Active Choice Plus with HSA 2014 Active
<$95,481 20% $57.57 $64.86 $1,496.82 $1,686.36
>$95,481 25% $71.97 $81.07 $1,871.22 $2,107.82
Part-time employees**
Bi-Weekly Co-Shares Annual Co-Shares
Annual Base Salary Percentage* Choice Plus with HSA 2014 Active Choice Plus with HSA 2014 Active
<$90,000 20% $57.57 $64.86 $1,496.82 $1,686.36
>$90,000 35% $100.75 $113.50 $2,619.50 $2,951.00

Family coverage

Full-time employees
Bi-Weekly Co-Shares Annual Co-Shares
Annual Base Salary Percentage* Choice Plus with HSA 2014 Active Choice Plus with HSA 2014 Active
<$49,670 15% $121.05 $136.37 $3,147.30 $3,545.62
$49,670–$95,481 20% $161.40 $181.82 $4,196.40 $4,727.32
>$95,481 25% $201.76 $227.28 $5,245.76 $5,909.28
Part-time employees**
Bi-Weekly Co-Shares Annual Co-Shares
Annual Base Salary Percentage* Choice Plus with HSA 2014 Active Choice Plus with HSA 2014 Active
<$90,000 20% $161.40 $181.82 $4,196.40 $4,727.32
>$90,000 25% $282.46 $318.19 $7,343.96 $8,272.94

* Percent of working rates for the Choice Plus Plan with HSA or the 2014 Active Plan.
** If your scheduled work hours are fewer than the full hours specified for your position, you will be classified as a part-time employee. Your co-share amount is determined according to the full-time annual salary for your job specification, not your part-time wages actually earned.


Printable Co-Share Tables

2018 Calendar Year Co-Share Rates

2017 Calendar Year Co-Share Rates

In-Network Claims

To view your in-network claims history, please log in to your account at myuhc.com.

Out-of-Network Claims

To submit claims for out-of-network doctor visits, please fill out and submit the UHC Out-of-Network Claim Form to UHC.

Please contact UnitedHealthcare (UHC) if you have questions regarding your medical coverage:

  • Create an account on myuhc.com to view and manage your UHC medical coverage
  • Call 1-866-202-0434 (also found on the back of your UHC ID card)