Page 6 - Thompson Coburn 2022 Beneftits Summary

2022 Medical Plan Design—Comparison Chart

Plan HDP Core Plan (Embedded) HDP Buy-up Plan (Non-Embedded)
Feature In-Network Out-of-Network In-Network Out-of-Network
Network UnitedHealthcare Choice Plus Network
Deductible (ded.) $3,000 per person $6,000 per person $1,400 single $2,800 single
(per calendar year) $6,000 per family* $12,000 per family* $2,800 per family* $5,600 per family*

Coinsurance 20% of eligible expenses 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the ded.
after the ded.
after the ded.
after the ded.
Out-of-pocket maximum
$8,000 per person
$6,000 per person
(per calendar year: $12,000 per family $12,000 per person $4,000 per person $16,000 per family
$8,000 per family
$24,000 per family
includes ded.)
Physician Visits
Primary care 20% of eligible expenses 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the ded.
after the ded.
after the ded.
after the ded.
Specialist 20% of eligible expenses 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the ded.
after the ded.
after the ded.
after the ded.
Preventive care Plan pays 100% Not covered Plan pays 100% Not covered
Virtual oice visits 20% of eligible expenses Not covered 20% of eligible expenses Not covered
after the ded.
after the ded.
Hospital Services
Hospital—inpatient stay 20% of eligible expenses 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the ded.
after the ded.
after the ded.
after the ded.
Outpatient surgery 20% of eligible expenses 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the ded.
after the ded.
after the ded.
after the ded.
Prescription medications—In-Network Coverage Only
You pay the discounted price of the prescription You pay the discounted price of the prescription
medications until you reach the combined medical/ medications until you reach the combined medical/
pharmacy ded.; after the ded. is met, you pay pharmacy ded.; after the ded. is met, you pay
20% of the discounted price until the out-of-pocket 20% of the discounted price until the out-of-pocket
maximum is met maximum is met
Emergencies
Emergency room service 20% of eligible expenses 20% of eligible expenses 20% of eligible expenses 20% of eligible expenses
after the ded.
after the ded.
after the ded.
after the ded.
Urgent care service 20% of eligible expenses 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the ded.
after the ded.
after the ded.
after the ded.
Qualities and Features
Same level of lexibility within the UHC Choice Plus network (same network of preferred providers, with
the option to choose providers outside of the network—generally out-of-pocket costs are lower when you
Flexibility to choose use an in-network provider); a complete list of providers in the UHC network can be found on the UHC
doctors website, www.myuhc.com; remember, if you can choose an in-network provider, you will receive the
highest level of beneits under the plan; you can still see a doctor who is outside the network, but your
services will be covered at a lower level of beneits
Control how healthcare More control—you are eligible to have an HSA allowing you to choose how to spend your healthcare
dollars are spent dollars
More awareness required
Consumer awareness (for example, research your healthcare options to determine the most cost-efective care)
Preventive care No cost when in-network providers are utilized
* Please see page 5 for deinitions of Embedded and Non Embedded.
Note: All oice visits, urgent care, emergency room, inpatient hospital stay, outpatient surgery, and deductibles apply towards the out-of-pocket
maximum. Preventive care does not apply towards the out-of-pocket maximum.

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