2025 Annual Benefits Enrollment

Q1. What is the difference betweeen the two Marquette medical plans?

A1. The two plans offer the same benefits at a different cost to you. With the PPO plan, you’ll pay a higher monthly premium, but the plan will pay benefits sooner. With the HDHP plan, the premium will be lower, but you’ll need to meet a higher deductible before the plan will pay for your care. To decide which plan to elect, it will be important for you to:

• Understand what type of health care services you may expect in the coming year.
• Evaluate the deductibles and your out-of-pocket costs including premiums or the cost as you seek care.
• Determine funding a Flexible Spending Account (FSA) or a Health Savings Account (HSA) based on the plan you choose.

See the 2025 Annual Enrollment Guide for help selecting a plan.

The two plans encourage you to work with your Primary Care Provider (PCP) whenever you need care. Although you won’t need to formally request a referral from your PCP to see a specialist, it’s in your best interest to do so. Having one central person to care for you ensures you will receive the right care, at the right time, from the right provider.

Q2. What is the NexusACO provider network?

A2. UMR created a new provider network called NexusACO. ACO stands for Accountable Care Organization. This new network of high-efficiency providers is a subset of the UnitedHealthcare Choice Plus Network you’ve been familiar with for the last several years. In Southeastern Wisconsin, the NexusACO Tier 1 providers include those contracted with Advocate Aurora, Children’s Wisconsin, Froedtert (excludes Froedtert South) and the Medical College of Wisconsin. If receiving care outside of Southeastern Wisconsin, look for a Tier 1 provider in the national NexusACO network in your area to receive the Tier 1 benefit.​

Q3. Why did medical plan premiums increase overall?

A3. Although medical premiums increased to align with increasing healthcare costs, cost containment strategies Marquette has deployed for 2024 (using the NexusACO network, the Specialty Access Program, and other plan design changes) allowed the university to manage cost increases. The university continues to bear the majority of the increase in health care costs.

Q4. What am I required to do during the annual enrollment period (Oct. 21 – Nov. 4)?

A4. To be covered under a Marquette medical plan in 2025, you do not need to make an active election if you are currently enrolled, unless you want to change your medical plan or the family members you cover. If you do nothing, your 2025 benefits will default to your 2024 medical plan election and the family members you cover.

If you are covering a spouse and enrolled that spouse in coverage for 2025, you must complete the spousal surcharge certification to re-certify your spouse’s access to other coverage through their employer or the spousal surcharge for 2025 will apply.

Similarly, as in past years, if you want to fund a Flexible Spending Account (FSA) or a Health Savings Account (HSA) you will need to make an active election also, indicating the annual amount you want to contribute.

If you want your dental and vision elections to stay the same for 2025 (as they were in 2024), there is nothing you need to do. Those elections are passive and will carry over into the new year. The same passive elections apply to any voluntary benefits you have elected.

Q5. How does the Specialty Access Program work for specialty medications?

A5. The Specialty Access Program provides assistance to the member by evaluating alternative methods to help pay for these medications while ensuring the member is adhering to their recommended course of treatment. In its simplest form, it works as follows:

• Member seeks to fill a specialty medication.
• Navitus ensures drug is medically necessary.
• Member’s medication qualifies for the Specialty Access Program.
• Member works with a specialist to enroll.
• Member receives medication from the program and continues to have access to Lumicera’s clinical expertise and support.

*Enrolling in this program will be mandatory for all members using specialty medications. If a medication does not qualify for funding assistance, the member, once enrolled, will pay their share of the cost as usual. If they do not enroll in the program and adhere to its guidelines, they will pay the full cost of the medication.

Q6. How can benefits be received from the Marquette University Physical Therapy Clinic?

A6. If you are enrolled in the PPO or HDHP plan, you can receive care through the Marquette University Physical Therapy clinic at a fee of $35 per visit. This fee will not count toward your deductible or out-of-pocket maximum.

Q7. What is the Samaritan Fund?

A7. Marquette University is excited to announce its new partnership with the Samaritan Fund Program. This program supports those who have serious medical conditions or high-cost medications that may be financially difficult, even with insurance in place.

All employees and family members who participate in the university’s medical plan are eligible to apply for assistance. If accepted, you would get an individual health insurance plan combined with financial assistance that will leave you with little to no out-of-pocket costs for insurance premiums or care. If not accepted, you remain on the university’s medical plan you enrolled in.

Please direct any questions on this program to the Samaritan Fund Program team via phone at (866) 764-9290 or via email at service@samaritanfundprogram.com. Additional information can be found here.

Contact Samaritan Fund to apply prior to the close of open enrollment.

Q8. Will I receive new ID cards at the start of the new year?

A8. For 2025, you can expect the following:

• Medical: You will only receive a new UMR ID card if you are newly enrolling in the plan or if you changed covered family members for 2025.
• Dental: You will only receive a new Delta Dental ID card if you are newly enrolling in the plan or if you changed covered family members for 2025.
• Vision: VSP does not send ID cards to members. VSP will continue using your 9-digit MU Employee ID number as your unique identifier and as the means to determine your eligibility.

Q9. Why do I need to elect a PCP?

A9. Your PCP works with you as a single point of contact to help guide your care, and to ensure you are receiving the right care when you need it. They provide you with an annual physical, wellness visits, routine and diagnostic tests, vaccinations, medication management, and more. The bottom line is that they get to know you and can tailor your care to fit your particular needs. Because the PCP relationship is important, those enrolled in a university medical plan will be required to identify a PCP this year.

Q10. What kind of provider is considered a PCP?

A10. A PCP can be a physician, nurse practitioner or physician assistant in the following specialties: family practice, general practice, nonspecialized internal medicine, mental health, pediatrics, or obstetrics/gynecology. ​Not all physician assistants and nurse practitioners are listed in the NexusACO or UnitedHealthcare Choice Plus search engines. Sometimes they are contracted on their own – while other times they are contracted and working under the supervision of a doctor. If you do not find your provider listed, you can elect any other doctor from that same office location as a PCP and continue to get care like you normally do without any benefit disruption.

Q11. Do I need to select a PCP?

A11. Yes, you can update your PCP with UMR in the portal or by calling (800) 207-3172. If you don’t select a PCP, UMR will select one for you based on zip code. 

Q12. I live outside of Southeastern Wisconsin. How do I select a PCP that will be covered in Tier 1?

A12. If receiving care outside of Southeastern Wisconsin, look for a Tier 1 provider in the national NexusACO network in your area to receive the Tier 1 benefit.​

Q13. How do I login to view and enroll in benefits?

A13. Benefit information is stored on the benefits enrollment system. You can view your benefits at any time during the year by clicking the “Enroll/View Your Benefits” button. During Annual Enrollment you will be able to make changes to your benefits using this same button. If you are logged into a Marquette system, the button will take you right to your information without additional log-in steps (you are authenticated as a Marquette employee once you have logged in to start your computer or have used email or another Marquette system requiring authentication). If you are not logged into a Marquette system, you will receive a prompt to provide your email address and password.

Please note: all benefit enrollments can be done at this site EXCEPT TIAA retirement information which is on the TIAA site.

Q14. Can I enroll on my own or must I use a Benefits Educator?

A14. To enroll in your 2025 plan year benefits, you may speak with a Licensed Benefits Educator via a phone or virtual appointment, or you may enroll yourself by Nov. 4, 2024. You may schedule your phone or virtual appointment beginning on Oct. 14 by visiting marquettebenefitsenrollment.com or by calling (877) 759-7668. The appointment will allow you time to ask specific questions regarding the benefits, compare offerings, and make the best decision for your individual needs with the help of a benefits educator. You may also use the benefits enrollment system to complete the enrollment on your own beginning Oct. 21.

Benefits Educators are licensed, non-commissioned advisors (contracted through Optavise) who can answer your questions about Marquette’s health insurance options and other optional benefit programs. Appointment slots are set during the annual enrollment period.

Q15. Will I get an email confirming my appointment?

A15. Yes. You will receive an email from noreply@timetap.com.

Q16. How do I join my Benefits Educator phone or virtual appointment?

A16. If you scheduled a virtual appointment, there will be a link to join the meeting in the confirmation email. This is NOT a Teams call, please join from the link in the email. If you scheduled a phone appointment, the Benefits Educator will call you directly at your appointment time.

Appointments are limited, so if your plans change please call (877) 759-7668 to cancel or reschedule.

Q17. What information will I need when enrolling?

A17. Be sure to review the 2025 Annual Enrollment Guide prior to enrolling. Along with your personal information, if you would like to enroll a spouse and/or dependent child, you must have their date of birth and Social Security number to complete your enrollment. Once your enrollment is complete, you will need to upload a copy of the birth/adoption certificate for enrolled dependent children and/or marriage certificate for an enrolled spouse in the online enrollment tool (unless you have done so in previous years). You can view the document upload instructions at marquettebenefitsenrollment.com.

Q18. Can I make a change during the plan year once my elections are made?

A18. There are certain IRS regulations that allow you to make a change during the plan year if you experience a Qualifying Event.

Any change you make due to a qualifying event needs to be consistent with that change. For example, if you were to marry during the plan year, you could add your spouse to a plan or waive coverage if you decided to be covered under your spouse’s plan. However, this event would not allow you to move from one medical plan to another. Similarly, if you gave birth to a child, you could add that child to your current plan(s). Please note that any changes need to be made within 30 days of the event.

The list below includes many of those events.

Qualifying Events

• Marriage, divorce, legal separation or annulment
• Birth or adoption of a child
• Obtaining legal guardianship of a child
• Change in employment status for your spouse or child that affects benefit eligibility, including commencement or termination of employment, or change in worksite
• You or your dependent become eligible or lose eligibility for Medicare or Medicaid
• The death of your spouse or child
• Court ordered coverage of your child by you or your spouse, allowing you to add or drop the child’s coverage
• Loss of eligibility for a child, including graduation or reaching age limitations
• Change in your MU employment or work hours that affects benefits eligibility
• Change in your access to health care due to annual enrollment through your spouse or a substantial mid-year increase in premiums.

Q19. What can I do if my spouse’s annual enrollment has already closed this year?

A19. Your spouse’s annual enrollment is considered a qualifying event that would allow you to make a new election. For example, if your spouse’s annual enrollment was held in September and you waived coverage through your spouse’s employer and now want to make a new election based on the options Marquette is offering, your spouse would need to contact their employer to ask about making the change. You might be asked to submit documentation of Marquette’s annual enrollment dates. If so, your spouse could show their employer the flyer you received in the mail to substantiate the dates.

The same process would apply if your spouse’s annual enrollment occurs at any other time of year as well.

Q20. Why is Marquette charging spouses more for medical insurance?

A20. Marquette University continually strives to maintain high quality and cost-effective medical coverage for all our employees. While Marquette University continues to offer spouses coverage, we believe that every employer bears the responsibility of providing medical benefits to its own employees. Spouses who have the option to take medical coverage with their own employer, but choose to take Marquette’s medical plan coverage instead, will automatically be assessed a $100 monthly spousal surcharge. This charge will only apply if your spouse is eligible for medical coverage through their own employer (or is in a partnership and self-employed for tax purposes) but chooses instead to enroll in the Marquette Medical Plan. Employees must re-certify their spouse’s coverage every year during the annual enrollment period.

Q21. How will employees notify Marquette of the other coverage their spouse has available?

A21. The spousal surcharge will automatically be assessed for employees enrolling for Employee + Spouse, or Family medical coverage, unless they complete the spousal surcharge waiver on the enrollment system during the annual benefit enrollment process. The completion of the waiver will be required each year during the annual benefit enrollment period. Waivers can also be completed in the enrollment system as a result of a qualifying life event (e.g., loss of coverage, marriage, etc.) and will become effective the first of the month following the requested change.

Q22. Am I able to enroll different family members in medical, dental and vision coverage? For example, my children are young and may not need vision coverage yet.

A22. Yes, for example you can enroll your whole family (yourself, spouse and children) in a medical plan, but only yourself and your spouse in dental and vision, if that’s all they require. However, remember to enroll them the following year if you think they will need coverage at that time.

Q23. How can I be sure that my elections and dependent information have been successfully updated?

A23. If enrolling with a Benefits Educator, a confirmation statement will be sent to your email address on file once you have completed your 2025 Plan Year enrollment. If you enroll on your own, you will be prompted to print or email yourself the confirmation statement upon completion of the enrollment.

This confirmation statement will reflect elections you have made at Annual Enrollment to be effective as of Jan. 1, 2025, as well as reflect enrolled dependents/spouse. Please review carefully for accuracy and save a copy of the statement for your records.

Q24. Can I use the pharmacists at Tria Health?

A24. Marquette partners with Tria Health to offer medical plan members the ability to speak with a pharmacist about the medications they take. Any member who has questions about their medications can call Tria to ask questions about the efficacy of their prescription drugs, drug interactions, or if there are other more cost-effective drugs.

Tria Health also provides condition management services to medical plan members with diabetes, heart disease, high cholesterol, high blood pressure, mental health disorders, asthma/COPD, osteoporosis, or migraines. This is a free and confidential service. Tria Health will identify members through medical and prescription drug claims data and will reach out to them directly to invite them into the program. Members who actively participate in the program will have an opportunity to receive discounted medications and equipment for managing specific chronic conditions.

Q25. How can 2nd.MD help me?

A25. Marquette partnered with 2nd.MD in 2023 to offer members enrolled in the Marquette medical plans an opportunity to access specialists who can provide a second opinion when they are faced with decisions about a treatment plan for their condition.

Through a medical consultation and navigation service, they can connect with a board-certified, elite specialist for a virtual expert medical consultation via phone or video from the comfort of home.

2nd.MD specializes in medical certainty by providing access to elite specialists for questions about:

• Diseases, cancer, or chronic conditions
• Surgeries or procedures
• Medications and treatment plans

The Plan still offers members the ability to seek a second opinion from a provider of their choosing; however, 2nd.MD has experts in many specialties, so you may want to learn more about how they can help you, and at no cost to you.

Q26. Do I need to be a member of Costco to take advantage of the 6 for $6 program?

A26. No, you do not need to be a Costco member to use this program. Marquette took advantage of this offering for its medical plan members through a partnership between Navitus and Costco. There are several different drug therapies that will be offered at $6 for a six-month supply at Costco stores. See drugs and their strengths listed below:

Q27. Do my medical plan premiums count towards my deductible and out-of-pocket maximums?

A27. No. The expenses that do apply to your deductible and out-of-pocket maximum are your out-of-pocket costs such as copayments and coinsurance amounts. Please note: The only difference is the $35 fee for using the Marquette University Physical Therapy Clinic will not apply to your deductible or out-of-pocket maximum.

Q28. How can I determine what medical plan is best for me?

A28. First, know that both medical plans are identical in the covered services provided, the provider network, and include coverage for wellness and preventive care in-network at 100%. The only differences between the plans are premiums, deductibles, copays and out-of-pocket maximums. If you want to allocate pre-tax dollars for health care expenses, read more about FSAs and HSAs.

There are a variety of resources to help you make a good decision for your personal situation:

1. Scheduling a 30-minute phone or virtual appointment with a Benefits Educator by calling (877) 759-7668.
2. Use the “Ask Emma” enrollment tool on the benefits enrollment system.
3. Refer to the chart and payment examples in the 2025 Annual Enrollment Guide 
4. Call a UMR Plan Advisor at (800) 207-3172 to discuss procedures planned for next year.

Q29. Can you clarify how the dental plan deductible works for families?

A29. The per person deductible in the dental plan is $50. Once an individual satisfies the deductible, that person’s future claims are paid at the set coinsurance levels until the individual annual maximum plan benefit of $2,500 is reached. The maximum family deductible in the dental plan is $150. If three or more family members meet a total deductible of $150 in the plan year, the family’s claims from that point on through the end of the plan year will be covered at the coinsurance levels based on the type of service up to each person’s annual maximum benefit of $2,500 each.

Q30. Is it a good idea to participate in a Flexible Spending Account (FSA)?

A30. The advantage of funding an FSA is that you are able to save for out-of-pocket expenses on a pre-tax basis. During the annual enrollment period, you can elect to fund an amount that you expect to use during the plan year. If you enroll in the health care FSA (available if you enroll in the PPO Plan, or waive medical coverage and are not enrolled in a high-deductible health plan), you might want to set aside pre-tax money to pay for out-of-pocket expenses such as your copays, deductibles, and coinsurance for medical, dental, vision and prescription drug care.

If you pay for qualified day care services for your dependent child or an elderly parent that allow you (and your spouse, if applicable) to work, go to school, or look for work, you can set aside money through a pre-tax dependent care FSA. You can be reimbursed for those qualified day care expenses.

With either the health care or dependent care FSA, you should only elect an amount for expenses you know you will incur. These accounts are known as “use it or lose it.” Any amounts remaining after year-end and the grace period will be forfeited (per the IRS), so you want to make sure to plan carefully. See the 2025 Annual Enrollment Guide for more details.

Q31. What is a Limited Purpose Flexible Spending Account (FSA)?

A31. You could enroll in this type of account if you are enrolled in the HDHP medical plan to pay for out-of-pocket expenses you expect to incur for dental and vision expenses only. See the 2025 Annual Enrollment Guide for more details.

Q32. What are the advantages of contributing to a Health Savings Account (HSA)?

A32. HSAs allow you to set aside pre-tax contributions to pay for eligible expenses you pay for out of your pocket if you are enrolled in a high-deductible health plan. These include out-of-pocket health care expenses not reimbursed by other sources including deductibles, co-payments, and coinsurance. You can only enroll in the HSA if you are enrolled in the HDHP medical plan.

Your HSA balance rolls over from one year to the next. It’s also portable, which means if you leave Marquette, the balance in your account goes with you. See the 2025 Annual Enrollment Guide  for more details.

Q33. How do I calculate the maximum amount I can contribute to a Flexible Spending Account (healthcare FSA) or a Health Savings Account (HSA)?

A33. The maximum amount you can contribute to a Health Care FSA in 2025 is $3,200. If you are receiving a Wellness Reward from your 2024 activities and plan to contribute the maximum allowed, you will need to subtract the amount of the reward from the total you plan to contribute. For example, if you earned the maximum FSA contribution of $125 for single coverage, the maximum you can voluntarily contribute to an HC FSA is $3,075 ($3,200 minus $125).

You would calculate the maximum contribution to an HSA in the same manner. If you were enrolled in single coverage in 2024 and expect to receive the maximum Wellness Reward of $250 from your 2024 activities, you will need to subtract the amount of the reward from the total you plan to contribute to avoid contributing above the IRS maximum. In this scenario, you could contribute the maximum of $4,050 ($4,300 minus $250). Note: If you are age 55 or older and enroll in the HSA, you are eligible to contribute an additional $1,000. So, in this example, you would be able to contribute $5,050.

Q34. What are the advantages of enrolling in Accident Coverage?

A34. By enrolling in Accident Coverage through MetLife, you can receive payments if you or any covered family member were to suffer from an accidental injury, including those from playing organized sports. Injuries range from broken bones to a concussion, and many more. The payment you receive is in addition to the benefits paid under the medical plan. Annual enrollment is the only opportunity you have to enroll in this program; premiums will be deducted from your pay.

Q35. Describe the Auto/Home Insurance program.

A35. MetLife offers automobile and homeowners insurance through Farmers Insurance. You can opt in/out at any time throughout the calendar year. Through this program, the benefits include:

• A group discount of up to 15%
• Automatic payment discount
• Good driving rewards
• Loyalty discount
• Multi-policy discounts
• Multi-vehicle savings
• 24/7 customer service

Q36. Tell me more about the life insurance coverage for spouses and dependent children.

A36. The details of the program are as follows:

• Employees who are enrolled in the Optional Life Program can purchase voluntary life insurance through MetLife for their spouse and dependent children, age 26 or younger.
• The spouse benefit can be purchased in $25,000 increments, not to exceed the lesser of $75,000 or 100% of the employee’s Optional Life election.
• A flat $10,000 benefit can be purchased for each covered child, age 26 or younger.
• If the employee is newly enrolling in Optional Life (for employee only and to cover a spouse, if applicable), the newly insured person is required to go through medical underwriting. No underwriting is required for children regardless of age.

Q37. Who can access LifeMatters and what services do they provide?

A37. Employees, covered dependents, and members of the employee’s immediate household will have access to LifeMatters, the Marquette-sponsored EAP. LifeMatters has professional counselors available to meet your needs. You’ll be able to reach them 24/7/365 by calling (800) 634-6433. Counselors can talk with you about a wide variety of concerns, including:

• Mental health concerns
• Job Concerns
• Legal or Financial Worries
• Alcohol and Drug Abuse Problems
• Relationship Issues
• Emotional and Stress Related Issues
• Family Needs

These services are available at no cost to you, your dependents, and anyone residing in your household. Each eligible member has access of up to six face-to-face or telephonic counseling sessions, per issue, per year. If additional services are recommended, the counselor will assist you with accessing providers covered by your insurance plan.

You can also access resources on the LifeMatters portal. Use your Marquette email and the password MU1.

Q38. What is new for the 2024-2025 Wellness Program?

A38. The My Wellness program will continue to offer many features as well as new opportunities for the new Wellness Year (Sept. 1, 2024 through Aug. 15, 2025).

For example:

• New for 2025, members on the university's medical plan can earn 50 points by connecting with a Tria Health pharmacist expter by phone to discuss optimizing medications and health managment. 
• To emphasize the importance of seeing your PCP, this year, 200 points will be awarded for PCP Visits. See the Employee Wellness site for more details.
• This year, the wellness program will end on Aug. 15, 2025.
• The My Wellness program and activities will have a continued focus on physical, mental, spiritual and emotional well-being.
• Employees and spouses enrolled in the medical plan are still able to earn wellness points toward their 2026 FSA/HSA contributions.

Q39. Can my spouse who is not a Marquette employee participate?

A39. Yes, your spouse can participate.

Q40. What if I am not on a Marquette sponsored health plan, can I still participate?

A40. Yes, you and your spouse can still participate and earn raffle entries. However, neither you nor your spouse can earn FSA/HSA rewards.

Q41. How do I earn FSA/HSA contributions through the My Wellness program?

A41. If you are enrolled in one of Marquette’s medical plans, you are eligible to earn FSA/HSA contributions. To earn contributions, employees and spouses must achieve one of the wellness levels below by Aug. 15, 2025. If both employee and spouse are enrolled in Marquette medical insurance, the contribution amount depends on the levels that both of them achieved during the 2024-2025 program year. Points can be earned for activities like seeing your PCP and preventive care visits, walking 8,000 steps per day, participating in coaching, and many others. See the Employee Wellness site for more information.