Human Resources

Health Insurance

Washington University in St. Louis ("WUSTL") provides its employees and their families with the choice of five health plans and access to high quality providers. Each comprehensive plan, which includes medical, dental, prescription drug and vision exam coverage, offers protection against catastrophic health or dental expenses.

Note: Effective 1/1/16, UnitedHealthcare is the sole claims administrator for all Washington University in St. Louis Health Plans.

Who is Eligible? 

  • Faculty members with an appointment of 50% or more of the required full-time faculty workload or regular semester-based teaching faculty members on the Danforth Campus with a semester appointment of at least 6.5 credit hours; regular staff employees whose standard work schedule is 20 or more hours per week; employees who are permanently disabled; or employees who otherwise meet the eligibility requirements for coverage under the Employer Shared Responsibility provisions of the Affordable Care Act.  

  • Your Spouse or Domestic Partner, who resides with you.  A Spouse is the person to whom you are legally married.  A Domestic Partner is defined as a person of either gender to whom you are not legally married, but who resides with you in a non-platonic relationship and with whom you have an emotional and financial commitment. You and your Domestic Partner must not be legally married to, or the Domestic Partner of, another person under either statutory or common law.

  • Your (or your Spouse/Domestic Partner’s) children (including natural or legally adopted children, stepchildren, children placed with you for adoption, or children for whom you have full legal guardianship) from birth to age 26.  A child for whom health care coverage is required under a Qualified Medical Child Support Order or other court or administrative order also qualifies as an eligible dependent.

  • Your (or your Spouse/Domestic Partner's) children (including natural or legally adopted children, stepchildren, children placed with you for adoption, or children for whom you have full legal guardianship) who are age 26 or older, are dependent upon you for support, and are incapable of self-support due to mental or physical disability, as long as the disability existed prior to the child attaining age 26 and the child was covered as your dependent under the Plan immediately prior to attaining age 26.

Enrollment Period

Eligible employees may enroll within 31 days after their date of hire, during the annual open enrollment  (in November) and/or within 31 days (62 days for birth of baby) after a qualified Family Status change/Life Event

 

Guidelines for Health Care Benefits Enrollments and Changes

 

Effective Date

First of the month coincident with or following date of hire, January 1 following annual open enrollment, and/or first of the month following a qualified Family Status change/Life Event. (Birth of baby is effective the date the baby is born) 

 

Health Care Reform  

The Patient Protection and Affordable Care Act (PPACA), commonly referred to as Health Care Reform, was enacted in 2010 with the goal of making affordable health care available to all Americans. Both employers and individuals have certain responsibilities under the PPACA.

Click here for information on the Employer Mandate, the Look-Back Measurement Period for determining eligibility for full-time health premiums, the Individual Mandate, and IRS Reporting Requirements relating to Health Care Reform. 

 

WUDirect© Program 

The WUDirect© program provides WUSTL health plan participants priority access for initial appointments with Washington University’s network of over 1300 physicians.  In addition to receiving world-class medical care, seeing a WUDirect© physician helps lower WUSTL health plan participants’ out-of-pocket costs through reduced co-pays and co-insurance, as reflected below: 

Physician Office Services

(non-preventive)

HMO/POS Plans

PPO Plans (including HDHP)

Primary Care Physician

WUDirect© provider - $15

Other network provider -  $25

WUDirect© provider – 10%

Other network provider – 20%

Specialist

 WUDirect© provider - $25

Other network provider - $40

WUDirect© provider – 10%

Other network provider – 20%

 
A listing of WUDirect© providers is available on-line at https://wudirect.wustl.edu.  To access this website, you will be required to enter the group number for your WUSTL health plan. Your health plan group number is listed on your health insurance ID card. Most appointments for Washington University health plan participants will be scheduled within two weeks or less.  If, however, patient records and/or pre-appointment testing are required in advance of the appointment, scheduling may take longer.  If you have difficulty scheduling an appointment within the above time frame, you may contact a WUDirect© scheduling assistant for help in securing a more timely appointment.  The phone number for the WUDirect© scheduling assistant is posted on the WUDirect© website listed above.


Medical Coverage for International business travel through GeoBlue

Website: https://global.wustl.edu/international-policies-resources/health-insurance/

To register, visit the geo-blue.com website and click on the 'Register' box on the main page.  Enter the Washington University Group Access Code: QHG99999WUBT

For questions about registration or medical coverage, you may call 1-888-412-6403 inside the U.S. or 1-610-254-5830 outside the U.S.

  

Other Helpful Links

Danforth Benefit Representative:
Jennifer Gang
jennifergang@wustl.edu
(314) 935-7745
Campus Box: 1190

Medical School Benefit Representative:
John Henderson
john.henderson@wustl.edu
(314) 362-9341
Campus Box: 8002
 

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