Medical insurance

The premium amounts shown above will be deducted from each of your first two paychecks per month.

Helpful links

• Medica price transparency
• Search networks and learn about medical plan
• Required dependent documentation

Enrolling in a medical plan

Most regular, full-time employees may enroll for benefit coverage to be effective on the first of the month following the first day of employment. Waiting periods and participation start dates can be found in the policy or collective bargaining agreement governing your employment.

Other employees may become eligible to enroll in the medical plan and HRA/VEBA due to provisions of the Affordable Care Act. If this applies to you, plan and enrollment information will be provided at the time you become eligible.

If you have questions about your eligibility for the medical plan, please contact the Benefits Office.

Plan design

The City of Minneapolis Medical Plan features one plan design with a choice of provider networks. The plan provides coverage for a wide range of covered services including physician services, hospital services and prescription drugs.

• Eligible preventive services are paid at 100%. Other covered services are subject to an annual deductible.
• The annual deductible is $2,000 for an individual and $4,000 for a family. A deductible is a fixed dollar amount you pay for covered services before your medical plan pays for anything during the plan year. Prescriptions are not counted toward the annual deductible.
• You will pay co-insurance of 20% of the cost for covered services received from network providers after you have met your deductible. Coinsurance is a percentage amount that you pay after a service has been provided and a claim has been processed.
• The out-of-pocket maximum is $3,000 for an individual and $6,000 for a family. An out-of-pocket maximum is the maximum limit of deductible, prescription co-pays, and coinsurance for covered services that you could pay each year. If you reach the out-of-pocket maximum, the City of Minneapolis Medical Plan will pay 100% of charges for covered services for the remainder of the calendar year.
• When you fill prescriptions at a retail pharmacy that participates in your provider network, you will be responsible to pay the pharmacy a copayment that varies depending on the category your medication is in:
  • Generic: $10 copayment
  • Preferred brand: $25 copayment
  • Non-preferred brand: $50 copayment

  Provider network options

  When you enroll, you must select one provider network from the available options to provide care for you and all dependents covered by your plan.

  Medica Choice ® Passport

  Consider selecting Medica Choice Passport if it's important to you to be able to see a wide range of providers without a referral.

  • Choice Passport is Medica's largest network and includes more than 95% of Minnesota hospitals and physicians. Mayo Clinic is included in this network.
  • You do not need a referral to see specialists in the network.
  • You do not need to designate a primary care clinic to enroll.

  Medica Elect ®

  Consider selecting the Medica Elect network if you'd prefer to designate a primary care provider to coordinate any specialty care you may need.

  • You must designate a primary care clinic from a participating care system when you enroll.
  • All family members must enroll in the Medica Elect network, but each may designate a different primary care clinic or care system within the network. You can change your primary care clinic designation as often as once a month by calling Medica Customer Service.
  • All of the Medica Elect care systems require a primary physician's referral in order for you to see specialists or facilities outside the care system.
  • You can use the list of clinics, below, to see if yours is covered in the Elect network and to get the 11 digit primary care clinic number:

  Accountable care organizations (ACOs)

  Consider selecting one of the ACO networks listed below if you already use the providers that participate and would like to receive more personalized care and services at a lower cost. When you enroll in an ACO network, you don't need to designate a primary care clinic or get a referral for specialty care, but you must get all your care from the ACO in order to receive in-network benefits.

  VantagePlus with Medica SM (ACO)

  • Includes physicians from M Health Fairview, North Memorial Health, and many popular independent clinics.
  • Special features include a personal welcome call if you're new to the plan; a single phone number for questions about your coverage or your care; a 24/7 nurse line; and multiple virtual care options, including 24/7/365 eVisits, video visits and online messaging with your care team through MyChart.

  Park Nicollet and HealthPartners Medical Group First with Medica SM (ACO)

  • Includes more than 50 neighborhood Park Nicollet clinics offering primary care, urgent care and specialty care, plus access to Park Nicollet Methodist Hospital, St. Francis Regional Medical Center and other network providers.
  • Special features include nationwide coverage when you travel, no referrals when visiting a Park Nicollet and HealthPartners Medical Group First provider, same-day primary care appointments plus weekend and evening hours, online diagnosis and treatment for 60 common conditions at Virtuwell.com, and nurse advisors you can reach 24/7/365.

  Ridgeview Community Network ® powered by Medica (ACO)

  • Includes all Ridgeview Clinics; Catalyst Medical Clinic; Lakeview Clinic, Ltd.; OBGYN West; South Lake Pediatrics; Wayzata Children's Clinic; and Western OBGYN, a division of Ridgeview Clinics; plus 150+ specialty care partnerships; and seven hospitals (Abbott Northwestern Hospital, Children's Minnesota, HCMC, Ridgeview Arlington Campus, Ridgeview Chaska Campus (Two Twelve Medical Center); Ridgeview Le Sueur Campus and Ridgeview Waconia Campus).
  • Special features include a navigator to answer questions about network providers, community services and wellness programs; five urgent care locations; convenient Saturday morning appointments at select clinics; free local home delivery of prescriptions from partner pharmacies; access to online care; and a free meet-and-greet provider visit.

  Clear Value with Medica SM

  • Includes providers and facilities from Hennepin Healthcare, an integrated system of care that includes a nationally recognized Level 1 adult and pediatric trauma center, as well as a clinic system with eight primary care clinics and 60 specialty clinics located in Minneapolis and across Hennepin County. When you enroll in this ACO, you may see any primary or specialty care provider in the Hennepin Healthcare network without a referral.
  • Also features convenient and quick access to same and next day care; on-site pharmacies and medication therapy management; concierge scheduling support; integrative health services - including acupuncture, chiropractic care, physical therapy and primary care -- offering whole-person, customized care to promote healing and well-being; and a secure online patient portal.

  Summary of Benefits and Coverage (SBC)

  As part of the Patient Protection and Affordable Care Act (PPACA) employers are required to provide a standard Summary of Benefits and Coverage (SBC) for each plan. Please note that the coverage examples presented on page 7 of the SBC use hypothetical costs to show how the plan works. The costs presented should not be interpreted as actual costs under the City of Minneapolis medical plan.