Medical Coverage


Please visit the News page for the latest information on the January 1, 2020 transition from UnitedHealthcare to Blue Cross & Blue Shield of Rhode Island (BCBSRI) as the State's third-party medical plan administrator.

Overview

The State of Rhode Island offers eligible active employees three medical plans—Anchor, Anchor Plus and Anchor Choice with HSA. All 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

What's New in 2019

Keep the following things in mind as you choose among the Anchor, Anchor Plus and Anchor Choice with HSA plans:

  1. All three plans cover the same medical services.
  2. All three plans use the same UHC network.
  3. All three plans require you to pay 10% of the cost (your coinsurance) for covered medical expenses when you visit a network provider, after you’ve met your deductible.
  4. All three plans have a combined medical and prescription out of pocket maximum (OOPM)
  5. New! All three plans require you to pick a Primary Care Physician (PCP) to coordinate your care.
  6. New! All three plans feature place of service tiering for imaging.
    • You are highly recommended to obtain major imaging services at a freestanding facility not affiliated with a hospital group.
      • Before you've met your deductible: Your out-of-pocket cost for imaging services is typically lower if you use a freestanding facility.
      • After you've met your deductible: Your cost for major imaging services is covered in full if you use a freestanding facility.
    • To find a free-standing facility, visit myuhc.com and choose a facility that is marked as "Freestanding Facility": Freestanding facility indicator
  7. New! All three plans will only cover services that are medically necessary.
What Are the Differences?

The biggest difference in the three plans is when you pay for coverage. Do you pay more in premiums from your paycheck, or (potentially) more when you seek medical services? It’s important to do the math. There are a number of factors to consider, like your medical needs for the coming year (having a baby or an elective surgery?), your family situation, and your age.

Plan Comparison

Click on the chart below to see how Anchor, Anchor Plus and Anchor Choice compare across specific coverages.

2019 medical and prescription plans comparison
Plan Documents
Document What It Is
Summary of Benefits and Coverage A brief plan outline Anchor
Anchor Plus
Anchor Choice with HSA
Summary Plan Description A comprehensive description regarding the terms of coverage, including exclusions and limitations Anchor
Anchor Plus
Anchor Choice with HSA
Coordination of Benefits A brief overview of how plan coverage works when someone has dual coverage. UHC Coordination of Benefits

Need Help Choosing Your Plan?

Visit the Decision Support page for tools such as ALEX®, the State Employee Benefits Guide and benefits videos & presentations that can help you better understand your plan options and make the best choice for you and your family.

Talk to ALEX

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
    • If your domestic partner does not meet the definition of a dependent pursuant to Internal Revenue Code Section 152 (as modified by Section 105(b)), federal law requires that the fair market value of any State health coverage extended to your domestic partner must be imputed to you as income on your paycheck and must be reflected on the W-2 issued to you by the State of Rhode Island. For example, if you were a 26 pay-period employee covering your domestic partner under the State medical, dental and vision plans, your imputed income would be around $200 per pay period and be deducted from each paycheck.
    • If you get married, or if your domestic partnership ends, it is YOUR responsibility to inform the Office of Employee Benefits in writing immediately. Your failure to do so will prevent you from obtaining refunds of co-shares paid and/or imputed income tax withheld. The Office of Employee Benefits will not coordinate such refunds if it is not notified within 31 days of the date of the change.
  • Children* (Up to the end of the month in which they reach age 26. At that time, COBRA continuation coverage will be offered.)

* Children of domestic partners are not eligible unless they are also the natural/adopted child of the employee, or the employee has legal guardianship.

Enrollment Periods

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


Enrollment Process

Step 1: Do your research!

Step 2: Enroll in medical, dental and/or vision coverage online
Visit the Enrollment page for details on how to access the online enrollment system.


Medical Coverage Waiver

You may waive the State medical and prescription coverage if you have other coverage. Waiver elections can only occur at the time of hire or during the annual open enrollment period unless a status change occurs during the year. If you waive medical coverage, you may elect to receive an opt-out payment if you are eligible to do so. You are ineligible to receive the opt-out payment if:

  1. Your alternative coverage is state-subsidized under a Medicaid program (Rite Care, MassHealth, etc.);
  2. Your alternative coverage was purchased through a health insurance marketplace under the Affordable Care Act (e.g., HealthSource RI); or
  3. Both you and your spouse were hired by the State on or after June 29, 2014 and you are both covered under a State family plan (higher-earning spouse must pay the co-shares and the lower-earning spouse is ineligible to receive the medical waiver opt-out payment).

Medical opt-out payment credit accrues credit at the rate of $38.50 per biweekly pay period. Payments are made once each year, in late November/early December, up to a maximum payment of $1,001. The opt-out payment is taxed like normal wages.

See below for 2019 premium rates—i.e., your co-share.

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. Non-classified union & non-union employees working in higher ed should refer to their college/university website (URI, RIC, CCRI) for their co-shares.


Bi-weekly Co-share Rates

Effective 1/1/2019

› 26 Pay Period Classified & Unclassified Employees
Full-time employees
Individual Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $101,822 20% $55.16 $59.01 $54.76
$101,822 and above 25% $68.94 $73.77 $68.45
Family Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $52,969 15% $115.97 $124.08 $115.13
$52,969 to less than $101,822 20% $154.63 $165.44 $153.51
$101,822 and above 25% $193.28 $206.80 $191.89

Part-time employees***
Individual Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $95,977 20% $55.16 $59.01 $54.76
$95,977 and above 35% $96.52 $103.27 $95.82
Family Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $95,977 20% $154.63 $165.44 $153.51
$95,977 and above 35% $270.60 $289.52 $268.64

* Does not include overtime or other non-salary wages.
** Percent of health plan working rates.
*** 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.

› 20 Pay Period Employees
Full-time employees
Individual Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $101,822 20% $71.70 $76.72 $71.18
$101,822 and above 25% $89.63 $95.90 $88.98
Family Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $52,969 15% $150.76 $161.31 $149.67
$52,969 to less than $101,822 20% $201.01 $215.07 $199.56
$101,822 and above 25% $251.27 $268.84 $249.45

Part-time employees***
Individual Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $95,977 20% $71.70 $76.72 $71.18
$95,977 and above 35% $125.48 $134.26 $124.57
Family Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $95,977 20% $201.01 $215.07 $199.56
$95,977 and above 35% $351.78 $376.38 $349.24

* Does not include overtime or other non-salary wages.
** Percent of health plan working rates.
*** 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.

› RITA & State Police Command Staff
Full-time employees
Individual Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $101,323 20% $55.16 $59.01 $54.76
$101,323 and above 25% $68.94 $73.77 $68.45
Family Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $52,709 15% $115.97 $124.08 $115.13
$52,709 to less than $101,323 20% $154.63 $165.44 $153.51
$101,323 and above 25% $193.28 $206.80 $191.89

* Does not include overtime or other non-salary wages.
** Percent of health plan working rates.



Printable Rate Tables—2019 Calendar Year

Co-Share Rates
Working Rates (full plan costs)

Historical Rates

› 2018

Co-Share Rates

Working Rates (full plan costs)

› 2017

Co-Share Rates

Working Rates (full plan costs)

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 Customer Service: 1-866-202-0434 (also found on the back of your UHC ID card)
    • You can reach a Spanish interpreter via the initial prompt. To request an interpreter for another language, press 0. TTY 711.

Please contact Optum Bank if you have questions regarding your health savings account (HSA):