Medical
Having medical coverage provides you and your family with some financial protection in the event of illness or injury. You have three medical plan options to choose from and the coverage offered by the Firm provides access to health care through UnitedHealthcare and includes:
- In-network preventive care covered at 100 percent with no copay or coinsurance.
- Access to providers in the UnitedHealthcare Choice Plus network and the United Behavioral Health network.
- United Healthcare Advocates to answer questions about your care or claims.
- In-network telehealth visits for preventive or acute care at no cost to you.
- Additional support programs such as Maternity Support and Substance Use Disorder Helpline.
To find a UnitedHealthcare provider or to learn if your physician is in the UnitedHealthcare Choice Plus network, contact UnitedHealthcare at 844-637-7501.
Prescription Drugs
Optum Rx manages the prescription drug program for all three plan options. The amount you pay for prescriptions depends upon which coverage option you choose, the type of drug your doctor prescribes and where you get your prescription filled. Remember that if you choose one of the HSA Plan Options, you will pay the full cost of prescriptions until you meet your deductible. You may also sign up for OptumRx mail service to have your prescriptions sent right to your home.
You will receive one insurance card for both medical and prescription drug coverage.
myUHC.com provides you access to the tools and information you need at any time. You can access in-network physicians, review your Explanation of Benefits, access telehealth services, compare medication pricing and options, view your prescription history and more!
PPO Plan
Medical Benefit Highlights
In-Network
Deductible (Individual/Family)
$5,000 / $10,000
Out-of-Pocket Max (Individual/Family)
$6,850 / $13,700
Preventive Care
$0
Primary Care Visit
$30 copay per visit for the first 4 visits; then 20%* for all other visits in the same year
Specialist Visit
$75 copay per visit for the first 4 visits; then 20%* for all other visits in the same year
Urgent Care
$50 copay per visit for the first 4 visits; then 20%* for all other visits in the same year
Emergency Room
20%*
* After deductible
Out-of-Network
Deductible (Individual/Family)
$10,000 / $20,000
Out-of-Pocket Max (Individual/Family)
$12,500 / $25,000
Preventive Care
50%
Primary Care Visit
50%
Specialist Visit
50%
Urgent Care
50%
Emergency Room
20%
Prescription Benefit Highlights
In-Network
Retail Rx (Up to 30-Day Supply)
Tier 1 (Generic)
$10**
Tier 2 (Brand Preferred)
$35**
Tier 3 (Brand Non-Preferred)
$125**
Tier 4 (Specialty)
$250**
Mail-Order Rx (Up to 90-Day Supply)
Tier 1 (Generic)
$25**
Tier 2 (Brand Preferred)
$87.50**
Tier 3 (Brand Non-Preferred)
$312.50**
Tier 4 (Specialty)
$625**
** After the Annual Pharmacy Deductible has been met.
Out-of-Network
Retail Rx (Up to 30-Day Supply)
Tier 1 (Generic)
$10**
Tier 2 (Brand Preferred)
$35**
Tier 3 (Brand Non-Preferred)
$125**
Tier 4 (Specialty)
$250**
Mail-Order Rx (Up to 90-Day Supply)
Tier 1 (Generic)
Not covered
Tier 2 (Brand Preferred)
Not covered
Tier 3 (Brand Non-Preferred)
Not covered
Tier 4 (Specialty)
Not covered
Gold HSA Plan
Medical Benefit Highlights
In-Network
Deductible (Individual/Family)
$3,400 / $6,800
Out-of-Pocket Max (Individual/Family)
$4,000 / $8,000
Preventive Care
$0
Primary Care Visit
10%*
Specialist Visit
10%*
Urgent Care
10%*
Emergency Room
10%*
* After deductible
Out-of-Network
Deductible (Individual/Family)
$8,000 / $16,000
Out-of-Pocket Max (Individual/Family)
$10,000 / $20,000
Preventive Care
40%*
Primary Care Visit
40%*
Specialist Visit
40%*
Urgent Care
40%*
Emergency Room
10%*
Prescription Benefit Highlights
In-Network
Retail Rx (Up to 30-Day Supply)
Tier 1 (Generic)
$10**
Tier 2 (Brand Preferred)
$35**
Tier 3 (Brand Non-Preferred)
$125**
Tier 4 (Specialty)
$250**
Mail-Order Rx (Up to 90-Day Supply)
Tier 1 (Generic)
$25**
Tier 2 (Brand Preferred)
$87.50**
Tier 3 (Brand Non-Preferred)
$312.50**
Tier 4 (Specialty)
$625**
** After the Annual Pharmacy Deductible has been met.
Out-of-Network
Retail Rx (Up to 30-Day Supply)
Tier 1 (Generic)
$10**
Tier 2 (Brand Preferred)
$35**
Tier 3 (Brand Non-Preferred)
$125**
Tier 4 (Specialty)
$250**
Mail-Order Rx (Up to 90-Day Supply)
Tier 1 (Generic)
Not covered
Tier 2 (Brand Preferred)
Not covered
Tier 3 (Brand Non-Preferred)
Not covered
Tier 4 (Specialty)
Not covered
Silver HSA Plan
Medical Benefit Highlights
In-Network
Deductible (Individual/Family)
$6,000 / $11,500
Out-of-Pocket Max (Individual/Family)
$6,650 / $13,000
Preventive Care
$0
Primary Care Visit
20%*
Specialist Visit
20%*
Urgent Care
20%*
Emergency Room
20%*
* After deductible
Out-of-Network
Deductible (Individual/Family)
$10,000 / $20,000
Out-of-Pocket Max (Individual/Family)
$20,000 / $40,000
Preventive Care
50%*
Primary Care Visit
50%*
Specialist Visit
50%*
Urgent Care
50%*
Emergency Room
20%*
Prescription Benefit Highlights
In-Network
Retail Rx (Up to 30-Day Supply)
Tier 1 (Generic)
$10**
Tier 2 (Brand Preferred)
$35**
Tier 3 (Brand Non-Preferred)
$125**
Tier 4 (Specialty)
$250**
Mail-Order Rx (Up to 90-Day Supply)
Tier 1 (Generic)
$25**
Tier 2 (Brand Preferred)
$87.50**
Tier 3 (Brand Non-Preferred)
$312.50**
Tier 4 (Specialty)
$625**
** After the Annual Pharmacy Deductible has been met.
Out-of-Network
Retail Rx (Up to 30-Day Supply)
Tier 1 (Generic)
$10**
Tier 2 (Brand Preferred)
$35**
Tier 3 (Brand Non-Preferred)
$125**
Tier 4 (Specialty)
$250**
Mail-Order Rx (Up to 90-Day Supply)
Tier 1 (Generic)
Not covered
Tier 2 (Brand Preferred)
Not covered
Tier 3 (Brand Non-Preferred)
Not covered
Tier 4 (Specialty)
Not covered