Medical Benefits

An HMO is a managed care program that provides a wide range of healthcare services through an organized network of physicians and hospitals. You are required to select a primary care physician (PCP), from the Keystone network to guide your care. Referrals from the PCP are required for specialist visits.

Under the HMO plan, most services are paid at 100% with no deductibles or 100% after a small co-payment for physician visits. Referrals from the PCP are required for specialist visits. For more details, please review the Summary of Benefits Coverage for the HMO plan. 

If you will be traveling out of the area for at least 90 days, please click here for more information about HMO Guest Membership

The PPO plan provides you in and out of network benefits
and allows you to select your own doctors and hospitals. You
do not need to select a Primary Care Physician and referrals
are not required. By staying in the Blue Cross network you
will maximize your benefits. However, if you choose to see an
out-of-network provider, you will incur higher out-of pocket
costs. Premium costs in the PPO plan will be higher than the
HMO but network flexibility will be greater.

For more details, please review the Summary of Benefits
Coverage for the PPO plan.

The CDHP plan is similar to the PPO plan in that it provides you in and out of network benefits and allows you to select your own doctors and hospitals. You do not need to select a Primary Care Physician and referrals are not required. By staying in the Blue Cross network you will maximize your benefits. However, if you choose to see an out-of-network provider, you will incur higher out-of pocket costs. The CDHP with Health Savings Account (HSA) is a different approach to how you pay for today’s health care and save for your future. It is a lower-premium, high-deductible health insurance plan, which means you pay less out of your paycheck for premiums and more out of pocket at the point of service—before the plan pays for services that are not considered preventive. Villanova’s CDHP meets the minimum federal requirements that allow an enrollee to also qualify for a tax-advantaged HSA.

For more details, please review the Summary of Benefits Coverage for the CDHP plan.

1. What is this Form 1095-C?
The 1095-C is a new tax form that is sent to you by Villanova that includes information about your healthcare insurance coverage. All full-time benefit eligible faculty and staff will receive this form. It serves as a “proof of insurance statement” that shows the IRS that you have been properly covered by Villanova. You’ll take information from it to use in your tax filing, similar to how you take information from your W-2 form and transfer it to your tax forms.

You can see what the 1095-C looks click here.

2. Why am I even receiving a Form 1095-C?
You’re receiving it because it’s required that you get it as part of the new healthcare law, the Affordable Care Act.

3. When will I receive my Form 1095-C?
You should receive your 1095-C form in February.

4. What will I need to do with my Form 1095-C?
As mentioned in the previous question, your 1095-C will contain information that you will transfer to your 1040, 1040A or 1040EZ tax form. You do not need to submit the 1095-C form with your 1040. In fact, most people will only have to check a box on their 1040s stating that they (and their dependents if applicable) were covered by Villanova for the year.

5. Where can I get more information about the Form 1095-C?
You can find more Form 1095-C information here on the IRS website: https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Understanding-Form-1095C.

You can also view a brief video regarding this form by visiting https://villanovauniversity.a.guidespark.com/videos/44141

6. Who can I contact if I have questions?
Please contact the Human Resources Department at 610-519-7900.

Keystone Health Plan (HMO)

Personal Choice (PPO and CDHP)

Amerihealth HMO