Mental Health Resource Guide
Health system benefits for employees
Medical plan coverage
The health system offers two plans for medical coverage to its employees: the HSA Advantage Plan and Signature Plan. Learn more about our benefits here.
When employees enroll in benefits, they may enroll for employee-only, employee-plus spouse, employee-plus children or family coverage. The charts below will help you understand the coverage provided by the health system plans for you and, if enrolled, your dependents
Note
Health system physicians are offered different medical plan coverage and should consult their benefits guide for details.
HSA Advantage Plan Signature Plan Health system network In-network* Out-of-network Health system network In-network* Out-of-network Annual deductible $1,800 individual $3,600 family $4,000 individual $8,000 family $6,400 individual $12,800 family $500 individual $1,000 family $2,000 individual $4,000 family $4,000 individual $8,000 family Annual maximum out-of-pocket costs $4,500 individual $9,000 family $6,000 individual $9,200 family $19,800 individual $39,600 family $4,500 individual $9,000 family $6,000 individual $12,000 family $10,500 individual $21,000 family Member coinsurance You pay 10%; You pay 30%; You pay 40%; You pay 10%; You pay 30%; You pay 40%; At the doctor’s office Routine preventive care You pay $0; You pay $0; 40% coinsurance after deductible You pay $0; You pay $0; 40% coinsurance Primary care 10% coinsurance 30% coinsurance after deductible 40% coinsurance after deductible $20 copay $30 copay 40% coinsurance Specialist 10% coinsurance after deductible 30% coinsurance after deductible 40% coinsurance after deductible $40 copay $60 copay 40% coinsurance Urgent care 10% coinsurance 30% coinsurance after deductible 40% coinsurance after deductible $40 copay $60 copay 40% coinsurance At the hospital Emergency 10% coinsurance after deductible 30% coinsurance after deductible 30% coinsurance after deductible** 10% coinsurance after deductible 30% coinsurance after deductible 30% coinsurance after deductible** Inpatient services Outpatient services 10% coinsurance 30% coinsurance after deductible 40% coinsurance after deductible 10% coinsurance 30% coinsurance 40% coinsurance after deductible Other medical benefits Outpatient therapy (speech, hearing, PT, OT) High-tech radiology (MRI, CT, PET scan) 10% coinsurance after deductible 30% coinsurance after deductible 40% coinsurance after deductible 10% coinsurance after deductible 30% coinsurance after deductible 40% coinsurance Mental health & substance use Inpatient services^ 10% coinsurance after deductible 30% coinsurance after deductible 40% coinsurance after deductible 10% coinsurance after deductible 30% coinsurance after deductible 40% coinsurance Outpatient services^^ 10% coinsurance 30% coinsurance after deductible 40% coinsurance after deductible $20 copay for office visits; all other services $30 copay for office visits; 30% coinsurance after deductible for all other services 40% coinsurance after deductible Pharmacy Prescription medication coverage is a big factor in choosing a medical plan. Review the Prescription drug coverage section for important details on prescription drug coverage for each plan. *In-network providers are part of either HCH Sync Centrus local network or Aetna nationwide network (outside the designated local network only). **To ensure access to emergency care, coinsurance for qualified ER visits applied after deductible is met for in-network care. ^ Preauthorization required; coverage of room and board may be denied. ^^Preauthorization required for ABA therapy.
plan pays 90%
plan pays 70%
plan pays 60%
plan pays 90%
plan pays 70%
plan pays 60%
plan pays 100%
plan pays 100%
plan pays 100%
plan pays 100%
after deductible
after deductible
after deductible
after deductible
after deductible
after deductible
Department
after deductible
after deductible
after deductible
after deductible
after deductible
after deductible
100% covered
Note
If you have additional questions about your coverage of mental health, behavioral health or substance abuse services, email BenefitsConnection@kumc.edu or call 888-494-9119.
FMLA Leave of Absence
The Family and Medical Leave Act (FMLA) provides eligible employees up to 12 weeks of unpaid leave in a rolling 12-month period.
- To qualify, you must have been employed for 12 months and worked at least 1,250 hours in the 12 months directly preceding your leave.
- Mental health conditions may meet the qualifying reasons for FMLA leave if they are considered serious and require inpatient care or continuing treatment by a healthcare provider. Inpatient care includes an overnight stay in a hospital or other medical care facility, such as a treatment center for addiction or eating disorders.
- You may be required to submit a certification from a healthcare provider to support your need for FMLA leave, but a diagnosis is not required.
Personal Medical Leave is available to employees who are not eligible for or who have exhausted their FMLA leave entitlement.
- Mental health conditions may qualify for Personal Medical Leave if approved as a disability qualifying for short-term disability benefits, or if the employee’s health care provider establishes the need for leave for the employee’s condition.
Both FMLA leave and Personal Medical Leave may be taken on either a continuous or intermittent basis, depending on what your provider has documented.
Employees with a legacy sick leave balance or those acquired as a result of an integration may have their sick leave balance transferred to a legacy Extended Illness Reserve (EIR) account.
The health system will give you the option to use your available paid time off (PTO)/EIR during approved FMLA leave and/or Personal Medical Leave.
- While you are on approved FMLA leave and/or Personal Medical Leave, your accrued PTO/EIR will automatically be applied to your timecard. Any paid leave taken for this reason will be designated as FMLA leave (if available) and counted toward the total amount of FMLA entitlement you have available to use in the applicable 12-month period.
- If you do not want to use your PTO/EIR while on leave, you must notify Human Resources at AskHR@kumc.edu or 913- 945-6500 before the date your PTO/EIR would be used.
- If you qualify for short-term disability, your PTO will be adjusted to account for the short-term disability benefit. When utilizing the short-term disability benefit, your pay cannot exceed 100% of your base hourly rate.
Before returning to work, you will need to submit a completed Return to Work form to Employee Health before your return. This form will indicate whether you have any restrictions upon returning to work or if you are fully cleared to return.
Learn more about leaves of absence, including FMLA leave, and submitting a leave of absence request here. If you have questions, contact the HR Support Center at 913-945-6500 or AskHR@kumc.edu.