Medical Plans

Regular full–time and regular part–time employees working 20 hours per week are eligible on the first day of the month after employment.

USP pays all or a substantial portion of the cost of the coverage. Employee pre–tax bi–weekly contributions are:

United Healthcare offers three plan designs with comprehensive coverage allowing maximum employee choice:

Silver Plan – In–Network benefits only:

$30 co–payment required for medical office visits
Annual deductibles, individual ($250) or family ($500) for major services including inpatient and outpatient hospitalization, durable medical equipment, and inpatient rehabilitation services
After satisfying deductible for major services, Plan requires 10% cost sharing for medical expenses up to an out–of–pocket maximum of $2,000 for individual coverage or $4,000 for family coverage
Open access plan; see a specialist without primary care physician referral
Hospital emergency room services require a $75 co–payment
Prescription coverage co–payments: $10, generic; $30, brand–name drugs; $50, nonpreferred brand–name drugs
90–day prescription co–payments: $25, generic; $75, brand–name drugs; $125, nonpreferred brand–name drugs
In–network provider network is nationwide

Gold Plan – In–Network benefits only:

$20 co–payment required for medical office visits
Annual deductibles, individual ($250) or family ($500) for major services including inpatient and outpatient hospitalization, durable medical equipment, and inpatient rehabilitation services
After satisfying deductible for major services, Plan pays 100% for medical expenses
Open access plan, see a specialist without primary care physician referral
Hospital emergency room services require a $50 co–payment
Prescription coverage co–payments: $10, generic; $25, brand–name drugs; $40, nonpreferred brand–name drugs
90–day prescription co–payments: $25, generic; $62.50, brand–name drugs; $100, nonpreferred brand–name drugs
In–network provider network is nationwide

Platinum Plan – In– and Out–of–Network benefits: In–network:

$20 co–payment required for medical office visits
No deductibles for major services including inpatient and outpatient hospitalization, durable medical equipment, and inpatient rehabilitation services
Hospital emergency room services require a $50 co–payment
Prescription coverage co–payments: $10, generic; $25, brand–name drugs; $40, nonpreferred brand–name drugs
90–day prescription co–payments: $25, generic; $62.50, brand–name drugs; $100, nonpreferred brand–name drugs
In–network provider network is nationwide

Out-of-network:

An individual ($250) or family deductible ($500)
After satisfying deductible for out-of-network services, Plan pays 80% of the Usual, Customary, and Reasonable (UCR) cost