Table of Content
- Header
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Page
- What's New for 2022!
- IMPORTANT!
- Benefits Overview
- Medical - United Healthcare
- Additional Resources
- Basic Life and AD&D - Guardian
- HRA - Health Reimbursement Arrangement
- How To Enroll?
- Contact Us
- Footer
What's New for 2022!
United Healthcare will be the new carrier for Medical & Prescription Drugs effective August 1, 2022.
Plan Highlights:
• United Healthcare utilizes the Choice Plus PPO network.
• 100% coinsurance after $4,000 deductible (single), $8,000 (family) deductible has been met.
• Preventive services will be covered at 100% no deductible, no copay.
• Prescription Drug will be administered by Optum RX that uses a formulary drug program, Essential PDL.
IMPORTANT!
PLEASE REFILL ALL EXISING PRESCRIPTIONS PRIOR TO 8/1/2022, SO YOU HAVE AN AMPLE SUPPLY OF PRESCRIPTION DRUGS DURING THE TRANSITION TO THE NEW CARRIER.
If you are on a mail order prescriptions, you need to contact your physician to have a new mail order prescription written and submitted to the new carrier.
Medical - United Healthcare
• United Healthcare utilizes the Choice Plus PPO network, visit myuhc.com to register (Link Below).
• Plan pays 100% after $4,000 single deductible, $8,000 family deductible is met.
• Preventive services will be covered at 100% no deductible, no copay.
• Prescription Drug will be administered by Optum RX that uses a formulary drug program, Essential PDL.
• To look up your prescriptions: Go to welcometouhc.com/Benefits/Pharmacy Benefits and select ESSENTIAL to view your medications that are covered under your plan (Link Below).
IN NETWORK - Plan Summary - P4000i/LX100LXES21 RX 4 ES
United Healthcare utilizes the Choice Plus and offers 1 plan option. Please refer to the United Healthcare summary of benefits/certificate of coverage for a full description of In-Network and Out-of-Network coverage in addition to the limitations and/or exclusions that may apply to your plan.
DEDUCTIBLE
Single/Family Total Deductible - $4,000/$8,000
Employee Deductible Portion - $400/$800
Helical Line (ER) Deductible Portion - $3,600/$7,200
COINSURANCE (applies after deductible is met) & Out of Pocket Max (includes coinsurance and deductible)
Plan Coinsurance - 100%
Single Out of Pocket Maximum - $8,150
Family Out of Pocket Maximum - $16,300
PLAN SUMMARY
Office Visit PCP - $0 (under age 19) / $25 copay over age 19
Preventive Services - 100%, no copay, no ded
Specialist - Office Visit - $75
OP Lab, X-Ray, MRI/Cat Scan - 100% after deductible
Hospital IP, OP Surgery - 100% after deductible
Urgent Care Facility - $50
Emergency Room Visit - $300, after deductible
PRESCRIPTION DRUGS
Tier 1 - $10 copay / Tier 2 - $35 copay / Tier 3 - $75 copay / Tier 4 - $250 copay / Specialty Rx Tier 4 - $500 copay (30 day supply only)
Additional Resources
Basic Life and AD&D - Guardian
Life and Accidental Death & Dismemberment (AD&D) benefit is a flat $25,000 with premiums paid in full by Helical Line Products for all full-time employees and is provided through Guardian Insurance.
HRA - Health Reimbursement Arrangement
Helical Line will administer an HRA that offsets a large portion of the plan deductible as follows:
FOR SINGLE (employee only) coverage:
-The employee will pay the first $400 of the deductible
-Helical Line will pay the remaining $3,600 of the deductible
FOR FAMILY (employee + spouse, employee + child(ren) or family) coverage:
-The employee will pay the first $800 of the deductible
-Helical Line will pay the remaining $7,200 of the deductible
How To Enroll?
Contact Us
Client Contacts
Kym Russ
helical@lor.net
440-933-9263
Account Team Contacts
Kevin Lurie
Producer / Sales Consultant
kevin.lurie@nfp.com
216-410-6751