General
What is Premium Sharing?
What is the purpose of the Annual Enrollment period?
What is Evidence of Insurability (EOI)?
Medical
What is a deductible?
What is a copayment?
What is coinsurance?
How do I find out what providers (doctors, hospitals, etc.) are in a specific health plan?
If I enroll in an HMO, will I be covered if I have an emergency while traveling outside the service area?
If I change health plans this year, will the new plan honor my old prescription?
If I am currently being treated for a chronic medical condition and change health plans this year, will I be allowed to continue to use my current doctor?
Dental
If I enroll in the Assurant Dental plan, do I have to select a primary dentist?
Vision
Why can't I get both eyeglasses and contacts under the Superior Vision plan?
UT FLEX
I want to continue my Medical Expense Reimbursement Account next year with the same amount being withheld monthly from my paycheck. Why do I have to re-enroll?
Life
Do I have to complete a Beneficiary Designation Form for my Basic/Voluntary Term Life and Accidental Death & Dismemberment Insurance?
Long Term Disability and Long Term Care
What is the difference between Long Term Care and Long Term Disability?
Is Evidence of Insurability required to enroll in the Long Term Care plan?
UT TOUCH
I do not want to make any changes for next year. Do I still have to use UT TOUCH?
What do I do if I lose my PIN or want to change my PIN?

General
What is Premium Sharing?
Premium sharing is the monthly contribution provided by the State of Texas and component institutions toward group insurance premiums of an enrolled employee or qualified retiree. The amount of premium sharing is determined by the Texas Legislature on a bi-annual basis in the Appropriations Act.

What is the purpose of the Annual Enrollment period?
Annual Enrollment is the designated time each year for you to make certain changes to your group insurance coverages.

What is Evidence of Insurability (EOI)?
EOI is documentation of a person's medical history to determine whether the person meets the carrier's definition of good health. Find out about when EOI is required here.

Medical
What is a deductible?
A deductible is the amount of out-of-pocket expenses that you must pay for health services before other expenses are payable by the plan. (Copayments are not included in the deductible.)

What is a copayment?
A copayment is a payment made by you in lieu of deductibles and coinsurance. For HMO plans, deductibles and coinsurance do not apply.

What is coinsurance?
Coinsurance refers to the cost amount that you share in hospital and medical expenses after the deductible is met. For example, your coinsurance for network care under the UT SELECT plan is 20%.

How do I find out what providers (doctors, hospitals, etc.) are in a specific health plan?
You can obtain information about a plan's participating providers by checking EGI's online provider directory page.

If I enroll in an HMO, will I be covered if I have an emergency while traveling outside the service area?
Yes. The Texas Department of Insurance (TDI) requires state licensed HMOs to provide coverage for emergencies, as defined by TDI.

If I change health plans this year, will the new plan honor my old prescription?
Retail prescriptions will be honored; however, you will need a new prescription for the mail order pharmacy.

If I am currently being treated for a chronic medical condition and change health plans this year, will I be allowed to continue to use my current doctor?
Transition benefits are available for certain medical conditions including pending transplants, home health and hospice care, behavioral health and chemical dependency, high risk pregnancies, pregnancies that are in the third trimester on September 1, and those conditions currently being overseen by case management. This means that you may continue to use your current provider and receive network benefits for 90 days following the effective date of your new plan. You must complete a Transitional Benefits form (available at your campus benefits office) and submit it to your new insurance carrier.

Dental
If I enroll in the Assurant Dental plan, do I have to select a primary dentist?
Yes. However, you may be treated by a network specialist (i.e. Endodontist, Orthodontist) without a referral from your primary dentist.

Vision
Why can't I get both eyeglasses and contacts under the Superior Vision plan?
Coverage for both eyeglasses and contacts would substantially increase your premiums. This limitation is intended to keep your premiums affordable.

UT FLEX
I want to continue my Medical Expense Reimbursement Account next year with the same amount being withheld monthly from my paycheck. Why do I have to re-enroll?
In order to comply with federal IRS regulations, UT FLEX is an annual election. Therefore, you must re-enroll during Annual Enrollment each year and indicate the monthly amount that you want withheld from your pay. If you do nothing, your UT FLEX enrollment will not continue for the next year.

Life
Do I have to complete a new Beneficiary Designation Form for my Basic/Voluntary Term Life and Accidental Death & Dismemberment Insurance?
Yes. Because there is a new carrier for life and AD&D insurance effective Sept. 1, 2004, all employees and retirees must complete a new Beneficiary Designation Form which you can also get from your campus benefits office. You must return the completed form to your campus benefits office by Sept. 1st.

Long Term Disability and Long Term Care
What is the difference between Long Term Care and Long Term Disability?
Long Term Disability pays a percentage of your monthly income while you are disabled.
Long Term Care provides coverage for some or all of your long term care costs for a limited time. Nursing home care is an example of a service covered by Long Term Care.

Is Evidence of Insurability required to enroll in the Long Term Care plan?
Yes.

UT TOUCH
I do not want to make any changes for next year. Do I still have to use UT TOUCH?
If you are currently enrolled in a UT FLEX account and wish to continue your account next year, you must re-enroll. All other coverages (medical, dental, life, etc.) will continue if you do not make changes during Annual Enrollment.

What do I do if I lose my PIN or want to change my PIN?
To access UT TOUCH to make changes to your current coverages, you must have a unique Personal Identification Number (PIN) which was included in the Coverage Option Letter sent to you prior to the beginning of the Annual Enrollment period. To obtain a new PIN or change an old PIN online, just follow the instructions in the UT TOUCH Online Help Center.