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Medical
The medical plans offered by the Company are designed to help protect you and your covered dependents against financial loss by paying for a substantial portion of eligible expenses incurred for medically necessary care and treatment. The medical plans are insured by UnitedHealthcare.
If you enroll for coverage within your initial eligibility period, your coverage will be effective on the first of the month following 30 days of employment.
If you do not enroll for coverage within your initial eligibility period, you may enroll for coverage during the next annual enrollment period or in accordance with the section entitled Making Changes During the Year.
Finding a Medical Provider
Click here to find a Doctor in your area and follow the steps below:
- Click on Medical Directory
- Click on All UnitedHealthcare Plans
- Click on the Choice Plus option for PPO & HSA plans
- Select Your Location: Zip Code, City & State
- Find your Health care by Category: (People, Places, Test and Imaging, Services and Treatments or Care by Condition)
Health Savings Account (HSA) Funding
If you enrolled in a medical plan with a Health Savings Account (HSA) – UHC plan 557 or UHC plan 552 – and qualify to open an HSA you may open the account through Optum Bank. Whether you are contributing to your HSA through a pretax payroll deduction or not, you are eligible to receive the employer contribution. However, you must open the HSA to receive the funds. To open an HSA, please click here and follow the instructions provided by Optum Bank. You may direct any questions to Optum Bank at 866.234.8913.
The Company will contribute towards the HSA on your behalf in the amount of:
- $25.00 per month for individual coverage
- $50.00 per month for 2-party or more coverage
The Company contribution is deposited semimonthly.
In addition to the Company contributions, you can contribute to the HSA. The total amount contributed to the HSA account (the Company contributions and your contributions) cannot exceed the IRS allowable amount for the 2018 calendar year of:
- $3,450 for individual coverage
- $6,850 for 2-party or more coverage
If you are age 55 or older you can also make catch-up contributions of $1,000 per year, in accordance with federal regulations.
Click here to watch a quick 2 minute video on the many benefits that come with having an HSA account. Learn about the three ways you can save on taxes and tips on HSA rules based on where you live.
When you sign up for your HSA, UnitedHealthcare will send you a packet of information on how to use your account. You will also receive a HSA debit card. Once your account is open and funded, you can use your new card to access your HSA funds.
HSA accounts are fully portable. This means that if you terminate employment with the Company, the money is yours and stays in your account until you use it, become deceased or close the account. Money in the HSA can be carried over to help save for medical expenses in subsequent years (such as retirement) and you can continue to contribute up to the maximum amount each year, as long as you remain eligible.
In subsequent years, if you decide not to enroll in a qualified high deductible health plan, you can continue to use your HSA for qualified medical expenses, but you will no longer be able to contribute to the HSA.
Find out if you qualify for an HSA - click here.
Your Cost
The Company and you share the cost of medical coverage. Your cost is generally deducted from your pay on a pretax basis. (Note: Coverage for domestic partners is generally deducted on an after-tax basis, unless otherwise permitted by state or federal law.) Refer to Employee Contributions for the applicable cost.
Summary of Benefits and Coverage
The Patient Protection and Affordable Care Act (also known as Health Care Reform) requires that you receive a Summary of Benefits and Coverage (SBC). The SBC is designed to help you understand and evaluate your health plan choices. To obtain a copy of the SBC for any of the Company-sponsored medical plans, please call the medical plan's member services department or contact HR/Benefits.
Medical Plan Key Features
The medical plans provide substantial benefit levels to protect you from catastrophic loss in the event of illness or injury. The following table summarizes the key features of the plans available to you and your dependents. To receive the highest level of benefits, you should use in-network providers and fully understand what is expected of you.
| Medical Plans (UnitedHealthcare) | ||||||||
|---|---|---|---|---|---|---|---|---|
Key Features |
Option 1 |
Option 2 |
Option 3 |
Option 4 |
||||
PPO (Plan 494) |
PPO (Plan 521) |
HDHP HSA (Plan 557) |
HDHP HSA (Plan 552) |
|||||
In-Network |
Out-of-Network |
In-Network |
Out-of-Network |
In-Network |
Out-of-Network |
In-Network |
Out-of-Network |
|
You pay |
You pay |
You pay |
You pay |
|||||
| Annual Deductible | ||||||||
| Individual | $500 |
$1,000 |
$1,000 |
$2,000 |
$2,700 |
$5,200 |
$3,000 |
$5,000 |
| Family | $1,000 |
$2,000 |
$2,000 |
$4,000 |
$5,400 |
$10,400 |
$6,000 |
$10,000 |
| Annual Out-of-Pocket Maximum | ||||||||
| Individual | $2,500 |
$5,000 |
$3,000 |
$6,000 |
$3,900 |
$10,400 |
$4,000 |
$6,000 |
| Family | $5,000 |
$10,000 |
$6,000 |
$12,000 |
$7,800 |
$20,800 |
$8,000 |
$12,000 |
| Physician Services | ||||||||
| Office visits | $20 copay |
40% after ded |
$15 copay |
30% after ded |
0% after ded |
20% after ded |
0% after ded |
20% after ded |
| Specialist visits | $20 copay |
40% after ded |
$15 copay |
30% after ded |
0% after ded |
20% after ded |
0% after ded |
20% after ded |
| Preventive Care | ||||||||
| Routine physical exams |
No copay |
Not covered |
No copay |
Not covered |
No copay |
Not covered |
No copay |
Not covered |
| Immunizations | No copay |
Not covered |
No copay |
Not covered |
No copay |
Not covered |
No copay |
Not covered |
| Well-woman exams |
No copay |
Not covered |
No copay |
Not covered |
No copay |
Not covered |
No copay |
Not covered |
| Hospital | ||||||||
| Inpatient hospital services |
20% after ded |
40% after ded |
10% after ded |
30% after ded |
0% after ded |
20% after ded |
0% after ded |
20% after ded |
| Emergency | ||||||||
| Hospital emergency room |
$100 copay |
$100 copay |
$100 copay |
$100 copay |
0% after ded |
0% after ded |
0% after ded |
0% after ded |
| Other Medical Services | ||||||||
| Laboratory and x-ray services |
No copay |
40% after ded |
10% after ded |
30% after ded |
0% after ded |
20% after ded |
0% after ded |
20% after ded |
| Imaging (MRI, CAT, PET scans) |
20% after ded |
40% after ded |
10% after ded |
30% after ded |
0% after ded |
20% after ded |
0% after ded |
20% after ded |
| Prescription Drugs (Retail) | ||||||||
| Tier 1 | $10 copay |
$10 copay |
$10 copay |
$10 copay |
$10 copay after ded |
$10 copay after ded |
$10 copay after ded |
$10 copay after ded |
| Tier 2 | $30 copay |
$30 copay |
$30 copay |
$30 copay |
$30 copay after ded |
$30 copay after ded |
$30 copay after ded |
$30 copay after ded |
| Tier 3 | $50 copay |
$50 copay |
$50 copay |
$50 copay |
$50 copay after ded |
$50 copay after ded |
$50 copay after ded |
$50 copay after ded |
| Prescription Drugs (Mail Order) | ||||||||
| Tier 1 | $25 copay |
Not covered |
$25 copay |
Not covered |
$25 after ded |
Not covered |
$25 after ded |
Not covered |
| Tier 2 | $75 copay |
Not covered |
$75 copay |
Not covered |
$75 after ded |
Not covered |
$75 after ded |
Not covered |
| Tier 3 | $125 copay |
Not covered |
$125 copay |
Not covered |
$125 after ded |
Not covered |
$125 after ded |
Not covered |
This summary is provided for general information only. Refer to the specific plan documents available on the Forms and Downloads page for detailed information and complete plan provisions, exclusions and limitations. |