Page 5 - 2016 Enrollment
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2016 Medical Plan Design
Comparison Chart
Plan POS Plan HDP
Feature In-Network Out-of-Network In-Network Out-of-Network
Network UnitedHealthcare Choice Plus POS Network
Deductible $750 per person $1,500 per person $2,750 per person $5,500 per person
(per calendar year) $1,500 per family* $3,000 per family * $5,500 per family * $11,000 per family *
Coinsurance 20% of eligible expenses 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the deductible after the deductible after the deductible after the deductible
Out-of-pocket maximum $3,500 per person $7,000 per person $5,500 per person $11,000 per person
(per calendar year: $7,000 per family $14,000 per family $11,000 per family $22,000 per family
includes deductible)
Physician Visits
Primary care $25 copay 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the deductible after the deductible after the deductible
Specialist $35 copay 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the deductible after the deductible after the deductible
Preventive care Plan pays 100% Not covered Plan pays 100% Not covered
Virtual ofice visits $25 copay Not covered 20% of eligible expenses Not covered
after the deductible
Hospital Services
Hospital—inpatient stay $300 copay per stay; 20% 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
of eligible expenses after after the deductible after the deductible after the deductible
deductible
Outpatient surgery $200 copay per date of 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
service; 20% of eligible after the deductible after the deductible after the deductible
expenses after deductible
Prescription medications—In-Network Coverage Only
You pay the discounted price of the prescription medications You pay the discounted price of the prescription
until you reach the combined medical/pharmacy deductible. medications until you reach the combined medical/
After the deductible is met you pay 20% of the discounted pharmacy deductible. After the deductible is met you
price until the out-of-pocket maximum is met. pay 20% of the discounted price until the out-of-pocket
maximum is met.
Emergencies
Emergency room service $250 per visit $250 per visit 20% of eligible expenses 20% of eligible expenses
after the deductible after the deductible
Urgent care service $75 per visit 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the deductible after the deductible after the deductible
Qualities and Features POS Plan HDP
Cost Higher medical premium cost but lower deductible Lower medical premium cost but higher deductible
Flexibility to choose Same level of lexibility with the Choice Plus POS network (same network of preferred providers, with the option
doctors to choose providers outside of the network—generally out-of-pocket costs are lower when you use an in-network
provider). A complete list of providers in the UHC network can be found on the UHC 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 over how Some control More control—you are eligible to have an HSA allowing
healthcare dollars are you to choose how to spend your healthcare dollars.
spent
Consumer awareness Some awareness required since you are responsible for More awareness required (for example, research your
expenses that apply to the deductible and out-of-pocket healthcare options to determine the most cost-effective
maximum. care since the deductibles and out-of-pocket maximums
are higher under the HDP).
Preventive care No cost when in-network providers are utilized
* Both the POS Plan and the HDP Plan are embedded. This means if you are covering dependent(s) on either plan, only one
person is required to reach the single deductible (or out-of-pocket maximum) before coinsurance is applied for that person.
Note: all ofice visit, urgent care, emergency room, inpatient hospital stay, outpatient surgery copays,
and deductibles apply towards the out-of-pocket maximum.
2016 Benefits Guide
2016 Medical Plan Design
Comparison Chart
Plan POS Plan HDP
Feature In-Network Out-of-Network In-Network Out-of-Network
Network UnitedHealthcare Choice Plus POS Network
Deductible $750 per person $1,500 per person $2,750 per person $5,500 per person
(per calendar year) $1,500 per family* $3,000 per family * $5,500 per family * $11,000 per family *
Coinsurance 20% of eligible expenses 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the deductible after the deductible after the deductible after the deductible
Out-of-pocket maximum $3,500 per person $7,000 per person $5,500 per person $11,000 per person
(per calendar year: $7,000 per family $14,000 per family $11,000 per family $22,000 per family
includes deductible)
Physician Visits
Primary care $25 copay 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the deductible after the deductible after the deductible
Specialist $35 copay 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the deductible after the deductible after the deductible
Preventive care Plan pays 100% Not covered Plan pays 100% Not covered
Virtual ofice visits $25 copay Not covered 20% of eligible expenses Not covered
after the deductible
Hospital Services
Hospital—inpatient stay $300 copay per stay; 20% 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
of eligible expenses after after the deductible after the deductible after the deductible
deductible
Outpatient surgery $200 copay per date of 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
service; 20% of eligible after the deductible after the deductible after the deductible
expenses after deductible
Prescription medications—In-Network Coverage Only
You pay the discounted price of the prescription medications You pay the discounted price of the prescription
until you reach the combined medical/pharmacy deductible. medications until you reach the combined medical/
After the deductible is met you pay 20% of the discounted pharmacy deductible. After the deductible is met you
price until the out-of-pocket maximum is met. pay 20% of the discounted price until the out-of-pocket
maximum is met.
Emergencies
Emergency room service $250 per visit $250 per visit 20% of eligible expenses 20% of eligible expenses
after the deductible after the deductible
Urgent care service $75 per visit 40% of eligible expenses 20% of eligible expenses 40% of eligible expenses
after the deductible after the deductible after the deductible
Qualities and Features POS Plan HDP
Cost Higher medical premium cost but lower deductible Lower medical premium cost but higher deductible
Flexibility to choose Same level of lexibility with the Choice Plus POS network (same network of preferred providers, with the option
doctors to choose providers outside of the network—generally out-of-pocket costs are lower when you use an in-network
provider). A complete list of providers in the UHC network can be found on the UHC 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 over how Some control More control—you are eligible to have an HSA allowing
healthcare dollars are you to choose how to spend your healthcare dollars.
spent
Consumer awareness Some awareness required since you are responsible for More awareness required (for example, research your
expenses that apply to the deductible and out-of-pocket healthcare options to determine the most cost-effective
maximum. care since the deductibles and out-of-pocket maximums
are higher under the HDP).
Preventive care No cost when in-network providers are utilized
* Both the POS Plan and the HDP Plan are embedded. This means if you are covering dependent(s) on either plan, only one
person is required to reach the single deductible (or out-of-pocket maximum) before coinsurance is applied for that person.
Note: all ofice visit, urgent care, emergency room, inpatient hospital stay, outpatient surgery copays,
and deductibles apply towards the out-of-pocket maximum.
2016 Benefits Guide
