Preferred Provider Organization (PPO) Plan
In-network Features of this plan include:
- Annual deductible of $300/person or $600/family.
- Annual out-of-pocket maximum of $2,000/person or $4,000/family. Deductible and coinsurance applies to the OOP Maximum; Copays do not.)
- 100% coverage for Preventive Care - such as routine check-ups and screenings.
- $25 copay for primary care physician visits; $40 copay for specialists.
- 80% coverage (coinsurance), after deductible, of plan's allowable amount.
- $100 copay (after deductible and coinsurance) for emergency services
- $125 copay (after deductible and coinsurance) for outpatient surgery
- $250 copay (after deductible and coinsurance) for hospital admission
- 80% coverage (coinsurance), after deductible, of plan's allowable amount for maternity services.
- 100% coverage of plan's allowable amount, except for copays, for remainder of year once the annual out-of-pocket limit is reached.
- Out-of-network feature included.
Out-of-network features of this plan include:
- 60% coverage (after deductible) of plans allowable amount.
Two companies will provide administrative services for the self-funded preferred provider organization (PPO). Select the proper administrator from the list below:
- If you reside in Indiana, Michigan, Nevada, New Jersey, North Carolina, Ohio, Pennsylvania, South
Carolina, Tennessee and Virginia -
- All other locations -
Consumer Driven Health Plan (CDHP)
Features of this plan include:
- Employees receive an annual company contribution into a Health Reimbursement Account (HRA) at United Healthcare to cover health care expenses
- Employee Only: $1,000
- Employee & Spouse: $1,500
- Employee & Children: $1,500
- Employee & Family: $2,000
- Annual deductible (includes HRA & member responsibility)
- Employee Only: $1,500 ($1,000 HRA & $500 member responsibility)
- Employee & Spouse: $2,250 ($1,500 HRA & $750 member responsibility)
- Employee & Children: $2,250 ($1,500 HRA & $750 member responsibility)
- Employee & Family: $3,000 ($2,000 HRA & $1,000 member responsibility)
- Annual out-of-pocket maximum
- Employee Only: $2,000
- Employee & Spouse: $3,000
- Employee & Children: $3,000
- Employee & Family: $4,000
- 100% coverage for Preventive Care - such as routine check-ups and screenings
- 80% coverage (after deductible) of plan's allowable amount
- 100% coverage of plan's allowable amount for remainder of year once the annual out-of-pocket limit is reached
- Out-of-network feature included.
Out-of-network features of this plan include: 60% coverage (after deductible) of plans allowable amount.
In all locations, United Healthcare will provide administrative services for the self-funded consumer driven health plan (CDHP) in all locations. Click on the link below for plan administration information.