Medical Coverage


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 are called “Navigate Plans”—they require you to pick a Primary Care Physician (PCP) to coordinate your care.
    • If you do not obtain a PCP referral prior to seeing a specialist, the only impact is that you will pay a higher co-pay under Anchor/Anchor Plus or co-insurance after deductible under Anchor Choice for the specialist office visit. Any covered services the specialist provides are covered regardless of whether you have a PCP referral.
    • You'll designate your PCP through the State's online enrollment system.
      • Your PCP must be a general practice physician, family practice physician, pediatrician, internal medicine physician, nurse practitioner or physician's assistant.
      • Your PCP must participate in UnitedHealtcare’s Navigate Plus network and be located in RI, CT, MA, NH or ME.
        • If you designate a PCP not located in one of these states, a different PCP will be assigned based on your zip code.
    • If you have a dependent living outside RI, CT, MA, NH or ME, their designated PCP must still be in one of these states.
    • To change your designated PCP after you receive your UHC ID card, call the Customer Care number on your ID card or log on to myuhc.com.
  6. New! All three plans will only cover services that are medically necessary.
  7. New! All three plans feature place of service tiering for imaging.
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 Highlights
Anchor Anchor Plus Anchor Choice
In-network annual deductible $1,000 Individual
$2,000 Family
$500 Individual
$1,000 Family
$1,500 Individual
$3,000 Family
Does the State contribute to a Health Savings Account? No No Yes! In 2019*:
$1,500 Individual
$3,000 Family
Do I have to meet the deductible for preventive care services? No. Preventive care is covered at 100% in-network. No. Preventive care is covered at 100% in-network. No. Preventive care is covered at 100% in-network.
In-network coinsurance You pay 10%
Plan pays 90%
You pay 10%
Plan pays 90%
You pay 10%
Plan pays 90%
What’s the most I can pay in medical/Rx expenses each year? (Out-of-pocket maximums) $2,000 Individual
$4,000 Family
$1,000 Individual
$2,000 Family
$3,000 Individual
$6,000 Family
What is my annual premium (co-share)? See the "Premium Rates" tab

* For the 2018 plan year. Contributions are made biannually with half deposited on January 1, 2018 and the other half deposited on July 1, 2018. The State’s HSA contributions are not pro-rated for employees that enroll after those dates.

Plan Details

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

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
    • 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* (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 elect to waive the State medical and prescription coverage if you have other coverage. 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. However, if your alternative coverage is government-subsidized, including Medicaid (e.g., Rite Share, Rite Care, and MassHealth) and coverage purchased through HealthSource RI, you are not eligible to receive this opt-out payment.

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.

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 $99,825 20% $55.16 $59.01 $54.76
$99,825 and above 25% $68.94 $73.77 $68.45
Family Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $51,930 15% $115.97 $124.08 $115.13
$51,930 to less than $99,825 20% $154.63 $165.44 $153.51
$99,825 and above 25% $193.28 $206.80 $191.89

Part-time employees***
Individual Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $94,095 20% $55.16 $59.01 $54.76
$94,095 and above 35% $96.52 $103.27 $95.82
Family Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $94,095 20% $154.63 $165.44 $153.51
$94,095 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 $99,825 20% $71.70 $76.72 $71.18
$99,825 and above 25% $89.63 $95.90 $88.98
Family Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $51,930 15% $150.76 $161.31 $149.67
$51,930 to less than $99,825 20% $201.01 $215.07 $199.56
$99,825 and above 25% $251.27 $268.84 $249.45

Part-time employees***
Individual Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $94,095 20% $71.70 $76.72 $71.18
$94,095 and above 35% $125.48 $134.26 $124.57
Family Coverage
Annual Salary* Percentage** Anchor Anchor Plus Anchor Choice
Less than $94,095 20% $201.01 $215.07 $199.56
$94,095 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.