Medicine

QUICK LINKS


Eligibility

All regular, full-time employees (those who work a minimum of 37.5 hours per week on a nine-twelve month annual basis) and full-time temporary employees (who have at least a one year appointment) are eligible. Regular part-time employees can enroll in health insurance, but must pay the full premium on a payroll deduction basis.

Enrollment

Benefit

EPO

PPO

Prescription

30 day supply 30 day supply
Mail Order 90 day supply 90 day supply
Your deductible
Single
Family

$75
$150

$75
$150

Your coinsurance
Generic
Formulary Brand
Nonformulary Brand

You pay

10%

30%

40%

You pay

10%

30%

40%

Your out of pocket maximum

Single
Family

$1,500
$3,000

$1,500
$3,000

Update on mandated Affordable Care Act prescription coverage requirements
Beginning Jan. 1, 2014, the Affordable Care Act requires that all employers must provide access to FDA-approved contraceptive methods for women. Like many religiously affiliated institutions nationwide, Marquette has been granted a religious accommodation, which means that Marquette’s health benefits plan and prescription coverage will not change. As of Jan. 1, to comply with the Affordable Care Act requirement, a third-party administrator, Express Scripts, will administer and pay for mandated prescription coverage for contraception methods that the university’s health benefits plan does not cover.

This update affects all female employees of a reproductive age, as defined by the Affordable Care Act, who utilize the university’s health benefits plan, as well as all employees utilizing Marquette’s health benefits plan who have a woman of reproductive age listed as a beneficiary of their plan. Express Scripts has mailed a letter and a new prescription ID card to affected employees. The new Express Scripts prescription ID cards can only be utilized to secure and pay for mandated prescription coverage for contraception methods that the university’s health benefits plan does not cover.

This process is being used by Marquette to ensure the university is not administering, overseeing or paying for any of the mandated prescription contraceptive methods that were not previously part of its health benefits plan and are now required to be provided under the Affordable Care Act.

Express Scripts by mail

For some routine maintenance prescription drugs, you can elect to participate in Express Scripts by mail. This program allows you to purchase your prescription drugs in bulk, you may even save money while participating in this program. There is no coverage for prescription drugs dispenses by any other mail-order service other than through Express Scripts family of Pharmacies. To order a prescription drug from Express Scripts follow the instructions below:

Common terms

Brand-name drug is medication that is available only from its original
manufacturer.

Co-insurance is the cost-sharing requirement between you and the plan.

Coverage review is the process of obtaining approval for certain prescription
drugs.

Deductible is the "off the top" amount you are responsible for before the co-
insurance is activated.

Formulary a comprehensive drug list used to highlight preferred products.

Generic drugs contain the same active ingredients and are manufactured to the
same strict federal regulations as its brand-name counterpart. Generic
medications may differ in color, size, or shape.

Step therapy encourages the prescribing of generic drugs to lower the costs of
alternative brand preferred drugs, when appropriate, by using effective
communications to members and physicians.

Useful links and forms

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The detail of the prescription benefit is contained in the official Plan document. This site is meant to only cover highlights of the prescription benefit. It does not contain all of the details that are included in the Summary Plan Description (SPD) (as described by the Employee Retirement Income Security Act). If there is ever a question about this plan, or if there is a conflict between the information on this site and the formal language of the Plan documents, the formal wording in the Plan documents will govern. Please note that the benefits described on this site may be changed at any time and do not represent a contractual obligation on the part of Marquette University.

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PROSPECTIVE EMPLOYEES

CURRENT EMPLOYEES

STUDENTS

Contact Human Resources

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Question/comments:

Marquette University Department of Human Resources
David Straz Tower, Room 185
915 W. Wisconsin Ave., Milwaukee, WI 53233
Phone: (414) 288-7305 | (414) 288-7425 (FAX)