Page 5 - Pathway EE Guide OOS 06-17
P. 5

BENEFITS





         Medical Insurance


         Pathway  offers  all  regular  full-time  employees  and  their  eligible  dependents  medical  insurance  through  United  Healthcare.
         Coverage becomes effective the first day of the month following date of hire.

         United Healthcare | HDHP
         This plan is a “qualified” High Deductible Health Plan (HDHP) through United Healthcare, which combines a high deductible plan
         with a special, tax-qualified savings account called a Health Savings Account (HSA). You have the freedom to choose your doctor
         without  using  a  Primary  Care  Physician  (PCP)  and  you  may  self-refer  to  specialists.  You  may  use  a  network  provider  whose
         negotiated rates provide richer levels of benefits with claim forms filed by the providers. You may also  obtain services using a non-
         network provider; however, you will be responsible for the difference between the covered amount and the actual charges and
         you may be responsible for filing claims. This plan requires all medical and prescription drug expenses to be applied towards the
         deductible before services are covered, except for preventive services. Additional information on how the HDHP plan works is
         located on page 7.






                         Finding a Medical Provider
                         Go to www.myuhc.com or call (800) 624-8822 for HMO or (866) 314-0335 for HDHP. HMO participants
                         should refer to the “Signature Value HMO” network and HDHP participants should refer to the “Select Plus”
                         network when prompted.

                         Virtual Visits on the PPO Plan: Log on  to myUHC.com







         Plan Differences                                     HMO                               HDHP



         Out-of-Pocket Costs                                    $                                 $$

         Savings Account                                                                          ✓

         Cost Sharing                                   Contribution, Copay,              Contribution, Copay,
                                                           Coinsurance                   Deductible, Coinsurance

         Network
          - Name                                       Signature Value HMO                    Select Plus
          - Size                                                                              
          - In-Network Benefits                                ✓                                  ✓
          - Non-Network Benefits                                                                  ✓

         Access to Providers                           Managed by Your PCP                  Managed by You
          - Primary Care Physician                           Required                        Not Required
          - Referral for Specialist                          Required                        Not Required






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