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Healthcare FAQs: The Cost, What’s Covered, and Differences Between Plans

"What's the difference between the Gold and Silver Plan?" "How much will I pay per month?" Get answers to these questions and others below.

UnitedHealthcare® Health Insurance Plans: Key Differences

We offer two UnitedHealthcare plans: Gold PPO and Silver POS (NexusACO Network)

 

GOLD PPO PLAN - DX-YP NexusACO OAP

SILVER POS PLAN - DX-YU NexusACO

Cost and Pay Schedule 

The monthly premium for the Gold PPO plan varies according to coverage level: 

  • Employee coverage only - $629.20/month
  • Employee & spouse coverage only - $1,258.40/month
  • Employee & children only - $1,164.02
  • Employee, all family - $1,793.22 

Once your coverage officially begins, monthly payments will be made from your bank account on the 15th of every month. Payments apply to the following month's coverage; for instance, your July 15th payment would go toward coverage in August. 

Note: Your reimbursable Care Benefits can be used toward your healthcare plan premium, which can potentially lower the cost by $250 per month. 

 

 The monthly premium for the Silver POS plan varies according to coverage level: 

  • Employee coverage only - $559.01/month
  • Employee & spouse coverage only - $1,118.02/month
  • Employee & children only - $1,034.17
  • Employee, all family - $1,593.18 

Once your coverage officially begins, monthly payments will be made from your bank account on the 15th of every month. Payments apply to the following month's coverage; for instance, your July 15th payment would go toward coverage in August. 

Note: Your reimbursable Care Benefits can be used toward your healthcare plan premium, which can potentially lower the cost by $250 per month. 

 

Plan Details 

The Gold PPO plan is our most comprehensive healthcare plan, which includes 100% preventative coverage and lower upfront costs. It's a top-notch plan at a fraction of the usual cost—and the first of its kind offered to temp dental workers. It offers a lower deductible (when compared to the Silver POS plan) for Tier 3 and Tier 4 prescriptions.  A non-exhaustive list of plan details:

  • PPO plan with in- and out-of-network benefits. Out-of-network doctors and hospitals may be used without a referral (with higher costs). 
  • Annual Deductible: 

    $2000 Individual / $4000 Family

  • Separate Rx Deductible: 

    A $50 individual / $100 family deductible applies to Tier 3 and 4 drugs.

  • Coinsurance: You pay 25% / Carrier pays 75%
  • Annual Out-of-Pocket Maximum:
    $7,900 Individual / $15,800 Family
  • 100% in-network preventative coverage, plus coverage for diagnostics, labs and x-rays. 
  • United Healthcare (UHC) network includes 1,196,000 doctors/providers and 67,000 pharmacies across the U.S.
  • Access to reward programs through UHC, for additional rewards. 
  • Access to sleep apnea diagnosis and treatment

The Silver POS plan is a comprehensive healthcare plan for a lower monthly premium in exchange for slightly higher upfront costs. Beneficiaries must designate a primary care physician. A non-exhaustive list of plan details:

  • POS (point of sale) plan that acts as a combination of the HMO (designated provider/lower copay) and PPO plan. In- and out-of-network benefits. Out-of-network doctors and hospitals may be used without a referral (with higher costs). 
  • Annual Deductible: 

    $5,500 Individual / $11,000 Family

  • Separate Rx Deductible: 

    A $500 individual / $1000 family deductible applies to Tier 3 and 4 drugs.

  • Coinsurance: You pay 45% / Carrier pays 55%
  • Annual Out-of-Pocket Maximum:
    $9,200 Individual / $18,400 Family
  • 100% in-network preventative coverage, plus coverage for diagnostics, labs and x-rays. 
  • United Healthcare (UHC) network includes 1,196,000 doctors/providers and 67,000 pharmacies across the U.S.
  • Access to reward programs through UHC, for additional rewards. 
  • Access to sleep apnea diagnosis and treatment
Eligibility

To qualify for this plan, you must be able to work 68 hours (approximately 8.5 shifts) through onDiem per month. 

This eligibility requirement does not apply until after your waiting period is over and your coverage officially begins.

To qualify for this plan, you must be able to work 68 hours (approximately 8.5 shifts) through onDiem per month. 

This eligibility requirement does not apply until after your waiting period is over and your coverage officially begins.

 

For more information, please visit the rest of our Healthcare Benefits FAQs, or contact us at support@ondiem.com