We’re excited to offer Medical plans that provide you and your family with the care you need at a price that fits your budget. You have the option of selecting from a Health Savings Account (HSA) Plan, a Preferred Provider Organization (PPO) Plan, or a Health Maintenance Organization (HMO) Plan.
Questions about your Medical plans? Call a Quantum Health Coordinator at 866-920-1980.
HDHPs offer coverage for both in-network and out-of-network providers. You’ll need to meet a higher deductible before your plan kicks in, but you may qualify for a Health Savings Account, your trusty tool for paying certain medical expenses tax-free.
Note: If you are a 3508 Sales Representative, you are eligible to enroll in either HSA Medical plan. However, due to IRS regulations, you do not qualify to open the pre-tax Health Savings Account associated with this plan.
Flexibility is key with PPO plans. You can choose between in-network or out-of-network providers for each visit, but you’ll save more by sticking to the in-network doctors.
| Plan Features | UMR/UHC Choice Plus Network | |||
|---|---|---|---|---|
| PPO Choice Plus Low | PPO Choice Plus High | HSA Choice Plus Low | HSA Choice Plus High | |
| In-Network | In-Network | In-Network | In-Network | |
| Annual Deductible* Individual/Family |
$750 / $1,500 | $2,000 / $4,000 | $2,000 / $4,000 | $5,000 / $10,000 |
| Annual Out-of-Pocket Maximum* Individual/Family |
$3,000 / $6,000 | $5,000 / $10,000 | $3,500 / $7,000 | $5,000 / $10,000 |
| Renovo Annual HSA Contribution Individual/Family |
N/A | N/A | $500 / $1,000 | N/A |
| You pay: | You pay: | You pay: | You pay: | |
| Preventive Care | Covered in full | Covered in full | Covered in full | Covered in full |
| Telemedicine | $40 | $65 | 20% after deductible | 0% after deductible |
| Primary Care: First Stop Health (Virtual) |
Covered in full | Covered in full | Covered in full | Covered in full |
| Primary Care: UHC Tier 1 |
$25 | $50 | 20% after deductible | 0% after deductible |
| Primary Care: UHC Tier 2 |
$75 | $100 | 40% after deductible | 30% after deductible |
| Specialist: First Stop Health (Virtual) |
$0 | $0 | Covered in full | Covered in full |
| Specialist: UHC Tier 1 |
$40 | $65 | 20% after deductible | 0% after deductible |
| Specialist: UHC Tier 2 |
$80 | $120 | 40% after deductible | 30% after deductible |
| Lab & X-ray | 20% after deductible | 30% after deductible | 20% after deductible | 0% after deductible |
| Urgent Care: First Stop Health (Virtual) |
$0 | $0 | Covered in full | Covered in full |
| Urgent Care | $75, then 20% after deductible | $150, then 20% after deductible | 20% after deductible | 0% after deductible |
| Emergency Room | $150 | $150 | 20% after deductible | 0% after deductible |
| Outpatient Hospital | 20% after deductible | 30% after deductible | 20% after deductible | 0% after deductible |
| Inpatient Hospital | 20% after deductible | 30% after deductible | 20% after deductible | 0% after deductible |
| Retail Prescription Drugs (30-day supply) | ||||
| Generic | $10 | $15 | 20% up to $250 | 0% after deductible |
| Preferred Brand | $35 | $50 | 20% up to $250 | 0% after deductible |
| Non-Preferred Brand | $65 | $100 | 20% up to $250 | 0% after deductible |
| Specialty** | 20% up to $250 | 20% up to $250 | 20% up to $250 | 0% after deductible |
| Mail Order Prescription Drugs (90-day supply) | ||||
| Generic | $20 | $30 | 20% after deductible, up to $250 | 0% after deductible |
| Preferred Brand | $70 | $100 | 20% after deductible, up to $250 | 0% after deductible |
| Non-Preferred Brand | $130 | $200 | 20% after deductible, up to $250 | 0% after deductible |
| Specialty** | 20% up to $250 | 20% up to $250 | 20% after deductible, up to $250 | 0% after deductible |
*The annual deductible for the HSA Choice Low plan is a true family deductible, which means a family can meet the deductible by pooling together expenses (there is no limit to the amount one member can pay toward the family deductible), all other accumulators are embedded. An embedded deductible has a limit that one person can contribute before they meet their individual deductible. This also counts towards the family deductible, meaning the family deductible will kick in after the combination of individual deductibles adds up to the family deductible.
**Must be filled through Script Care specialty pharmacy.
The HMO plans provide you with an all-in-one health team. They cover Choice Plus in-network providers only, with a primary care physician coordinating your care and referrals. You’ll pay copays at the time of service, ensuring you get the care you need at budget-friendly costs. These plans are exclusively available in California.
| Plan Features | ||
|---|---|---|
| Alliance HMO (California) | Harmony HMO (California) | |
| Choice Plus Network | Choice Plus Network | |
| In-Network Only | In-Network Only | |
| Annual Deductible* Individual/Family | $500 / $1,000 | $500 / $1,000 |
| Annual Out-of-Pocket Maximum* Individual/Family | $3,500 / $7,000 | $3,500 / $7,000 |
| You pay: | You pay: | |
| Preventive Care | Covered in full | Covered in full |
| Telemedicine | $0 | $0 |
| Primary Care | $20 | $20 |
| Specialist | $40 | $40 |
| Lab & X-ray | $20 | $20 |
| Urgent Care | $20 | $20 |
| Emergency Room | $300 | $300 |
| Outpatient Hospital | Covered in full, deductible waived | Covered in full, deductible waived |
| Inpatient Hospital | 30% after deductible | 30% after deductible |
| Retail Prescription Drugs (30-day supply) | ||
| Generic | $10 | $10 |
| Preferred Brand | $50 | $50 |
| Non-Preferred Brand | $100 | $100 |
| Specialty** | Up to $250 | Up to $250 |
| Mail Order Prescription Drugs (90-day supply) | ||
| Generic | $25 | $25 |
| Preferred Brand | $125 | $125 |
| Non-Preferred Brand | $250 | $250 |
| Specialty** | N/A | N/A |
*The annual deductible for the HMO plans is embedded. An embedded deductible has a limit that one person can contribute before they meet their individual deductible. This also counts towards the family deductible, meaning the family deductible will kick in after the combination of individual deductibles adds up to the family deductible.
**Call the phone number on the back of your member ID card or visit specialty.optumrx.com to locate a designated specialty pharmacy for your medication.
When picking a Medical Plan for you and your family, it’s not just about the premiums taken from your paycheck. You also need to think about what you’ll pay for services. Each plan covers preventive screenings in full, but they differ in deductibles, copays, and coinsurance. This means you might end up paying more with one plan than another. Look for a plan that covers most of your needs with out-of-pocket costs that meet your budget.
Note: All plans use the UHC/UMR Choice Plus Network of providers.
| Benefit | PPO Choice Plus Low | PPO Choice Plus High | HSA Choice Plus Low | HSA Choice Plus High | HMO Alliance |
HMO Harmony |
|---|---|---|---|---|---|---|
| Annual deductible to satisfy | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Copayment for services | ✓ | ✓ | ✓ | ✓ | ||
| Coinsurance for services | ✓ | ✓ | ✓ | ✓ | ||
| Lower cost per paycheck | ✓ | ✓ | ✓ | |||
| In-network coverage | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Out-of-network coverage | ✓ | ✓ | ✓ | ✓ | ||
| Eligible to enroll in HSA | ✓* | ✓* | ||||
| Must select a primary care physician | ✓ | ✓ | ||||
| UHC/UMR Choice Plus Network | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Referrals needed for specialists | ✓ | ✓ |
*If you are a 3508 Sales Representative, you are eligible to enroll in either HSA medical plan. However, due to IRS regulations, you do not qualify to open the pre-tax Health Savings Account (HSA).
Consider how often you visit the doctor, what prescriptions you need, and your budget. Then, ask yourself these questions:
*HSA Choice Plus High Plan members can save up to 35% if they are enrolled in Employee Only coverage.
See how HSA and PPO Plan participants can earn a 15% (or more*) discount with the Medical Premium Discount.
Catch health issues early and prevent them from becoming chronic conditions. And it’s FREE!
Access FREE virtual medical and mental health care through First Stop Health.
UMR members can save and get better care by choosing Tier 1 doctors for in-person visits. Find Tier 1 providers at umr.com.
Script Care partners with Prescription Mart to get your medications delivered right to your home for less than you pay at the pharmacy! Sign up at presmartinc.com.
Rx Savings Solutions is your personal money-saving sidekick. Sign up for an online account to compare prices, get alerts when you’re overspending on prescriptions, and receive recommendations for changing to a less expensive prescription.
Your Medical Plan includes wellness perks: Discounted gym memberships, at-home fitness classes, grocery delivery through One Pass Select, and free personal health coaching via Quantum Health to help you reach your wellness goals.
*HSA Choice Plus High Plan members can save up to 35% if they are enrolled in Employee Only coverage.
Find real people, ready to help.
866-920-1980
(Weekdays, 8:30 a.m. – 10:00 p.m. ET)
renovohealthhub.com
Scan the QR code to download the Quantum Health app.
