DRAFT

 

EPO Plan Options

HDHP Option 
 

Quantum Care 750

UHC Choice 1000

UHC Choice Plan 2500
How It Works

You pay a set amount (called a copay) for things like doctor and urgent care visits without needing to meet your deductible first. When you need hospital care or MRIs, CTs, or PET scans, you must pay your deductible before the plan pays part of the bill (called coinsurance). 

 You pay the most when you need care because it is a High Deductible Health Plan option. Other than preventive care like checkups, this plan doesn’t pay any portion of your bill or prescriptions until you pay your full deductible.
Choosing a Facility

After you meet your deductible on any of the plans, your coinsurance payment depends on the facility you choose.

You pay 10% at Preferred Hospitals (a select list of hospitals where the plan pays the most for care, meaning you pay the least).

You pay 70% at all other in-network hospitals (hospitals that are covered in the UHC or Cigna network through Quantum but are not on the Preferred Hospital list).

You pay the full cost if you go out of network.
Search the Network for Doctors and Facilities 

To find a doctor or facility in the Cigna Open Access Plus Network through Quantum:

• Visit MyQHResource.com
• Under Find Provider, select Cigna Open Access Plus Provider Search

For the most up-to-date information, contact Quantum Care Coordinators at 1-877-MyTHRLink (1-877-698-4754), prompt 2, press 1.

To find a doctor or facility in the UHC Choice network:

• Visit WhyUHC.com/THR
• Click Health Plans
• Select a plan option

For the most up-to-date information, contact UHC customer service at 1-877-MyTHRLink (1-877-698-4754), prompt 2, press 2.
Deductible

Preferred Hospital:
$750 indiv / $2,250 family

Non-preferred Hospital:
$3,500 indiv / $10,500 family

Preferred Hospital:
$1,000 indiv / $3,000 family

Non-preferred Hospital:
$4,000 indiv / $12,000 family

Preferred Hospital: 
$2,500 indiv */ $7,500 family

Non-preferred Hospital:
$4,000 indiv */ $12,000 family
Medical and Rx Out-of-Pocket Maximum1 $6,850 individual
$13,700 family		 $6,750 individual 
$13,500 family 
Spending and Savings Accounts Health Care Flexible Spending Account:
You may contribute up to $2,850.		 Health Savings Account: 
You may contribute up to $3,850 (employee only coverage) or $7,750 (employee + family coverage)5. Comes with Employer contributions.
Office Visits $30 copay for PCP; $50 copay for specialist  Full deductible, then 10%
Urgent Care including DispatchHealth $50 copay Full deductible, then 10%
Inpatient Hospital Care Preferred hospital: 10% after deductible 
Non-preferred hospital: 70% after deductible 		 Preferred hospital: Full deductible, then 10%
Non-preferred hospital:  Full deductible, then 70%
Outpatient Surgery2 Preferred hospital: Office visit copay applies; 10% after deductible if not in doctor’s office
Non-preferred hospital: 70% after deductible		 Preferred hospital: Full deductible, then 10%
Non-preferred hospital: Full deductible, then 70%
Virtual Care Services3 $0 Full deductible, then $0
Well Women/ Man Exams and Well Child Care4 $0
Emergency Room  $200 copay, then 10% after deductible  Full deductible, then 10%