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State of Utah Open Enrollment

2020 Open Enrollment has ended. The next open enrollment period will be in April 2021.

The information on this page is for the 2020-2021 plan year, which runs July 1 through June 30, 2021. If you have questions about your PEHP benefits, please call 801-366-7555.

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Click a topic below to learn about different PEHP benefits

See What's New
Medical Plans
Vision Plans
Medical Networks
Life and Accident
Dental Plans
Savings Accounts
Biweekly Rates
Benefits Summary



New this Year: 2020-21

One-Time Refund Payment

Employees enrolled in a medical plan during 2019-20 will get a refund check from PEHP by the first week of May. PEHP provides self-funded plans, so when costs are lower than expected we are able to give back money. The check you receive represents your portion of the $25,460,000 in savings.

STAR HSA Plan

You pay a small premium, but the State of Utah gives it back in your HSA.

HSA Cash Conversion Option

You can convert up to 100% of the State HSA contribution in cash on the Consumer Plus Plan. Those on the STAR HSA Plan can still convert up to 50%. Your selection from last year will carryover unless you choose otherwise.

New Dental Plan Options

If you choose the STAR HSA or Consumer Plus plan, you can enroll in one of two new dental plans and get more money in your HSA.

Other Insurance Coverage?

If you have other insurance coverage, you can opt-out of medical and/or dental benefits and get cash added to your salary. Opt-out of coverage through your Medical and Dental online enrollment. Learn how.

New Prescription Cost Tool

Find drug options for your health condition, compare prices at different pharmacies, and see if cash back is available for your medication.

Learn more.

Life Insurance Opportunity

During this open enrollment you can get up to $200,000 of guaranteed issued life coverage. That means no examination and no questions for any new coverage up to $200,000. You can also get $50,000 of guaranteed issued life coverage for your spouse, and up to $15,000 guaranteed issued life coverage for your dependents. Additional coverage is available, but it must go through the usual underwriting process.  Learn more.

Expanded Mental Wellness Benefit for First Responders & Public Safety Staff

If you're a First Responder or work in Public Safety, you have access to PEHP's Expanded Mental Wellness Benefit. This benefit, available to you and your spouse at no cost, helps address the stress inherent in the workplace by offering counseling services for any reason. Learn more.


Medical Plans

Traditional

  • You pay 8% of the premium from your paycheck and don’t receive HSA contributions
  • It has a lower deductible and gives you predictable costs through fixed co-pays
  • Each family member has their own deductible and out-of-pocket maximum
  • Deductible does not apply to out-of-pocket maximum

STAR HSA

  • This plan provides an 8% higher benefit than the Traditional Plan, even with the small premium
  • You get money in an HSA for health-related expenses to offset a higher deductible. HSA funds carry over from year-to-year and grow tax-free. You never forfeit what you don’t spend.
  • If you’re not eligible for an HSA, you can still receive the contribution amount in a Statefunded HRA account
  • It covers more preventive services paid at 100% compared to other plans, including chronic medications like diabetes. See a list of medications on page 19 of the Covered Drug List.

Consumer Plus

  • Essential benefit plan with catastrophic coverage
  • Similar to the STAR HSA Plan with a higher deductible, lower coinsurance, but fewer covered benefits and medications. See the Benefits Summary and Consumer Plus Covered Drug List for what is covered
  • Your employer puts more money into an HSA or HRA for health-related expenses than the STAR HSA Plan to offset a higher deductible
  • You can participate in wellness programs, including Healthy Utah testing sessions; however, you’re not eligible for rebates

Opt-Out

  • If you have other ACA medical only coverage, you can opt-out of PEHP medical coverage in exchange for more money each paycheck
  • To opt-out, go to the Medical Section of online enrollment. Click "Change" then select "Opt Out" from the available plans. See instructions.
  • Income is subject to tax and counts toward other benefits like retirement, workers’ compensation, and LTD



Medical Networks

Advantage

This is an IHC facility-based network in which PEHP contracts directly with all providers.

Summit

Primarily non-Intermountain Healthcare facilities and practitioners. The network includes 35 hospitals, the University of Utah, Steward Health, and Mountain Star facilities. This network also includes Primary Children's Medical Center and all rural IHC facilities. PEHP contracts directly with all providers in this network.

Preferred

This network contains all major hospitals within the state, but it will cost you more in premium. PEHP contracts directly with all providers in this network.



Dental Plans

Traditional

  • No deductible
  • Pays 100% of in-network rate for X-rays and cleanings
  • Covers cleanings, preventive services, orthodontics, major services, etc.
  • $1,500 annual limit per member

Preferred Choice

  • Small deductible that doesn’t apply to preventive services
  • Pays 80% of in-network rate for X-rays and cleanings
  • Covers cleanings, preventive services, orthodontics, major services, etc.
  • $1,500 annual limit per member

Important Information

Cancel Coverage If you cancel PEHP dental coverage and don't have other dental insurance coverage, you'll have to wait 3 years to reenroll in a PEHP dental plan.

Waiting Period If you have been without dental coverage for more than 63 days, there is a waiting period of six months from the effective date of coverage for orthodontic, implant, and prosthodontic benefits.

Missing Tooth Exclusion Services to replace teeth missing prior to effective date of coverage are not eligible for a period of five years from the date of continuous coverage with PEHP.

Regence Expressions

  • Plan administered by Regence of Utah
  • No deductible
  • Pays 100% of in-network rate for X-rays and cleanings
  • Covers cleanings, preventive services, orthodontics, major services, etc.
  • $1,500 annual limit per member
  • For questions and calls directed to Regence, please use Group ID number 10003637

Basic HSA Dental

  • Must be on STAR HSA or Consumer Plus medical plan
  • No cost to you per paycheck
  • Small deductible that doesn’t apply to preventive services
  • Pays 20% of in-network rate for X-rays and cleanings
  • Covers ONLY cleanings, preventive services, cavities (no orthodontics)
  • $500 annual limit per member
  • State contribution to your HSA
  • If you choose this plan, you’re not eligible to enroll in Preferred Choice, Traditional or Regence Expressions for 3 years

Discount HSA Dental

  • Must be on STAR HSA or Consumer Plus medical plan
  • No cost to you per paycheck
  • Access to discounts, no insurance coverage
  • State contribution to your HSA
  • If you choose this plan, you’re not eligible to enroll in Preferred Choice, Traditional or Regence Expressions for 3 years

Opt-Out

  • If you have other dental coverage, you can opt-out of PEHP dental coverage in exchange for more money each paycheck
  • To opt-out, go to the Dental section of online enrollment. Click "Change" then select "Opt-Out" from the available plans
  • Income is subject to tax and counts toward other benefits like retirement, workers’ compensation, and LTD
  • If you waive PEHP dental coverage and don’t have other dental coverage, you will be eligible to reenroll in a PEHP dental plan only if you have proof of other dental coverage or at least 3 years have passed since you waived PEHP dental coverage.



Vision Plans

You get vision exams through your medical plan and shop for frames and lenses using pre-tax dollars. Or buy a vision plan to cover the bulk of vision costs.

If you're on the STAR HSA Plan, you get one annual vision exam covered at 100% before deductible.

If you're on the Traditional Plan, a vision exam costs only a $35 copay.

See vision rates

See Vision plans

Watch Opticare video

EyeMed info - use code EyeMedOE2020



Term Life & Accident Insurance

PEHP offers life and accident insurance plans to ensure your loved-ones are covered in the event of your death or disability. During this open enrollment you can get up to $200,000 of guaranteed issued life coverage. That means no examination and no questions for any new coverage up to $200,000. You can also get $50,000 of guaranteed issued life coverage for your spouse, and up to $15,000 guaranteed issued life coverage for your dependents. Additional coverage is available, but it must go through the usual underwriting process.  Learn more.



Savings Accounts

Health Savings Account

An HSA is like a flex account, but better. You never have to worry about forfeiting HSA money you don’ spend - it carries over year-to-year and employer-to-employer. Money goes in tax-and-FICA-free, grows tax-free, and can be used for eligible expenses tax-free. Your employer helps fund your HSA account. Use it to save for retirement and make penalty-free withdrawals after age 65. Contribute to your HSA with pre-tax money just like a 401(k), but, unlike a 401(k), your HSA contributions are exempt from FICA. To be eligible for a health savings account (HSA), the following things must apply:

  • You must enroll in an HSA-eligible medical plan, such as the STAR HSA Plan
  • You’re not covered by a general-purpose flex account (FSA) or HRA or the balance is $0 before you open an HSA
  • You’re not covered by another health plan (unless it’s another HSA-qualified plan)
  • You’re not covered by Medicare or TRICARE
  • You’re not a dependent of another taxpayer

HSA contribution limits for 2020

  • Single: $3,550
  • Double/Family: $7,100

Health Equity administers your HSA account. Health Equity will issue you a VISA card to pay for eligible expenses or you can submit your receipt to them and be reimbursed from your HSA account. Learn more.

Flexible Spending Account

FLEX$ is a flexible spending account that saves you money by setting aside a portion of your pre-tax salary to pay eligible expenses. There are two different FLEX$ accounts – one for medical expenses and another to help with dependent childcare costs – and each has important rules to keep in mind when using the benefit.

  • Great option to save for expenses if you’re not eligible for an HSA
  • If you have an HSA, you can have a limited FLEX$ account to pay for dental and vision expenses only
  • If you sign up for a FLEX$ account, PEHP will issue you a Mastercard to use as payment for eligible expenses.

You can contribute up to $2,750 in 2020

Learn more.

Health Reimbursement Account

An HRA is an employer-paid fund that reimburses you for qualified medical expenses for you and your dependents. The employer contribution is made twice per plan year. Funds are available by the end of July and January. However, unlike with an HSA, you can't make personal contributions to an HRA. PEHP will issue you a healthcare MasterCard from which to pay medical expenses. Or, you can submit claims and be reimbursed from your HRA.

If you are ineligible for a health savings account (HSA), your employer contribution will be deposited into a health reimbursement account (HRA) if you choose the STAR HSA Plan or Consumer Plus Plan.

For more information about FLEX$, HSAs, or HRAs, call 801-366-7503 or 800-753-7703