Rolling Hills Industries

Table of Content

  1. Header
  2. Page
    1. Introduction
    2. Benefits Overview
    3. UPMC RX Maximizer Program
    4. How To Enroll
    5. New Hires
    6. Additional Resources
    7. NFP Contacts
  3. Footer

Introduction

Your Employee Benefits landing page is your opportunity to learn about your health care benefits, review your current coverage and choose the best options for you and your family.

Your plan year runs from October 1, 2023 through September 30, 2024.

Please review all 2023-2024 Benefits Overview Information.

*If NO changes are needed, then your current benefits will just roll over into the new plan year.

Benefits Overview

Grids, Benefit Notices, and Summary of Benefits and Coverage (SBC's)
  • UPMC MyCare Advantage EPO MCA $1,000 $15/$30 - Medical Grid
  • UPMC MyCare Advantage EPO MCA $2,500 $20/$40 - Medical Grid
  • UPMC MyCare Advantage EPO MCA $5,000 $30/$60 - Medical Grid
  • UPMC Premium Dental PPO - Dental Grid
  • UPMC Premier Plus $0 Copay - Vision Grid
  • Employee Benefit Notices (Health Plan Compliance Notices)
  • Summary of Benefits and Coverage (SBC) 10/1/2023 through 9/30/2024
UPMC

EPO MCA $1,000 $15/$30

UPMC

EPO MCA $1,000 $15/$30

UPMC Summary of Benefits and Coverage

SBC - EPO MCA $1,000

UPMC Summary of Benefits and Coverage

SBC - EPO MCA $1,000

UPMC

EPO MCA $2,500 $20/$40

UPMC

EPO MCA $2,500 $20/$40

UPMC Summary of Benefits and Coverage

SBC - EPO MCA $2,500

UPMC Summary of Benefits and Coverage

SBC - EPO MCA $2,500

UPMC

EPO MCA $5,000 $30/$60

UPMC

EPO MCA $5,000 $30/$60

UPMC

SBC - EPO MCA $5,000

UPMC

SBC - EPO MCA $5,000

UPMC Dental Plan

Premium 100/80/50/$0/$1,500/No Ortho

UPMC Dental Plan

Premium 100/80/50/$0/$1,500/No ...

UPMC Vision Plan

Premier Plus $0 Copay Vision

UPMC Vision Plan

Premier Plus $0 Copay Vision

UPMC Benefit Notices

Health Plan Compliance Notices

UPMC Benefit Notices

Health Plan Compliance Notices

UPMC RX Maximizer Program

SaveOn SP Copay Maximizer Program

Effective July 1, 2022, UPMC Health Plan, Express Scripts Inc. and SaveOnSP are pleased to provide the SaveOnSP specialty cost share assistance service for our Health Plan members. 

This service targets a specific list of high-cost specialty medications and leverages manufacturer patient assistance program funds to lower the price for members who enroll.

 

SaveOnSP will help enroll eligible members in the service and will work with UPMC Health Plan’s preferred specialty pharmacies (Chartwell and Accredo) to apply manufacturer assistance to eligible pharmacy claims to reduce or eliminate the member’s cost-share obligation. 

 

Please note that eligible members are starting to be notified of their opportunity to participate in the service. 


**Members can also check the SaveOnSP drug list to see if their medication is eligible at saveonsp.com/upmc. (click on this link for web site and document)

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How To Enroll

Enrollment Form(s)
  • If you'd like to change your existing coverage or make new elections, you must do so by September 25.
  • Your current medical, dental and vision elections will carry forward to 2023-2024 if you don't make a new election.
UPMC Enrollment Form

UPMC Enrollment/Change Form

UPMC Enrollment Form

UPMC Enrollment/Change Form

New Hires

NEW HIRE ENROLLMENT INFORMATION

If you are a NEW HIRE and need to enroll for the FIRST time, please see above section How to Enroll.

All enrollment forms are attached for download.

NFP Contacts

You have dedicated Agents ready to handle any situation in a discreet and confidential manner.

For Service questions and needs such as:

  •        Understanding what your medical, dental or vision benefits cover
  •        Help finding in network providers
  •        Assistance with prescription or pharmacy issues
  •        Questions regarding bills you receive from your doctor, hospital, dentist, optometrist or lab
  •        Claims you believe haven’t been paid properly

Additional Contacts