Administrator: United HealthCare (UHC)
Network: Choice Care Plus
Your health and the health of your family are important and Clermont County recognizes that families have different needs and priorities, that’s why we offer two excellent medical plans to choose from.
Choice of two plan designs: Advantage Copay plan or the High Deductible plan (HDP) with a HSA (health savings account).
Advantage (copay) Plan In-Network Info:
- Primary Care Physician Office visit (including Pediatricians): $0 Copay
- Virtual Dr. Visit (including mental health): $0 Copay
- Tier 1 Specialists (2 blue hearts) Office visit : $50 Copay
- Non-Tier 1 Specialists Office visit: $100 Copay
- Urgent Care Visit: $25 Copay
- Emergency Room: $250 copay + 20% of the balance until the member reaches the maximum-out-of-pocket.
- Maximum-Out-of-Pocket (MOOP): $5,500 per person /maximum = $11,000 per family.
- Rx Copay = Retail: $15;/$30/$50/25% high cost Rx’s. Mail Order: $30/$100/$140/25% high cost Rx’s.
HDP w/HSA In-Network Info:
- Member pays 100% of the UHC provider contract rate until satisfying the deductible, including prescription drugs (Rx).
- Deductible: $3000 per person / $6000 maximum per family
- Member pays 10% co-insurance after meeting deductible, up to the MOOP.
- MOOP (Maximum-Out-of-Pocket): $4000 per person / maximum = $8000 per family
- Can be paired with an HSA and/or a Limited FSA (dental & vision only). Learn about HSA’s here.
Compare the SBC’s and SPD’s for each plan to understand the difference between the two plans.
Document links provided for easy access.