Health
Medical
Medical coverage to protect you and your family for everyday care and unexpected expenses.
You’re eligible to enroll in medical coverage if you’re a full-time employee, or a part-time employee working at least 30 hours per week.
You have three plans to choose from through United Healthcare (UHC):
- HDHP 1
- HDHP 2
- PPO
Understanding your medical plan options
This page reflects in-network coverage only. For out-of-network details, see the plan documents. [NEED LINK]
How the plans differ
The choice comes down to how you would rather pay.
- A PPO has higher premiums but fixed copays for office visits and prescriptions. Your costs are more predictable.
- An HDHP (either one) has lower premiums. You pay coinsurance for care until you meet your deductible, so your monthly cost is lower but your out-of-pocket cost rises with use.
- All three plans can be paired with a health care flexible spending account, but only the HDHP plans can be paired with a Health Savings Account.
Before you choose, consider
- Your total cost: premiums per paycheck plus the out-of-pocket expenses you expect this year.
- Whether your doctor is in network. Check at myuhc.com. Out-of-network care costs more or isn’t covered.
- The cost of the care and prescriptions you expect to use.
- Whether adding Accident or Critical Illness coverage would help offset out-of-pocket costs.
Contact:
United Healthcare
Medical insurance
800-444-6222
Resources:
Reminder:
UHC ID cards are digital only & available in the UHC app.
Deductibles and out-of-pocket maximums (in-network)
The deductible is the amount you pay before the plan starts to pay. The out-of-pocket maximum is the most you’ll pay for covered expenses each plan year. These reset annually on January 1.
There are two deductible types for family coverage:
- Non-embedded (HDHP 1 and HDHP 2): your whole family’s costs count toward one family deductible. The plan does not start sharing costs for anyone until the full family deductible is met.
- Embedded (PPO): as soon as one family member meets the individual deductible, the plan starts sharing that person’s costs, even before the family deductible is met.
| HDHP 1 | HDHP 2 | PPO | |
|---|---|---|---|
| Deductible type | Non-embedded | Non-embedded | embedded |
| Deductible, individual | $1,700 | $4,000 | $1,500 |
| Deductible, family | $3,400 | $8,000 | $3,000 |
| Out-of-pocket max, individual | $3,400 | $6,250 | $2,500 |
| Out-of-pocket max, family | $6,800 | $12,500 | $3,500 |
What you will pay for care (in-network)
Once you meet the deductible, the plan shares the cost of care with you. You'll pay either a percentage of the cost, called coinsurance, or a fixed-rate fee, called a copay.
| Service | HDHP 1 | HDHP 2 | PPO |
|---|---|---|---|
| Preventive care | No charge | No charge | No charge |
| Primary care visit | 20% | 20% | $25 copay |
| Specialist | 20% | 20% | $45 copay |
| Virtual visit | $5 copay | $5 copay | $5 copay |
| Urgent care | 20% | 20% | $50 |
| Emergency room | 20% | 20% | $250 |
| Outpatient, inpatient, lab, X-ray | 20% | 20% | 10% |
Prescriptions
On the HDHP plans, you pay the full cost of prescriptions until you meet your deductible, then these copays apply. On the PPO, the copays apply right away.
| Drug tier | Retail (30-day supply) | Mail Order (90-day-supply) |
|---|---|---|
| Tier 1 | $10 | 2.5x the copay |
| Tier 2 | $35 | 2.5x the copay |
| Tier 3 | $60 | 2.5x the copay |
Cost for coverage
You pay monthly premiums for medical coverage through payroll deductions. The amount you pay in premiums depends on which plans you choose and who you cover.
How to enroll
You can enroll in medical coverage in ADP within 30 days of your hire date or qualifying life event.
Coverage starts the first of the month after your hire date.
Using your medical plan
- Find a provider: go to myuhc.com, choose Find a Doctor, and search the Choice Plus network.
- Your ID card is digital. Access it in the UHC app.
- Virtual visits are available 24/7 for minor illnesses, with a $5 copay on every plan.
- Your plan includes wellness rewards, an EAP, and more. See UHC Member Programs.
Benefits Questions?
Contact your HR Team:
ADP Portal
Secure access to your benefits information.