Skip to main content

Stepping up for a healthier you

You have 2 Plan Options

Plan Option: The Choice HMO Plan

You can use any doctor, clinic, hospital or health care facility in the national Choice network, which saves you money. You won’t have coverage if you go out-of-network. This means you will be responsible for the entire cost of the service.

View your benefit options at a glance (PDF, 256 KB)

Find Your Doctor

Find out if your doctor, clinic or facility is in the network.

The Choice HMO Plan features

  • You have the freedom to use any doctor or hospital in the Choice network. If you do not use the network, the plan will not cover the cost, unless it is a true emergency. This means you will be responsible for the entire cost of the service. 
  • You do not need to choose a primary care provider (PCP). 
  • You can see a network specialist without a referral. 
  • You have more predictable co-payments. 
  • Your preventive care is covered 100% in the network, when properly coded as preventive.
  • Medical and pharmacy expenses are combined for the out-of-pocket limit.

How the Choice HMO Plan works

You can use the well-being incentive credits in your HIA to help pay your co-payments, your deductible and other out-of-pocket expenses.

Note: the following does not apply for eligible preventive care that is received in the network. Co-payments, co-insurance and the deductible are included in the out-of-pocket limit.

  1. You will pay a co-payment for doctor visits, urgent care centers, emergency room visits and prescriptions. A co-payment is a fixed amount of money you have to pay each time you see a doctor or fill a prescription. All other services provided in an in-network doctor's office are covered at 100% after your co-payment.
  2. You will have a deductible for services not provided in a doctor’s office. The deductible is the amount you owe for covered services before your plan starts to pay.
  3. After you pay the deductible, your plan will have co-insurance for some services. Co-insurance is when the plan shares the cost of covered services with you. The plan will pay a percentage of each service, and you will pay the rest. For example, the plan will pay 80% of the cost, and you will pay 20%.
  4. You are protected with an out-of-pocket limit. This is the most you will pay during a plan year for covered services. If you reach the limit, the plan will pay 100% of covered services for the rest of the plan year.

You may be required to have approval for certain services before they can be covered by your plan. See your health plan documents for coverage details.

Using the Health Incentive Account (HIA) with the Choice HMO Plan

Earn well-being incentive credits.

SHBP members and covered spouses can each earn up to 480 well-being incentive credits each in a Health Incentive Account (HIA) just for participating and engaging in healthy activities.

Earn well-being incentive credits in your HIA to help you pay your health care expenses. Completing your wellness activities can earn you a maximum of: 

  • 480 well-being incentive credits (Employee Only, Employee + Child(ren))
  • 960 well-being incentive credits (Employee + Spouse, Family)

UnitedHealthcare will add an extra 240 credits.
Beginning January 1, 2015, UnitedHealthcare will add an additional 240 well-being incentive credits to help you save even more.

If you sign up for the Choice HMO
  • When you complete an activity, well-being incentive credits will be placed into your HIA. 
  • If you have a co-payment, deductible or co-insurance payment, we will automatically use the well-being incentive credits in your HIA to help pay or reimburse you the cost. 
  • The well-being incentive credits will automatically be used until they are gone. Then you will need to pay any remaining amount out of your pocket. 
  • Unused well-being incentive credits can roll over to next year if you enroll in the same plan.

Using the HIA for pharmacy 

  • You will need to pay out-of-pocket for your prescriptions. If you have well-being incentive credits in your HIA, we will automatically reimburse you from your account. 

Learn more about earning well-being incentive credits

Plan Option: The HDHP with an HSA

You can use any doctor, clinic, hospital or health care facility you want. You save money when you use the national Choice Plus network. You also have coverage if you go out of network.

View your benefit options at a glance (PDF, 256 KB)

You have the option to open a health savings account (HSA) with this plan.

An HSA is a personal bank account to help you save and pay for health care, while giving you real tax savings. The money you put into your HSA can be used to help pay your health care costs, including deductible and co-insurance.

Find Your Doctor

Find out if your doctor, clinic or facility is in the network.

The HDHP with an HSA features

  • You have the freedom to use any doctor or hospital you want. You also have coverage if you go out of the network. However, the coverage will be lower, which means you may pay more. If you use non-network doctors, those costs will apply to a separate non-network deductible. 
  • You do not need to choose a primary care provider. 
  • You can see a network specialist without a referral. 
  • Your preventive care is covered 100% in the network, when properly coded as preventive.

Paying for prescriptions

You will have to pay the full cost of your covered prescriptions until you’ve paid the deductible. This might be a big change for you. The good news is that unlike the HMO and HRA plan options, your prescription drug costs apply to both your deductible and your out-of-pocket limit. Plus, you can also use your HSA to help pay. Be sure to talk to your doctor or pharmacist about ways to help manage and lower your costs.

 

About the Health Savings Account (HSA)

This plan allows you to open a health savings account (HSA). An HSA is a personal bank account that you own. The HSA lets you save money, income-tax-free, to pay for qualified medical expenses. You can save the money to use for expenses today or in the future—even into retirement. It’s your choice.

Watch a video about Health Savings Accounts (HSA)

Before you can open and deposit money to an HSA, make sure you are eligible to do so.

What are the requirements for opening an HSA?

To deposit money into an HSA, you must be enrolled in an HSA-eligible health plan. You are eligible if:

  • You are covered under an eligible high-deductible health plan (HDHP).
  • You are covered by no other health coverage, unless it is permissible coverage.
  • You are not enrolled in Medicare.
  • You cannot be claimed as a dependent on someone else’s tax return.

Some other restrictions apply. Please talk to a tax, benefits or financial advisor if you have more questions.

Why open an HSA with the HDHP?

  1. You own the HSA.
    The money is yours to keep.
    • There is no “use-it-or-lose-it” rule. It can grow year to year.
    • You take it with you if you leave your employer or change plans.
    • You can save the money for retirement.
  2. It has triple tax benefits. 
    • Money deposited is federal income tax-free.
    • Savings grow tax-free.
    • Withdrawals made for qualified expenses are also income tax-free.
  3. It's not just for doctor visits and prescriptions. 
    You can use it to pay for:
    • Vision exams and eyeglasses
    • Dental exams and teeth cleaning
    • Hearing exams and hearing aids
    • Long-term care and more

Open your HSA with Optum BankSM, Member FDIC.

You can open an HSA with any bank you choose, but Optum Bank is UnitedHealthcare’s bank of choice. You can: 

  • Do your banking and pay qualified health care expenses on your plan website, myuhc.com
  • Use your HSA debit card to pay at the pharmacy, doctor’s office or elsewhere. 
  • Put your money in a retirement account and more. 

How to open your HSA

You'll want to open your HSA right after you sign up for your plan. 

If you need help, call Optum Bank at 800-791-9361 (toll free), 8 a.m. to 8 p.m., ET, Monday through Friday.

How the HDHP with an HSA works

You can use the well-being incentive credits in your HIA to help pay your deductible and other out-of-pocket expenses. 

    1. Your deductible – You pay until you reach the deductible.
      You pay all covered services (medical and pharmacy) until your entire deductible is satisfied. You have a different deductible for network services and non-network services. To keep your costs low, be sure to use network providers. You can use money you save in an HSA to help pay for qualified health care expenses.

      After you pay a portion of your deductible, you can use the well-being incentive credits in your HIA to pay for services.

    2. Your co-insurance – You and your plan share the cost. 
      After you’ve paid the network or non-network deductible, your plan has co-insurance. Co-insurance is when you and your plan share the cost of covered services. When you use network providers, the plan will pay 70% of the cost of each service, and you will pay the remaining 30%. You can use your HSA to help pay your share.
    3. Your out-of-pocket limit – You are done paying.
      If your deductible and co-insurance payments reach the out-of-pocket limit, you are done paying. Your plan will pay 100% of covered services for the rest of the plan year. This limit protects you if you have a major medical event. 

If you receive your preventive care outside of the network, the plan will not cover any of the cost. Preventive care is covered at 100% in-network when appropriately coded as preventive care per the Affordable Care Act guidelines.

Using the Health Incentive Account (HIA) with the HDHP with an HSA

Earn well-being incentive credits.

SHBP members and covered spouses can each earn up to 480 well-being incentive credits each in Health Incentive Account (HIA) just for participating and engaging in healthy activities. 

Earn well-being incentive credits in your HIA to help you pay your health care expenses. Completing your well-being actions can earn you a maximum of: 

  • 480 well-being incentive credits (Employee Only, Employee + Child(ren))
  • 960 well-being incentive credits (Employee + Spouse, Family)

UnitedHealthcare will add an extra 240 credits. 
Beginning January 1, 2015, UnitedHealthcare will add an additional 240 well-being incentive credits to help you save even more.

If you sign up for the HDHP 
  • When you complete an activity, money will be placed into your HIA. IMPORTANT: Before the money in the HIA can be used, you will need to pay for covered services until the following amounts have been paid toward your deductible. 
    • You - $1,300
    • You + Child(ren) - $2,600 (Please note that the brochure incorrectly shows $1,300)
    • You + Spouse - $2,600
    • You + Family - $2,600
  • After you pay the above amount, we will automatically use the money in your HIA to help pay for covered services. This lowers the amount you have to pay. 
  • The HIA will automatically be used until it is gone. Then you will need to pay any remaining amount out of your pocket. 
  • You can continue to save money in an HSA for services that the HIA may not pay for. Remember, your HSA can be used to save for expenses you’ll have in the future.
Using the HIA for pharmacy

You will need to pay out-of-pocket for your prescriptions. If you have well-being incentive credits in your HIA, we will automatically reimburse you from your account.

Please note: the credits you earn in your HIA are separate and apart from the dollars in your HSA.

Learn more about earning well-being incentive credits

Contact Us

Enrollment Support:

Please call Customer Service at 888-364-6352,
8 a.m. to 8 p.m., Monday - Friday.

If you are experiencing a medical emergency, call 911.