Medical Plans

Both the Core and Core Plus plans work the same way. You also have a choice of health carrier networks (via Aetna, Cigna, and Anthem; and Kaiser in California, Colorado, Georgia, Maryland, the District of Columbia, Washington State, and other Northwest locations).

You can go in- or out-of-network when you need care (except if you opt for Kaiser which requires you to use Kaiser's network, unless you require emergency medical services). But you’ll pay significantly more when you use a doctor or provider who does not participate in your network.

The difference between the two plans lies in how much you pay out of your own pocket (deductibles, out-of-pocket maximums, and coinsurance) vs. how much you pay out of your paycheck in monthly premiums.

• In-network preventive care. Covered at 100% and includes preventive prescription drugs. The deductible does not apply.
• Annual Deductible. You must meet the annual deductible before the plan pays for other care and prescription drugs. The entire family deductible applies if you cover one or more family members. Prescription drugs count toward the deductible.
• Coinsurance. After you meet the deductible, you and UBS share in the cost of coverage for most covered care, including prescription drugs. In-network primary care office visits are covered at 100%. Your portion of the cost is called coinsurance.
• Out-of-pocket maximum. If you reach this cap, UBS generally pays 100% of covered services for rest of the year. Coinsurance, annual deductible and prescription drugs all apply toward the out-of-pocket maximum.

CDHPs let participants decide how they want their healthcare dollars to be spent.

Enrollees can use their tax advantaged Health Savings Account dollars to pay their higher out-of-pocket healthcare costs (e.g., coinsurance expenses, annual deductible and out-of-pocket maximum amounts).

And they can make alternative choices that help manage their healthcare expenses.

For example, they can effectively manage healthcare expenses by:

• Opting for an urgent care facility instead of a hospital's high-cost emergency room, if it's appropriate.
• Access Telehealth at $0 cost to you
• Electing to use a generic drug instead of a brand-name drug.
• Selecting doctors and specialists who are in network rather than out of network.
• Following up on preventive care recommendations to keep a health issue from escalating, ultimately costing much more in medical care.
• Participating in wellness programs.
• Using funds from a Health Savings Account (HSA).

When you're looking for a new doctor, or checking to see if your current provider is in-network before switching networks, you'll be prompted to name your specific network. Please be sure to use the appropriate UBS network for your selected medical carrier:

• Aetna: Choice POS II Network, https://www.aetna.com/individuals-families.html
• Cigna: Open Access Plus Network, https://sites.cigna.com/ubs/
• Anthem: https://www.anthem.com/
  • FL: NetworkBlue (Select Network)
  • NY: Blue Access (Select Network)
  • NJ: Horizon Managed Care Network (Select Network)
  • All other states (except Hawaii and Puerto Rico): Anthem National PPO (Blue Card)
• Kaiser: https://kp.org/doctors