Student Health Insurance Policy FAQ
Reason for the change
- Why is UT Austin changing the default provider of health insurance for graduate student academic employees?
The reason for making this change is to improve access and continuity of care for students. The Graduate School was charged with implementing this change at the recommendation of the Graduate Education Task Force, which cited problems that graduate students experienced under UT Select, including loss of coverage, gaps in coverage, reset deductibles, expensive dependent coverage and lack of affordable vision and dental coverage. Academic Blue provides graduate student academic employees with access and continuity of health insurance coverage for the duration of their studies, dental and vision coverage at no cost and more affordable dependent coverage.
The change to insuring graduate students through Academic Blue (SHIP) also potentially provides centrally recoverable savings to the university, which we have directed to support graduate education. The Graduate School, working with Financial and Administrative Services and the Office of the Provost, approached the University Budget Council with a $10.9 million request (the upper bound estimate of centrally recoverable savings) to increase graduate student support.
- Does UT Select SHIP provide better health insurance coverage than Academic Blue?
UT Select and Academic Blue both provide quality health insurance and are both rated gold-level plans according to the Affordable Care Act. There are differences between the plans—the two plans are designed for different age groups and needs—and there are many ways in which Academic Blue provides better access to care at lower costs. For example, students on Academic Blue have the same network of providers as UT Select, and students on Academic Blue may access many services by University Health Services with no out-of-pocket costs or co-pays (unlike students on UT Select). These services include primary care and general office visits, annual physicals, physical therapy, radiology/x-rays and lab testing. Subscribers may also add dependents at significantly lower costs and, unlike students on UT Select, use the state’s premium-sharing contribution to receive free dental and vision care.
The university expects that most students will have lower out-of-pocket expenses under the Academic Blue plan. Nevertheless, we have determined that a small percentage of the overall benefits-eligible, graduate student population could experience increases in out-of-pocket costs under the Academic Blue plan. The impact of this change will vary based upon utilization and students’ specific healthcare needs. Some students whose conditions require diagnostic imaging may have higher out-of-pocket costs under Academic Blue than they do under UT Select. Others, whose conditions require visits to their mental health provider, may experience lower out-of-pocket costs. Please refer to this comparison sheet for a look at the differences in copays, coinsurance and deductibles based on particular services.
The Graduate School and Human Resources have been identifying ways to mitigate potential increases for students. Students who experience a significant increase in cost are eligible for the Health Care Assistance Fund.
- Why are premiums less expensive for Academic Blue than UT Select?
Premiums for Academic Blue are less expensive than UT Select, but this is not indicative of lower quality—rather, it primarily reflects that the two plans cover very different pools of individuals. UT Select has a greater number of older adults and retirees in its pool who utilize more services, care and prescriptions, while Academic Blue has a pool of younger, generally healthier individuals—leading to lower premium costs.
- Are graduate student employees at other UT system schools enrolled in UT Select?
All benefits eligible academic graduate student (AGS) employees at UT institutions are eligible for UT Select. Prior to September 1, UT Austin was the only UT academic institution to apply the full-time premium rate for UT Select to AGS part-time employees. All other UT academic institutions apply the part-time premium rate for UT Select to part-time AGS employees. It is not uncommon for graduate students to be enrolled in Academic Blue SHIP at other UT academic institutions, due to the UT Select premium cost associated with part-time employment. Only one other UT academic institution is providing premium support for Academic Blue SHIP for their graduate students, but they are not providing support for their dependents. UT Austin is providing 100% premium support for graduate students and 50% premium support for their dependents.
- Why is 30 hours the threshold for full-time employees?
The federal Patient Protection and Affordable Care Act, signed into law in 2010, changed the threshold for full-time insurance status to 30 hours per week. Previously, our plan considered 40 hours per week the threshold for full-time insurance status.
- Did the Graduate School research what impact this change would have on recruitment?
Universities, including UT, routinely survey their admitted graduate students. The top reasons students report for selecting a particular university are the attractiveness of the financial offer, research opportunities with faculty, reputation of the school, and geographical location. The new increases in salaries, fellowships, and top-off funding are expected to improve recruiting efforts.
- Will students pay more out-of-pocket under Academic Blue SHIP?
In recommending and implementing this change, the task force, the Graduate School and Human Resources reviewed the differences in coverage between Academic Blue SHIP and UT Select as well as utilization data provided by the UT System Office of Employee Benefits. They determined that most graduate students will pay less out-of-pocket on AcademicBlue SHIP than on UT Select, but that a small percentage of the overall benefits-eligible, graduate student population could experience increases in out-of-pockets costs.
Our expectation is that the financial benefits of free dental, vision and AD&D insurance, and the no-cost services provided by UHS will make up for or exceed any additional costs incurred as a result of this change. That said, we understand that there are many variables and that this may not be the case for every student. The impact of this change will vary based upon utilization and students’ specific healthcare needs. Some students whose conditions require diagnostic imaging may have higher out-of-pocket costs under Academic Blue SHIP than that they do under UT Select. Others whose conditions require visits to their mental health provider may experience lower out-of-pocket costs.
- How do we find out if our current providers are in-network?
Both the UT Select and Academic Blue SHIP health plans utilize the BlueChoice PPO provider network. For this reason, your UT Select providers will also be Academic Blue SHIP providers. A provider search is available on the Academic Health Plans website, under Quick Links.
- Will Academic Blue SHIP allow GRAs usage of EAP (employee assistance program)?
Employee Assistance Program eligibility is based upon enrollment in UT Select. Students enrolled in Academic Blue SHIP have access to the ASAP Academic Student Assistance Program. You may review the ASAP brochure available on the Academic Health Plans website. Students also have access to the UT Counseling and Mental Health Center, Blue Choice PPO providers and MD Live with Academic Blue SHIP.
- In what way does Academic Blue SHIP help students with lapses in coverage?
One goal of this change was to prevent gaps in coverage that occurred when students transitioned between plans while changing from employed positions, fellowships, to self-supporting status. There has been no change to eligibility or premium support for students in summer. However, students who do not have premium support in the summer will be able to continually stay on the Academic Blue SHIP insurance plan at a low premium cost without having to change insurance plans, face gaps in coverage periods and reset deductibles. Academic Blue SHIP helps provide continuous coverage to academic graduate student employees who lose eligibility for university-provided health insurance during the summer months. Academic Blue SHIP premiums are much more affordable to students than UT Select COBRA premiums during the summer months.
- If we elect into Academic Blue SHIP, will we be able to switch back to UT Select in the future?
Yes, if you select Academic Blue SHIP for the plan year beginning September 1, 2021 and want to later change to UT Select, you will have an opportunity to make that change for the next plan year beginning September 1, 2022.
- Does UT Select include coinsurance on medications?
UT Select includes a $100 prescription deductible that must be met first and then copayments for the drug tiers. For Academic Blue SHIP, only specialty medications are subject to 20% coinsurance. Generic, preferred brand name and non-preferred brand name drug tiers have copayments.
- Is birth control fully covered under Academic Blue?
Birth control is covered at 100% under Academic Blue SHIP. On the Academic Health Plans website, you may review details about contraception in the Preventative Care Services: Contraception brochure.
- How does Academic Blue SHIP coverage for expectant mothers compare with the care offered under UT Select?
Obstetrical care under UT Select and Academic Blue SHIP is covered similarly. Details of the care are included below. One difference is that UT Select includes an annual coinsurance maximum of $2,150 and then an annual out-of-pocket maximum of $8,550. Academic Blue SHIP includes an out-of-pocket maximum of $6,600. These differences in out-of-pocket cost could qualify a benefits-eligible academic graduate student employee transitioning from UT Select to Academic Blue SHIP for the Graduate School’s health care assistance fund.
Prenatal and Postnatal Care Office Visits
UT Select: FCP - $30 Copay / Specialist - $35 Copay (Initial visit only)
Academic Blue SHIP: $20 Copay (Initial visit only)
Delivery- Facility/Inpatient Care
UT Select: $100 Copay/Day ($500 max/admission); plus 20% Coinsurance
Academic Blue SHIP: 20% Coinsurance
Obstetrical Care and Delivery - Physician
UT Select: 20% Coinsurance
Academic Blue SHIP: 20% Coinsurance
- Can I confirm what the costs will be under Academic Blue for specialty medicines?
HR Benefits is available to help validate the cost of your specialty medication with Academic Blue SHIP. Please request an appointment with a Benefits Specialist by emailing firstname.lastname@example.org. HR Benefits maintains privacy of your information. However, if you are not comfortable sharing those details, you may email to request to be put in touch with individuals at the UT System Office of Employee Benefits or Academic Health Plans for assistance.
- Are there other options for managing the costs of specialty medicines?
We suggest you explore manufacturer rebate options for your drug or review rebate information on goodrx.com (no affiliation with UT insurance plans). You may also apply to the Graduate School’s Health Care Assistance Fund for students impacted by the transition from UT Select to Academic Blue SHIP.
You also have the option to remain with UT Select. If you are a part-time (20-29 hour) benefits eligible academic graduate student employee for the fall semester, your premium for UT Select would be $314.02 per month ($0 per month if full-time (30+ hours). If part-time, you would need to consider this UT Select premium cost in comparison to the Academic Blue SHIP medication cost, rebates available and your eligibility for them and funds available from the Graduate School’s Health Care Assistance Fund.
- Is the way we enroll and pay for dependents any different under Academic Blue SHIP?
There are differences between UT Select and Academic Blue SHIP. For Academic Blue SHIP, you must enroll your dependents in the Academic Health Plans enrollment system by October 1, 2021 for coverage effective September 1, 2021. During the enrollment process you will need to provide either credit card or ACH information to pay your dependent premiums directly to AHP on a monthly basis.
- How can I add Dental and Vision Insurance with Academic Blue SHIP? Would this incur an extra premium?
If enrolled in Academic Blue SHIP effective September 1, you may apply for the “Premium Sharing Credit” plan by October 1 to receive the dental and vision plans at no premium cost. The detailed instructions about how to make these changes are included in the Academic Graduate Student Employee Insurance Options FAQs. Review “How do I get dental, vision and voluntary AD&D coverage at no premium cost?” under the “Enrollment for Continuing AGS Employees” section.
- Will the Graduate School help students adversely impacted by higher costs as a result of the change to Academic Blue SHIP?
Yes. The Graduate School and Human Resources have been identifying ways to mitigate potential increases for students. Students who experience a significant increase in cost may be eligible for the health care assistance fund that the Graduate School has developed.
In its report, the Graduate Education Task Force also identified the need to elevate TA and AI stipends in units where they are particularly low. In response to this, the Graduate School is working with colleges and schools to improve graduate student compensation in key areas starting in the fall and spring semesters.
Health Care Assistance Fund
- Does the health care assistance fund cover deductibles for Academic Blue SHIP if they exceed those on UT Select?
UHS provides many services to students on Academic Blue SHIP at no cost, including physical therapy, physical exams, allergy shots, sports medicine services, digital x-rays, many common ultrasound exams and more. If there is a service that cannot be performed at UHS, then the student can apply for assistance for the estimated difference between the cost under UT Select and Academic Blue SHIP. For physical therapy, for example, if the cost under UT Select is $35 and the cost under Academic Blue SHIP is $350 + 20% coinsurance, then the fund can assist with the difference out of pocket if you choose to not use UHS.
- How do I access the application?
The application is accessible through the Graduate School website. Learn more and begin your application online.
- Will future students qualify for the fund?
Students who enrolled in the university after the 2021-22 academic year will be provided with detailed information about the health care plans offered to graduate students at the university before their decision to attend the university. The health care assistance fund is intended to help students experiencing an unexpected change in insurance plans. We will continue our efforts to support graduate students and to work toward making our offers to graduate students more attractive.
- Since we can only apply for assistance once per semester, should we wait until the end of the semester once we have all of our expenses recorded?
A student can submit an application for assistance once a semester or session, but the expense can be incurred earlier. As long as the expense is incurred while the student is a benefits eligible academic graduate student employee enrolled in Academic Blue SHIP and the student is still enrolled in a graduate program at the time of the application, then the student is eligible for support. So, for example, a student can apply in the spring for expenses incurred in the fall if the student has already submitted a fall application and then had further medical expenses in the fall.
- Why have you chosen a reimbursement system for the assistance fund?
The health care assistance fund is the primary mechanism available to assist students who experience higher health care costs due to the change in premium support for health insurance for benefits-eligible academic graduate student employees. We cannot provide compensation in advance for students in anticipation of health care expenses. Students will also have access to the Student Emergency Fund run by Student Emergency Service (SES). The Graduate School is providing SES with additional money for graduate students. We strive to make the administration of the health care assistance fund as smooth and convenient as possible.
- Does this kind of grant go through the financial aid office? If so, how will it affect eligibility for financial aid?
All financial aid provided by the university must go through the Office of Scholarships and Financial Aid. If the award causes the student’s aid to exceed their cost of attendance, the student can request a cost of attendance re-evaluation.
- How will the university ensure HIPPA compliance when submitting proof of expenses?
Students applying for the fund do not need to divulge details of their health care. They will submit explanation of benefits (EOB) forms with private information redacted.
- How would we know if there is a cost difference between Academic Blue SHIP and UT Select?
Students can identify potential cost differences using the comparison chart.
- Are dental expenses eligible for the health care assistance fund?
Dental expenses are not eligible for the health care assistance fund since student employees can select the best dental plan available at no premium cost by waiving UT Select.
The dental plan options for benefits eligible academic graduate student (AGS) employees are not changing. The three dental plan options remain UT Select Dental, UT Select Dental Plus, and DeltaCare USA Dental HMO. Details about these plans are available on the UT System Office of Employee Benefits’ website.
- Are graduate students transitioning to funding from a fellowship eligible for the health care assistance fund?
There is no change to the health insurance benefits for students on fellowship. They are not eligible for the fund because their health insurance options have not changed.
This situation has always been the case for students transitioning from a work appointment to a fellowship. Now that most graduate student work appointments will be on Academic Blue insurance, these transitions will be easier as students will no longer have gaps in coverage, nor have to restart their deductible due to switching back and forth between plans.
Graduate Student Fellows remain eligible for UT Select, if they meet the statutory eligibility criteria of a competitively awarded fellowship(s) with a value of $10,000 or more. Graduate Student Fellows have always been required to pay the full premium cost of UT Select, but may receive supplemental funding that could be applied toward insurance premiums.