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Medical

Medical

Health Plan Options

The Unison Risk Advisors Health Plan offers you the ability to customize your benefits plan through Personify Health, with the choice between five different health plans.

Each plan utilizes the Anthem Blue Cross Blue Shield network of providers, which is the most comprehensive network available in the country. Prescription drugs are managed by TrueRx, a transparent, patient-focused pharmacy benefits manager with over 65,000 network pharmacies, including low-cost mail order pharmacies such as Amazon Pharmacy & Mark Cuban Cost Plus Drugs.

Traditional PPO Plans

Two traditional PPO options:

  • Deductibles of $1,000 or $5,000
  • Enjoy the predictability of set copay amounts for office visits, ER & prescriptions
  • Experience a higher per pay cost from your paycheck
  • Preventive services are covered at 100%​

High-Deductible Health Plans (HDHP)

Three HSA plan options:

  • Select from a $3,300 Deductible, a $5,000 Deductible plan, and a $1,650 Deductible plan.
  • Enjoy lower per pay period medical plan costs
  • Preventive Services are covered at 100%
  • Open a Health Savings Account through our partner (Voya) for tax-free deposits
  • Receive per pay contributions from Oswald into your Health Savings Account​

PLAN #1

Anthem Blue Cross Blue Shield

$1,000 Preferred Provider Organization Plan (PPO)

Designed for those who prefer the predictability of set payments for doctor appointments and other medical services.
$1,000 PPO In-Network Out-of-Network
Annual Deductible (Individual/Family) $1,000 / $2,000 $3,000 / $6,000
Coinsurance Ded/20% Ded/40%
Office Visit / Exam $20 Ded/40%
Outpatient Specialist Visit $20 Ded/40%
Maximum Out-of-Pocket (Individual/Family) $6,000 / $12,000 $12,000 / $24,000
Deductible Included in Out-of-Pocket Limits Yes Yes
Deductible Embedded Yes Yes
Inpatient Hospital Services Ded/20% Ded/40%
Outpatient Service Ded/20% Ded/40%
Emergency Services $200 then 20% $200 then 20%
Urgent Care Visits $75 Ded/40%
Preventive Care Covered 100% Ded/40%
Prescription Drugs
Retail
Generic / Tier 1 $10 See plan documents for details
Brand (Formulary/Preferred) / Tier 2 $35 See plan documents for details
Brand (Non-Formulary/Non-preferred) / Tier 3 $70 See plan documents for details
Specialty / Tier 4 25% up to $250 or the max of any available manufacturer-funded copay assistance See plan documents for details
Mail Order    
Generic / Tier 1 $20 See plan documents for details
Brand (Formulary/Preferred) / Tier 2 $105 See plan documents for details
Brand (Non-Formulary/Non-preferred) / Tier 3 $210 See plan documents for details
Specialty / Tier 4 25% up to $250 or the max of any available manufacturer-funded copay assistance See plan documents for details

PLAN #2

Anthem Blue Cross Blue Shield

$5,000 Preferred Provider Organization Plan (PPO)

Designed for those who prefer the predictability of set payments for doctor appointments and other medical services.
$5,000 PPO In-Network Out-of-Network
Annual Deductible (Individual/Family) $5,000 / $10,000 $10,000 / $20,000
Coinsurance Ded/10% Ded/30%
Office Visit / Exam $25 Ded/30%
Outpatient Specialist Visit $50 Ded/30%
Maximum Out-of-Pocket (Individual/Family) $6,600 / $13,200 $12,700 / $25,400
Deductible Included in Out-of-Pocket Limits Yes Yes
Deductible Embedded Yes Yes
Inpatient Hospital Services Ded/10% Ded/30%
Outpatient Service Ded/10% Ded/30%
Emergency Services $200 then 10% $200 then 10%
Urgent Care Visits $75 Ded/30%
Preventive Care Covered 100% Ded/30%
Prescription Drugs
Retail
Generic / Tier 1 $10 See plan documents for details
Brand (Formulary/Preferred) / Tier 2 $35 See plan documents for details
Brand (Non-Formulary/Non-preferred) / Tier 3 $70 See plan documents for details
Specialty / Tier 4 25% up to $250 or the max of any available manufacturer-funded copay assistance See plan documents for details
Mail Order    
Generic / Tier 1 $20 See plan documents for details
Brand (Formulary/Preferred) / Tier 2 $105 See plan documents for details
Brand (Non-Formulary/Non-preferred) / Tier 3 $210 See plan documents for details
Specialty / Tier 4 25% up to $250 or the max of any available manufacturer-funded copay assistance See plan documents for details

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

PLAN #3

Anthem Blue Cross Blue Shield

$1,650 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.
$1,650 HDHP In-Network Out-of-Network
Annual Deductible (Individual/Family) $1,650 / $3,300 $3,300 / $6,600
Coinsurance Ded/20% Ded/40%
Office Visit / Exam Ded/20% Ded/40%
Outpatient Specialist Visit Ded/20% Ded/40%
Maximum Out-of-Pocket (Individual/Family) $3,500 / $7,000 $7,000 / $14,000
Deductible Included in Out-of-Pocket Limits Yes Yes
Deductible Embedded No* No*
Inpatient Hospital Services Ded/20% Ded/40%
Outpatient Service Ded/20% Ded/40%
Emergency Services Ded/20% Ded/20%
Urgent Care Visits Ded/20% Ded/20%
Preventive Care Covered 100% Ded/20%
Prescription Drugs
Retail
Generic / Tier 1 Ded/$10 See plan documents for details
Brand (Formulary/Preferred) / Tier 2 Ded/$35 See plan documents for details
Brand (Non-Formulary/Non-preferred) / Tier 3 Ded/$70 See plan documents for details
Specialty / Tier 4 Ded/25% up to $250 or the max of any available manufacturer-funded copay assistance See plan documents for details
Mail Order    
Generic / Tier 1 Ded/$20 See plan documents for details
Brand (Formulary/Preferred) / Tier 2 Ded/$105 See plan documents for details
Brand (Non-Formulary/Non-preferred) / Tier 3 Ded/$210 See plan documents for details
Specialty / Tier 4 Ded/25% up to $250 or the max of any available manufacturer-funded copay assistance See plan documents for details

*This plan has an Aggregate Deductible, which means if more than one person is on the plan, the family deductible must be met before coinsurance applies.

PLAN #4

Anthem Blue Cross Blue Shield

$3,300 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.
$3,300 HDHP In-Network Out-of-Network
Annual Deductible (Individual/Family) $3,300 / $6,600 $6,600 / $13,200
Coinsurance Ded/0% Ded/30%
Office Visit / Exam Ded/0% Ded/30%
Outpatient Specialist Visit Ded/0% Ded/30%
Maximum Out-of-Pocket (Individual/Family) $4,000 / $8,000 $10,400 / $20,800
Deductible Included in Out-of-Pocket Limits Yes Yes
Deductible Embedded Yes Yes
Inpatient Hospital Services Ded/0% Ded/30%
Outpatient Service Ded/0% Ded/30%
Emergency Services Ded/0% Ded/0%
Urgent Care Visits Ded/0% Ded/30%
Preventive Care Covered 100% Ded/30%
Prescription Drugs
Retail
Generic / Tier 1 Ded/$10 See plan documents for details
Brand (Formulary/Preferred) / Tier 2 Ded/$35 See plan documents for details
Brand (Non-Formulary/Non-preferred) / Tier 3 Ded/$70 See plan documents for details
Specialty / Tier 4 Ded/25% up to $250 or the max of any available manufacturer-funded copay assistance See plan documents for details
Mail Order    
Generic / Tier 1 Ded/$20 See plan documents for details
Brand (Formulary/Preferred) / Tier 2 Ded/$105 See plan documents for details
Brand (Non-Formulary/Non-preferred) / Tier 3 Ded/$210 See plan documents for details
Specialty / Tier 4 Ded/25% up to $250 or the max of any available manufacturer-funded copay assistance See plan documents for details

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

PLAN #5

Anthem Blue Cross Blue Shield

$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.
$5,000 HDHP In-Network Out-of-Network
Annual Deductible (Individual/Family) $5,000 / $10,000 $10,000 / $20,000
Coinsurance Ded/0% Ded/30%
Office Visit / Exam Ded/0% Ded/30%
Outpatient Specialist Visit Ded/0% Ded/30%
Maximum Out-of-Pocket (Individual/Family) $6,350 / $12,700 $12,700 / $25,400
Deductible Included in Out-of-Pocket Limits Yes Yes
Deductible Embedded Yes Yes
Inpatient Hospital Services Ded/0% Ded/30%
Outpatient Service Ded/0% Ded/30%
Emergency Services Ded/0% Ded/0%
Urgent Care Visits Ded/0% Ded/30%
Preventive Care Covered 100% Ded/30%
Prescription Drugs
Retail
Generic / Tier 1 Ded/$10 See plan documents for details
Brand (Formulary/Preferred) / Tier 2 Ded/$35 See plan documents for details
Brand (Non-Formulary/Non-preferred) / Tier 3 Ded/$70 See plan documents for details
Specialty / Tier 4 Ded/25% up to $250 or the max of any available manufacturer-funded copay assistance See plan documents for details
Mail Order    
Generic / Tier 1 Ded/$20 See plan documents for details
Brand (Formulary/Preferred) / Tier 2 Ded/$105 See plan documents for details
Brand (Non-Formulary/Non-preferred) / Tier 3 Ded/$210 See plan documents for details
Specialty / Tier 4 Ded/25% up to $250 or the max of any available manufacturer-funded copay assistance See plan documents for details
Oswald Companies
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