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Medical 2026

Note: The information provided on this page is intended to assist you with making decisions on your open enrollment selections. When you are ready to make your selections, you will do so on FlashLine. 

Medical Mutual will continue as administrator of Á½ÐÔÉ«Îçҹ’s Employee health insurance plans for 2026. They have provided a , where you can search for , read frequently asked questions, watch videos regarding Medical Mutual online tools and resources and more.

As a full-time, benefits-eligible employee you have a choice of the 85/60 PPO or the High Deductible Health Plan (HDHP) for 2026. As in 2025, both plans include Prescription and Vision coverage in their premiums, and both plans include preventive care covered at 100% with in-network providers – NO COST to you! Some examples of preventive care services (PDF) are annual exams, immunizations and preventive screenings. 

85/60 Health Plan

The 85/60 health insurance plan offers a lower deductible, but a higher monthly premium. The plan covers preventive annual exams, immunizations, and preventive screenings at no cost to the employee. For additional plan details, open the drop-down menu below.

Coverage Highlights of the 85/60 PPO PLAN

As we approach the beginning of Open Enrollment, some plan information below may change. Complete information will be available by Oct. 13.

  • Preventive care is covered 100% with in-network providers
  • Higher monthly premiums
  • Deductible for in-network providers: $300 for single coverage and $600 for family coverage.
  • Coinsurance for in-network providers: 15%
  • Office co-pays for non-preventive healthcare services:
    • $15 for primary care doctors
    • $30 for specialists
    • Co-pays do not go toward meeting your deductible
  • Out of Pocket Maximum for in-network providers
    • $1,500 for single coverage ($1,200 KSUFA)
    • $3,000 for family coverage ($2,400 KSUFA)
  • Optional Healthcare FSA and/or Dependent Care FSA
    • Contribution is taken pre-tax
    • Full amount is front-loaded at the start of the plan year
    • No employer contribution
    • Amounts cannot be changed during the plan year unless a qualifying event occurs
    • Use it or Lose it
      • Funds must be used by March 15, 2027
      • Leftover money will be lost

High Deductible Health Plan (HDHP)

The High Deductible Health Plan (HDHP) has a higher deductible and lower monthly premiums than a typical health plan like the university’s 85/60 PPO plan. If you would typically choose your health plan by premium cost, be sure you understand the tradeoff for a lower monthly premium. The HDHP requires you or your family to pay the full cost of your health care, including your medications, until you reach a fixed dollar amount. This is called your plan’s annual deductible. For HDHP plan highlights, open the drop-down menu below.

Coverage Highlights of the High Deductible Health Plan (HDHP)

As we approach the beginning of Open Enrollment, some plan information below may change. Complete information will be available by Oct. 13.

  • Preventive care is covered 100% with in-network providers
  • Lower monthly premiums
  • Deductible for in-network providers: $3,400 for single coverage and $5,400 for family coverage.
  • No Coinsurance for in-network providers
  • No Co-pay
  • Opportunity to invest in a Health Savings Account (HSA)
    • Contribution is taken pre-tax
    • Á½ÐÔÉ«ÎçÒ¹ contributes to all employee HSAs:
      • $1,300 for single coverage
      • $2,000 for family coverage
      • available after the first payroll of the year!
    • Funds roll over year-to-year
    • Savings can be invested for greater potential growth
  • Optional Dependent Care FSA
  • Preventive Therapy Drug List (PDF) 
How does my prescription coverage work when enrolled in the High Deductible Health Plan (HDHP)?

When enrolled in the High Deductible Health Plan, you will be charged the full negotiated price for your prescriptions until your HDHP annual deductible is met, unless those medications are on the Preventative Drug List. Any money paid toward prescriptions will count towards meeting your annual deductible. The prescription co-insurance will apply only after your deductible is met (see below).

  • 10% coinsurance of the negotiated price for generic medications
  • 20% coinsurance of the negotiated price for brand-name prescriptions when a generic equivalent is not available
  • 40% coinsurance of the negotiated price for brand-name prescriptions when a generic equivalent is available

Other Plan Information

Pre-Tax Working Spouse/Domestic Partner Fee

Those employees providing medical coverage to a spouse or domestic partner may be subject to the Working Spouse/Domestic Partner fee. This will automatically be added to your health insurance payroll deduction each pay. The fee may be waived if your spouse/partner meets any of the following criteria:

  • If your partner is also employed at Á½ÐÔÉ«ÎçÒ¹ University.
  • If your partner is retired, unemployed or is self-employed.
  • If your partner does not have health coverage available through their employer
  • If your partner is employed part-time

The Affidavit of Spousal/Domestic Partner Insurance Status form (PDF) must be submitted annually by all employees providing medical coverage to a spouse or domestic partner. The deadline to submit this form is November 21, 2025.

PLEASE NOTE: If your spouse/partner meets any of the fee waiver criteria, and the form is not received by the Employee Benefits Office by November 21, the fee will be added to your 2026 pay until the form is received. Any surcharge taken prior to submission of the form will not be refunded.

For complete information, visit the Working Spouse/Domestic Partner Fee webpage.

Flexible Spending Account (FSA) and Health Savings Account (HSA)

What is the difference between HSA and FSA accounts?

ConsiderationHSA (Health Savings Account)FSA (Flexible Spending Account)
Eligibility

Must enroll in a High Deductible Health Plan

Cannot contribute to an HSA if enrolled in Medicare

You cannot enroll in an FSA Medical Account if you have an HSA. 

You can still participate in FSA Dependent Care if you have an HSA.

Contribution Limit

$4,400 single or $8,750 family (2026)

*amounts include an employer contribution

Medical FSA:    $3,300 single or family (2026)

Dependent Care FSA ("daycare"):   $7,500

Change ContributionsAnytime throughout the yearOnly during open enrollment or life status change
Rollover

Unused balances roll over

NOTE: You must re-enroll each year.

Use it or lose it. Funds must be used by March 15 of the following year unless separating from the university. If separating, must be used within 30 days.

NOTE: You must re-enroll each year.

TaxesPre-tax deductionPre-tax deduction

For complete information, visit the FSA and HSA webpage.

Opting Out of Á½ÐÔÉ«ÎçÒ¹ Coverage

I have other insurance. Can I opt out of Á½ÐÔÉ«ÎçÒ¹ coverage?

Sometimes employees have other insurance through their parents or a spouse/domestic partner. If you have other insurance, you are welcome to opt out of university coverage, and you might even be eligible for opt-out incentive payments of $50 per pay (up to $100 per month).

Remember that opting out means that you chose not to receive the medical, vision, prescription, and dental benefits through Á½ÐÔÉ«ÎçÒ¹. To receive the cash incentive, you will need to submit an affidavit of alternate coverage every year. Also, please note: if you are covered by Á½ÐÔÉ«ÎçÒ¹'s insurance, even if you are not the policyholder, you are not eligible for the incentive payment.

If I opt out of coverage through Á½ÐÔÉ«ÎçÒ¹, then lose insurance, what then?

If you opt out and lose insurance coverage during the plan year, you can enroll in Á½ÐÔÉ«ÎçÒ¹'s plans under a Qualifying Event. Contact us at benefits@kent.edu within 31 days of the qualifying event to enroll or make any necessary changes to your benefits.

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