Healthcare Benefits
- Human Resources
- Benefits
- Healthcare Benefits
At Seattle University, we prioritize the health and wellness of our students, faculty, and staff. We believe that access to quality healthcare is fundamental to thriving in academic, professional, and personal pursuits. Our comprehensive healthcare benefits are designed to provide peace of mind and support individuals in achieving their full potential.
The University offers a choice of medical plans to faculty and staff. You are able to select the plan that best meets you and your family’s needs as you balance monthly premium with deductibles and other out-of-pocket costs.
When considering provider options, you have a choice between Aetna’s extensive network of preferred providers and the Kaiser Permanente HMO, which offers care provided by Kaiser staff and contracted facilities.
Healthcare Benefits Details
Aetna PPO
The Preferred Provider Organization ("PPO") Plan has a deductible of $500 per individual and a maximum of $1,000 for a family. Once you have met your deductible, you pay a percentage of the expenses, called coinsurance. If your coinsurance and deductible reach an amount called the out-of-pocket maximum, the plan will pay 100% of your eligible expenses for the rest of the year, excluding copays and premiums. If you receive care from a network provider, you will receive the highest level of benefit coverage available. See Aetna's provider directory.
Refer to the 2024 Enrollment Guide for a comprehensive description of plan benefits. Under all circumstances, the plan booklet will take precedence over information contained on this website. Contact Aetna Concierge Services at 800-836-2824 for questions of coverage.
Aetna HSA
If you choose the Health Savings Account (“HSA”) Plan, you are able to access the same broad network of providers as for the PPO. Your monthly premium is lower than the PPO while your deductible and out-of-pocket maximums are higher. Before the plan pays benefits, individuals must pay the first $2,000 of eligible health expenses. The deductible to cover you and your enrolled dependents is $4,000. Once you have met the deductible, you will pay a coinsurance percentage until you have reached your annual out-of-pocket maximum. To help you pay out-of-pocket costs, the University will contribute to a tax-advantaged Health Savings Account administered by Fidelity. You may also make paycheck contributions to your Fidelity account up to an IRS limit.
HSA Plan Benefit
Refer to the 2024 Enrollment Guide for a comprehensive description of plan benefits. Under all circumstances, the plan booklet will take precedence over information contained on this website. Contact Aetna Concierge Services at 888-901-4636 for questions of coverage.
Kaiser HMO
The Kaiser Permanente Plan is a Health Maintenance Organization (HMO) plan. Copayment is required for certain services. To receive coverage, you must use a Kaiser provider or services will not be covered. (Exceptions may be granted in certain emergency situations.) You don’t have to be referred by your primary care physician to see many specialists in network. You can search for a provider or clinic at wa.kaiserpermanente.org.
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Log in to your secure account at PlanSource to compare premiums and benefits.
Below is a brief outline of benefits provided under the Kaiser HMO plan. Refer to the official benefits booklet for a comprehensive description of plan benefits. Under all circumstances, the benefits booklet will take precedence over information contained on this website. Contact Kaiser Permanente for questions of coverage.
Benefit
| Type | Amount |
|---|---|
| Deductible | 2023: $250 individual/$500 family; 2022: none |
| Deductible | 2023: $250 individual/$500 family; 2022: none |
| Annual Out of Pocket Max | $2,000 individual/$4,000 family |
| Lifetime maximum benefit | Unlimited |
| Office Visits | 100% after $25 copay |
Preventive Care
| Type | Amount |
|---|---|
| Immunizations | 100% |
| Adult physicals | 100% |
| Well-woman exams/screenings | 100% |
| Well-baby exams | 100% |
Other Care
| Type | Amount |
|---|---|
| Emergency Room (copay waived if admitted) |
$100 copay |
| Inpatient hospital services | 100% |
| Outpatient hospital services | 100% after $25 copay |
| Outpatient surgical center | 100% after $25 copay |
Prescription Drugs (retail/pharmacy)
| Type | 30-day supply |
|---|---|
| Generic | $10 copay |
| Brand formulary | $30 copay |
| Nonformulary | N/A |
Prescription Drugs (mail order)
| Type | 90-day supply |
|---|---|
| Generic | $20 copay |
| Brand formulary | $60 copay |
| Nonformulary | N/A |
Delta Dental of WA
Delta Dental of Washington provides Seattle University’s dental coverage. Delta Dental is a Preferred Provider Organization (PPO) plan that will cover your dental claims both in and out of network. You will receive the highest level of benefit if you use in-network providers. You may elect dental coverage independent of your medical coverage. You can find a list of providers at deltadentalwa.com
Below is a brief outline of the benefits provided. Refer to the Benefits Booklet for a comprehensive description of plan benefits. Under all circumstances, the Benefits Booklet will take precedence over information contained on this website.
| Benefit | In Network | Out of Network |
|---|---|---|
| Calendar Year Deductible | $50 per person $150 per family |
|
| Annual Benefit Maximum | $1,500 per person | |
| Preventive Care Routine exams, x-rays, topical fluoride and space maintainers | 100% of the allowed amount (deductible waived) | 80% of the allowed amount (deductible waived) |
| Basic Care Fillings, simple extractions, oral surgery, periodontic & endodontics (root canal therapy) | 80% of the allowed amount after deductible | 70% of the allowed amount after deductible |
| Major Care Inlays, onlays, crowns, bridges & dentures | 50% of the allowed amount after deductible | 40% of the allowed amount after deductible |
| Orthodontia (Children only) | 50% up to a maximum lifetime benefit of $1,500 | |
VSP Vision
VSP provides Seattle University’s vision coverage to faculty/staff and their families. If interested in vision coverage, you may choose between a 'core' and 'enhanced' vision plan.
VSP is a PPO plan that covers both in-network and out — of-network providers. You will receive the highest level of benefit using in-network providers. You can find a list of network providers at vsp.com
Below is a brief outline of the benefits provided. Refer to the Certificate of Coverage for a comprehensive description of plan benefits. Under all circumstances, the Certificate of Coverage will take precedence over information contained on this website.
| Benefit | Core Vision Plan | Enhanced Vision Plan |
|---|---|---|
| Exam (once each 12 months) | $20 copay | $20 copay |
| Lenses (once each 12 months) | 100% for single vision, bifocal, trifocal and lenticular lenses | 100% for single vision, bifocal, trifocal and lenticular lenses |
| Frames | $130 allowance (once each 24 months) plus 20% off any out-of-pocket cost | $250 allowance (once each 12 months) plus 20% off any out-of-pocket cost |
| Benefit | Core Vision Plan | Enhanced Vision Plan |
|---|---|---|
| Exam (once each 12 months) | Not to exceed $60 copay | Not to exceed $60 copay |
| Elective (once each 12 months) | $130 allowance | $250 allowance |
Flexible Spending Accounts
Flexible Spending Accounts (FSAs) allow you to set aside pre-tax dollars to pay for eligible expenses each year. This means your contributions will be deducted from your paycheck before your pay is taxed. You will not pay federal income or social security tax on flexible spending account contributions. The University offers two FSAs:
Health Care Spending Account
Allows you to pay eligible health care expenses for yourself and your eligible dependents with tax-free dollars. Eligible expenses may include deductibles, copays, out-of-pocket vision or dental expenses, and prescribed over-the-counter medications. The healthcare spending account is available if not already eligible for similar tax benefits under the HSA medical plan.
- Maximum Contribution: $3,200 in 2024.
- Limitations: Reimbursement provided for medically necessary expenses.
No reimbursement for over the counter medicine or drugs purchased without a prescription or for all cosmetic procedures. - Restrictions: Up to $500 of unused Healthcare FSA dollars for a plan year may be carried over to the following plan year. Unused contributions above $500 will be forfeited if unclaimed. If enrolling in the HSA medical plan, 100% of unused contributions will be forfeited. Cannot change amount without qualifying event.
- Claims: Incur claims between January 1 and December 31.
Submit claims by March 31 of following year.
Dependent Care Spending Account
Enables you to pay for work-related dependent care expenses with tax-free dollars. Eligible expenses may include daycare centers, in-home child care and before/after school care.
Below is a brief outline of the benefits provided. Refer to the Plan Summary for a comprehensive description of plan benefits. Under all circumstances, the Plan Summary will take precedence over information contained on this website.
- Maximum Contribution: $5,000 per family per year.
- Limitations: Child under 13 or other dependents unable to care for themselves.
To be eligible, parents must be working (except that one parent can be attending school). - Restrictions: Unused contributions forfeited if unclaimed.
Cannot change amount without qualifying event. - Claims: Claims can be submitted for expenses incurred from January 1 until December 31.
Claim forms are due by March 31st of the following year.
Information for current employees
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