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Medical Mutual of Ohio Health Plan Options

​Choose from one of four medical plans to cover yourself and your dependents. All plans are through Medical Mutual of Ohio and include prescription coverage.

Employee Cost of Medical Coverage​
For all health plan options:  Employee contributions are reflected in the UKG platform, and based on your completion of the OswellThrives Wellness Program Initiatives / Tobacco Status / Spousal Surcharge.​

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RESOURCES

MMO PPO $1000-SBC
MMO HSA $3200 - SBC
MMO HSA $5000 - SBC

Consumer-Driven High-Deductible Health Plans​

With the two HDHP / HSA plan options, you will:​

  • Have the option to select from a $3,200 Deductible and a $5,000 Deductible plan​
  • Enjoy lower per pay period medical plan costs​
  • Have preventive services covered at 100%​
  • Be eligible for a Health Savings Account through MMO’s partner bank (Wealthcare Saver) for ​tax-free deposits​
  • Receive Oswald Companies’ per pay contributions to your Health Savings Account​

PPO Plans​

With the traditional plan options, you will:​

  • Have a lower deductible plan​
  • Experience a higher per pay cost for medical coverage as Oswald pays 78% of the premium, you pay 22% of the premium​
  • Enjoy the predictability of set copay amounts​
  • Have preventive services covered 100%​
PPO
HDHP-with-HSA
HDHP-vs-PPO
Prescription-Drug-Cost-Management

PLAN #1

Medical Mutual of Ohio

$1,000 Preferred Provider Organization Plan (PPO)

Designed for those who prefer the predictability of set payments for doctor appointments and other medical services.
Medical Plan Provisions In-Network Out-of-Network
Deductible (embedded) $1,000 Individual / $2,000 Family $3,000 Individual / $6,000 Family
Maximum Out-of-Pocket (embedded) $6,000 Individual / $12,000 Family $12,000 Individual / $24,000 Family
Coinsurance 20% after Deductible 40% after Deductible
Primary Care Visits $20 Copay 40% after Deductible
Preventive Care Covered in Full 40% after Deductible
Specialist Visits $20 Copay 40% after Deductible
Emergency Room $200 Copay / 20% $200 Copay / 20%
Urgent Care $75 Copay 40% after Deductible
Rx Retail Copays
Generic $10 Copay 50% after Deductible
Preferred Brand $35 Copay 50% after Deductible
Non-Preferred Brand $70 Copay 50% after Deductible
Specialty Drug 25% w/$250 max per script (30 day supply) 50% after Deductible
Rx Mail Order
Generic $20 Copay Not Covered
Preferred Brand $105 Copay Not Covered
Non-Preferred Brand $210 Copay Not Covered
Specialty Drug 25% w/$250 max per script (30 day supply) Not Covered

PLAN #2

Medical Mutual of Ohio

$3,200 High Deductible Health Plan (HSA Eligible)

Designed for those who prefer to save premium dollars and to set money aside in a Health Savings Account (HSA) on a pre-tax basis. Medical and Pharmacy (Rx) claims would first apply to the plan deductible, then the plan cost sharing would apply. This plan has the lowest out of pocket maximum.
Medical Plan Provisions In-Network Out-of-Network
Deductible (embedded) $3,200 Individual / $6,400 Family $6,000 Individual / $12,000 Family
Maximum Out-of-Pocket (embedded) $4,000 Individual / $8,000 Family $10,000 Individual / $20,000 Family
Coinsurance 0% after Deductible 50% after Deductible
Primary Care Visits 0% after Deductible 50% after Deductible
Preventive Care Covered in Full 50% after Deductible
Specialist Visits 0% after Deductible 50% after Deductible
Emergency Room 0% after Deductible 0% after Deductible
Urgent Care 0% after Deductible 50% after Deductible
Rx Retail Copays
Generic $10 Copay 50% after Deductible
Preferred Brand $35 Copay 50% after Deductible
Non-Preferred Brand $70 Copay 50% after Deductible
Specialty Drug 25% w/$250 max per script (30 day supply) 50% after Deductible
Rx Mail Order
Generic $20 Copay Not Covered
Preferred Brand $105 Copay Not Covered
Non-Preferred Brand $210 Copay Not Covered
Specialty Drug 25% w/$250 max per script (30 day supply) Not Covered

All Pharmacy claims would apply to the Medical plan deductible, then the prescription copays would apply.

PLAN #3

Medical Mutual of Ohio

$5,000 High Deductible Health Plan (HSA Eligible)

Designed for those who prefer to save premium dollars and to set money aside in a Health Savings Account (HSA) on a pre-tax basis. Medical and Pharmacy (Rx) claims would first apply to the plan deductible, then the plan cost sharing would apply. This plan has the lowest per pay cost of all four plan options.
Medical Plan Provisions In-Network Out-of-Network
Deductible (embedded) $5,000 Individual / $10,000 Family $10,000 Individual / $20,000 Family
Maximum Out-of-Pocket (embedded) $6,350 Individual / $12,700 Family $12,700 Individual / $25,400 Family
Coinsurance 0% after Deductible 30% after Deductible
Primary Care Visits 0% after Deductible 30% after Deductible
Preventive Care Covered in Full 30% after Deductible
Specialist Visits 0% after Deductible 30% after Deductible
Emergency Room 0% after Deductible 0% after Deductible
Urgent Care 0% after Deductible 30% after Deductible
Rx Retail Copays
Generic $10 Copay 50% after Deductible
Preferred Brand $35 Copay 50% after Deductible
Non-Preferred Brand $70 Copay 50% after Deductible
Specialty Drug 25% w/$250 max per script (30 day supply) 50% after Deductible
Rx Mail Order
Generic $20 Copay Not Covered
Preferred Brand $105 Copay Not Covered
Non-Preferred Brand $210 Copay Not Covered
Specialty Drug 25% w/$250 max per script (30 day supply) Not Covered

All Pharmacy claims would apply to the Medical plan deductible, then the prescription copays would apply.