Health | Sparrow Health System Benefits

UM Health-Sparrow PPO Plus is a preferred provider organization (PPO) which allows Caregivers to have services performed either in or out of network.

Offers lower out-of-pocket costs (deductibles and copays) but has a higher monthly premium (payroll deduction) than University of Michigan Health Plan (UM Health Plan) PPO Base.

No co share on most services, including durable medical equipment, after the deductible is met. Four-tier prescription drug coverage.

Prescription drug network changing from Caremark/CVS to ESI/Express Scripts Network, including UM Health-Sparrow Pharmacies effective 1/1/25.

University of Michigan Health-Sparrow has chosen UM Health-Sparrow Specialty Pharmacy as the exclusive specialty pharmacy on our UM Health-Sparrow health insurance plans, administered by University of Michigan Health Plan (f.k.a. Physicians Health Plan). Starting January 1, 2025, you will need to use UM Health-Sparrow Specialty Pharmacy to fill your prescriptions for specialty medications.

Prescriptions can be purchased at any Express Scripts/ESI network pharmacy for the same copay as UM Health-Sparrow pharmacy locations.

UM Health-Sparrow PPO Base

UM Health-Sparrow PPO Base is a preferred provider organization (PPO) which allows Caregivers to have services performed either in or out of network.

Offers a lower monthly premium (payroll deduction) with higher out-of-pocket (deductible and copay) costs than University of Michigan Health Plan (UM Health Plan) PPO Plus.

Please see the Rate Sheet for a side-by-side plan comparison.

Higher deductible

Lower annual maximum out-of-pocket

Increase in some copays, including ER visits and High Tech Imaging

10% co-share on most services, including on durable medical equipment.

No co-share on in-patient hospitalization.

Four-tier prescription drug coverage.

Prescription drug network changing from Caremark/CVS to ESI/Express Scripts Network, including UM Health-Sparrow Pharmacies effective 1/1/25.

Prescriptions can be purchased at any Express Scripts/ESI network pharmacy, for the same copay as UM Health-Sparrow pharmacy locations

UM Health-Sparrow HDHP w/HSA

An account based medical plan.

Provides a Health Spending Account (HSA) that allows Caregivers to reimburse yourself for eligible expenses.

Sparrow contributes money to a Caregiver’s HSA account annually and Caregivers can choose to contribute on a pre-tax basis as well.

Caregivers own the money in their HSA accounts and they can take the money with them when they leave employment. HSA money at the end of the year rolls over to the next year.

This plan has a higher deductible, but after the deductible is met in network coverage is 100%, except for prescriptions.

Monthly premiums are less than the other plan options, gives Caregivers more control over how and when they spend their health care dollars and allows Caregivers to save – tax-free – for future health care expenses.

Sparrow employer contribution: $750 (single) or $1,500 (family); HSA Employer Contributions will be prorated monthly based on benefit effective date.

Employer Contributions as a result of open enrollment, or continued participation in the Sparrow Health HSA plan, will be processed after the first pay period in January. All other HSA Employer Contributions will be prorated monthly based on benefit effective date and deposited within 30 days of the benefit election date. Please contact HR for further details.

HSA enrollees are not eligible for the Health Care Flexible Spending Account.

Note: Health Savings Accounts are not available to Caregivers enrolled in a Health Care Flexible Spending Account. You also may not contribute to an HSA if you are enrolled in Medicare Part A and/or Part B.

Four-tier prescription drug coverage after deductible is met.

Caregivers electing HSA/FSA benefit options are responsible to manage compliance with IRS HSA/FSA rules. Note regarding contributions: Sparrow automatically makes a one-time annual employer contribution to your HSA account, pro-rated based on effective date. Caregivers are responsible for managing annual HSA/FSA contributions to ensure that the annual IRS limit is not exceeded. Caregivers who should find they have over-contributed in any calendar year would be responsible to request the HSA vendor to distribute any excess contributions from their account by April 15 of the subsequent year.

The IRS increased the minimum deductible amount for qualifying High Deductible Health Plans (HDHP) effective 1/1/25 from $1,600 Individual / $3,200 Family to $1,650 Individual /$3,300 Family. In order for the UM Health HSA Plan to remain a qualified HDHP allowing participants to contribute to their corresponding HSA account, the annual In-Network deductibles must change to the IRS minimum.

The good news is that the IRS also increased the annual contribution limit as well, increasing the Individual amount by $150 and the family amount by $250.

If you have a healthcare FSA in 2024 and are electing the Sparrow Health HSA plan for 2025, per the IRS you MUST use all of your 2024 healthcare FSA funds by 12/31/24 in order to open your HSA account January 1. Otherwise, the HSA account cannot be established until April 2025, which includes receipt of the employer contribution. Additionally, if your account is not established until April due to remaining 2024 FSA funds, any expenses incurred from January to March 2025 may not be paid for by funds from the HSA account.

2025 IRS HSA maximum contribution limits increased to: $4,300 (single) and $8,550 (family); Contribution limits include any employer contributions.

Prescription drug network changing from Caremark/CVS to ESI/Express Scripts Network, including UM Health-Sparrow Pharmacies effective 1/1/25.

Prescriptions can be purchased at any Express Scripts/ESI network pharmacy, for the same copay as UM Health-Sparrow pharmacy locations.

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