Plan Administrator: United Health Care (UHC) UHC Network: Choice Care Plus
ADVANTAGE (Copay) PLAN, or
HDP / HSA (High Deductible Plan with an Health Savings Account).
Your health and the health of your family are important and we recognize that families have different needs and priorities, that’s why Clermont County offers two excellent medical plans to choose from, both designed to help your budget while allowing you and your covered dependents to obtain the care you need, when and where you need it.
ADVANTAGE (copay) Plan: This is slightly different than a traditional copay plan: In order to encourage members to seek treatment in the most appropriate place of care, the lowest cost care options carry the best benefits. Primary Care Physician’s (including Pediatricians), Virtual Dr (including mental health) visits will be a $0 copay in 2020! Urgent Care visits reduced to a $25 copay! Emergency Rooms which are the single most expensive place to obtain initial care will change from a flat $300 copay to $250 copay + 20% of the balance until the member reaches the maximum of pocket. The maximum out of pocket has increase to $5,500 per member (maximum is $11,000 per family). You can choose to pair this plan with the HealthCare FSA (see info on FSA’s on page), which will allow you to set aside a portion of your paycheck, up to $2,700, to cover the cost of your out-of-pocket medical, dental and vision expenses.
HDP with HSA (High Deductible Plan w/ Health Savings Account): The HDP is a plan that can easily be budgeted for. Provided you use premium providers (Tier 1) for specialist visits the most you would have to pay out of pocket in a single year is $3,000 for one member, and $6,000 for the entire family. The maximum out of pocket increases by $1,000 if the member uses any specialist not designated as a “Tier 1” after the initial deductible has been met. Its best feature is that it can be paired with a Health Savings Account (HSA) and a Limited FSA (Limited FSA’s can be used only for dental and vision out of pocket expenses).
Comparing the SBC’s and Plan Summaries for each plan can help you understand the differences between the two plans. Document links provided in table on the right of this page.