Coverage to Build a Foundation of Good Health
At Olympic Steel, we understand the importance of good health as the foundation for a productive life at home and at work. That is why we offer medical and prescription coverage, administered by UnitedHealthcare (UHC), to fit your needs and budget.
Keep in mind that you may use any provider or facility. However, if you choose a network provider, your UHC benefits will be paid at the highest level. In addition, if you use a Tier 1
Designated provider your office visit out of pocket amount will be reduced. Remember that you will pay more for care if you choose an out-of-network provider.
Use Your Coverage Wisely – Urgent Care vs Emergency Room
Everyone wants to save time and money and sometimes it takes a little legwork to do both. One way is to be aware of the appropriate usage of the Emergency Room versus using an Urgent Care center.
Urgent Care is for minor illness and injuries such as sprains and cuts, colds and the flu. The Emergency Room is for true emergencies such as broken bones, chest pains, and excessive bleeding…any condition that may be life-threatening or that will cause permanent damage without immediate and a higher level of care.
On average, the cost of the Emergency Room is five to eight times higher than the cost of Urgent Care and the average wait time is several hours instead of minutes. Why pay more and wait more for the same outcome?
UnitedHealthcare PPO Plan
How it Works
The UHC medical plan is a Preferred Provider Organization (PPO) which means UHC has contracted with a network of healthcare providers, including facilities, to provide better pricing for those who seek care within the network. UHC has further enhanced their PPO network by identifying certain providers as Designated Tier 1 providers. Tier 1 providers have demonstrated that they provide both quality and cost-effective care for their patients. Since managing healthcare dollars is everyone’s responsibility, there is a lower copay for you when you seek care from a Tier 1 provider. See the plan summary for more details.
In-Network Medical Plan FAQs:
- When you use network and Tier 1 providers you will pay less for your care;
- Copays:
- Office visits, ER, Urgent Care and Generic prescription drug all have flat copays and are not subject to the Plan deductible;
- Copays do not count toward your deductible
- Copays do accumulate toward your annual out-of-pocket maximum
- The annual deductible will apply to services such as Inpatient hospital stays, Outpatient services and some diagnostic testing
- Once the deductible is met, the Plan’s will begin to pay benefits at 80% (network)
- Your coinsurance amount after the deductible is 20%; once your annual out of pocket maximum is met the Plan will pay covered services at 100% for the rest of the plan year (network).
Preferred Lab Network (PLN)
Just like there are Tier 1 doctors and specialists in the UHC network, there are also Preferred Lab Networks (PLN). When you use a PLN there is no cost to you for diagnostic lab work, testing and x-rays. Participating labs include LabCorp, Quest Diagnostics and AmeriPath to name a few. To find the locations of these labs and those of other preferred labs, go to www.myuhc.com and look for the 
icon.
Prescription Coverage through UHC/OptumRx
If you enroll in the medical plan, you are automatically enrolled in prescription drug coverage. The pharmacy benefits manager is OptumRx, UHC’s pharmacy partner. To find out which drugs are covered, refer to the National Drug List found to the right side of this window or contact a customer service representative at 1-833-760-7890.
Some medications may require prior authorization from OptumRx before your prescription will be filled. Your doctor should contact OptumRx to initiate a prior authorization request.
Visit MyUHC.com if you have questions regarding your medical or prescription coverage.
Resources
PPO Plan Details
| Plan Features | In-Network | Out-of-Network |
| Deductible | $1,000 /individual $3,000/family |
$2,000/individual $6,000/family |
| Coinsurance | 20% | 40% |
| Out-of-Pocket Maximum | $5,000/individual $10,000/family |
$5,500/individual $11,000/family |
| Primary Care Copay | $25 | 40% after deductible |
Designated Primary Care Copay  |
$10 | N/A |
| Specialist Copay | $45 | 40% after deductible |
| Designated Specialist Copay |
$25 | N/A |
| Diagnostic Lab | 20% after deductible | 40% after deductible |
| Diagnostic Lab at Preferred Lab |
$0 | N/A |
| Virtual Visits | $0 | Not Covered |
| Urgent Care | $50 | 40% after deductible |
| Emergency Room | $200 | 40% coinsurance after deductible |
| Prescription Drug | $10 Generic 25% Brand Preferred 50% Brand Non-Preferred |
$10 Generic 25% Brand Preferred 50% Brand Non-Preferred |
Please refer to the benefits summary for more information.
Physician office visit copays, ER and urgent care copays, and prescriptions do not count toward your deductible, but do accumulate toward your out-of-pocket maximum. The annual deductible is included in the out-of-pocket maximum.
UnitedHealthcare HDHP Plan
A High Deductible Health Plan is a medical plan that typically has a much higher deductible than a traditional PPO plan. Eligible healthcare services are not payable by the insurance plan until you meet your annual deductible. Once the deductible is met, the plan will pay benefits according to the coinsurance amount and you will pay the balance. Once the sum of your deductible and your coinsurance amounts meet the annual out-of-pocket maximum the plan will pay eligible expenses at 100% for the rest of the plan year.
To help manage plan expenses, you are eligible to establish a Health Savings Account. You fund the account with pre-tax dollars from your paycheck or, if you add contributions on an after-tax basis, you can claim them on your healthcare annual tax return. Money in the HSA is to be used to offset a higher deductible and other IRS qualified expenses. If you don’t have expenses, the account serves as a tax-free savings vehicle for the future.
In-Network Medical Plan FAQs:
- When you use network and Tier 1 providers you will pay less for your care;
- The plan pays 100% for in-network preventive care.
- You pay all non-preventive care costs, including prescription drugs, up to the annual deductible. The annual deductible is $3,200 for Individual and $6,000 for Family when you use in-network providers.
- Once you have met the deductible, you will pay coinsurance for services received. When you use in-network providers, your coinsurance cost will be 20% for individual and family.
- Your coinsurance amount after the deductible is 20%; once your annual out of pocket maximum is met the Plan will pay covered services at 100% for the rest of the plan year (network).
Resources
HDHP Plan Details
| Plan Features | In-Network | Out-of-Network |
| Deductible | $3,200 /individual $6,400 /family |
$6,000 /individual $12,000 /family |
| Coinsurance | 20% | 40% |
| Out-of-Pocket Maximum (includes deductible) |
$6,000 /individual $12,000 /family |
$12,000 /individual $24,000 /family |
| Preventive Visit and Routine Services | Paid in full by plan | 40% after deductible |
| Primary Care Copay | 20% after deductible | 40% after deductible |
| Designated Primary Care Copay | 0% after deductible | 40% after deductible |
| Specialist Copay | 20% after deductible | 40% after deductible |
| Designated Specialist Copay | 0% after deductible | 40% after deductible |
| Diagnostic Lab | 20% after deductible | 40% after deductible |
| Diagnostic Lab and Preferred Lab | 0% after deductible | 40% after deductible |
| Virtual Visits | $49 before the deductible; 0% after deductible |
40% after deductible |
| Urgent Care | 20% after deductible | 40% after deductible |
| Emergency Room | 20% after deductible | 40% after deductible |
| Prescription Drug | 20% after deductible | 40% after deductible |
Please refer to the benefits summary for more information.
