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 medical, mental/behavioral health or other specialist provider, visit the member portal www.myuhc.com or call 866-314-0335. You can schedule in person and/or virtual visits, depending on type of service. Click here to see the complete list.

Before scheduling an appointment, be sure to check out www.uhc.com/quickcare to compare your service options and potential costs.

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 (SBCs), please review the $1000 FranklinCovey SBC and/or $2400 FranklinCovey SBC.

Certain preventive medications are included prior to your deductible on the 2400 HDHP medical offering. Click here to see the complete list.

We recognize life can get overwhelming and complicated. We all need help from time to time. If you or a loved one need additional support, be sure to check out the free mental and behavioral health resources available to you through UHC, EAP and other useful resources.

For Maternity support or resources through UHC and Maven partnership, visit www.mavenclinic.com/join/getstarted or download the Maven Clinic app.

	$1,000 PPO		$2,400 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 31-DAY SUPPLY)
Generic	$15		$15**
Formulary Brand	$35		$35**
Non-Formulary Brand	$65		$65**
Specialty	$100		$100**
MAIL ORDER RX (UP TO 90-DAY SUPPLY)
Generic	$37.50	Not covered	$37.50**	Not covered
Formulary Brand	$87.50	Not covered	$87.50**	Not covered
Non-Formulary Brand	$162.50	Not covered	$162.50**	Not covered
Specialty	$250	Not covered	$250**	Not covered

* With an embedded deductible, if one member meets the individual deductible, then coinsurance will begin for the future claims on that one member. If you have other family members on the plan, each family member must meet their own individual deductible or the remainder of the family deductible, whichever comes first.
** After Deductible