Medical
How the Plan Works
We provide you and your family with comprehensive and flexible medical insurance options. Both plans give you access to one of the country’s largest provider networks, UHC Choice Plus, and you won’t have to worry about referrals. Your in-network preventive care is covered at 100% with no copays, coinsurance, or deductibles. Benefits will be covered under the preventive care benefit if services or supplies are in accordance with age limits and frequency guidelines.
This summary is not intended as a guarantee of benefits. If there is ever a discrepancy with what is shown here and the summary of benefits and coverage (SBC) from the carrier, the SBC will govern. Contact the carrier to verify benefits before seeking services.
Hidden Accordion
Preventive care
Always 100% covered when you use in-network providers and includes things like physical exams, flu shots and screenings.
Your Deductible
The deductible is the amount you pay each year for eligible in-network and out-of-network charges before the plan begins to pay.
Your Coverage
Once your deductible is met, you and the plan share the cost of covered medical and pharmacy expenses with coinsurance.
Coinsurance means plan will pay a percentage of each eligible expense, and you will pay the rest.
Copay means you pay a flat dollar amount depending on the visit/service; the plan pays the rest.
Out of Pocket Maximums
When you reach your out-of-pocket maximum, the plan pays 100% of covered medical and pharmacy expenses for the rest of the plan year. Your deductible coinsurance, and any copays apply toward the out-of-pocket maximum.
To locate a participating UHC Choice Plus network provider visit the member portal www.myuhc.com.
For the Summary of Plan Description (SPD), please review the $1000 FranklinCovey SPD and/or $2400 FranklinCovey SPD.
For the Summary of Benefits and Coverages (SBC), please review the $1000 FranklinCovey SBC and/or $2400 FranklinCovey SBC.
Certain preventive medications are included prior to your deductible.
Click here to see the complete list.
| $1,000 PPO | $2,400 / $4,800 HDHP | |||
|---|---|---|---|---|
| IN-NETWORK | OUT-OF-NETWORK | IN-NETWORK | OUT-OF-NETWORK | |
| YOU PAY | YOU PAY | YOU PAY | YOU PAY | |
| CALENDAR YEAR | ||||
| Individual | $1,000 | $2,000 | $2,400 | $4,800 |
| Family | $2,000 | $4,000 | $4,800 | $9,600 |
| Embedded Deductible | Yes | Yes | No | No |
| CALENDAR YEAR OUT OF POCKET MAXIMUM (INCLUDES DEDUCTIBLE) | ||||
| Individual | $2,000 | $4,000 | $3,400 | $6,800 |
| Family | $4,000 | $8,000 | $5,800 | $11,600 |
| COINSURANCE / COPAYS | ||||
| Preventive Care | $0 | 40%* | $0 | 40%* |
| Primary Care Physician | $25 | 40%* | 20%* | 40%* |
| Specialist | $40 | 40%* | 20%* | 40%* |
| Urgent Care | $40 | 40%* | 20%* | 40%* |
| Emergency Room | $150 | $150 | 20%* | 20%* |
| PHARMACY BENEFITS | ||||
| RETAIL RX (UP TO 30-DAY SUPPLY) | ||||
| Generic | $15 | Ded, $15 | ||
| Formulary Brand | $35 | Ded, $35 | ||
| Non-Formulary Brand | $65 | Ded, $65 | ||
| Specialty | $100 | Ded, $100 | ||
| MAIL ORDER RX (UP TO 90-DAY SUPPLY) | ||||
| Generic | $37.50 | Ded, $37.50 | ||
| Formulary Brand | $87.50 | Ded, $87.50 | ||
| Non-Formulary Brand | $162.50 | Ded, $162.50 | ||
| Specialty | $250 | Ded, $250 | ||