Medical Plans

Cone Health will continue to offer the Choice and Save Plans administered by UMR and the Focus Plan administered by Centivo.

Medical Plan Cost Comparison

All of the plans have some things in common:

  1. You must use in-network providers for your care (Choice and Save Plans – United Healthcare Choice Plus; Focus Plan – Centivo).
  2. Preventive services are covered at 100%.
  3. You must get your maintenance and specialty medications from a Cone Health Outpatient Pharmacy either in-person or through mail-order.
  4. There are no exclusions for pre-existing conditions.
  5. Review requirements for the Healthy Lifestyle Premium program to ensure medical premiums remain low.
  6. A $100 spousal surcharge applies only IF your spouse has access to other coverage with another employer. This surcharge does not apply if your spouse is on Medicare, self-employed, unemployed, retired or is also an employee of Cone Health.
  7. The prescription drug plan is the same for all three plans. However, remember with the Save Plan that you pay the full cost of your prescription drugs until your deductible is met. Once your Save Plan deductible is met, you will have the same co-pays and co-insurance as the Choice and Focus Plans. The only exception to the Save Plan is the list of “Safe Harbor” drugs (please see additional information under the Save Plan description). Any out-of-pocket expenses covered by a manufacturer co-pay savings card will no longer be applied toward your deductible or out-of-pocket maximum.

PREMIUM COST for Each Medical Plan - Fulltime and Parttime Rates

 

FULLTIME RATES

PARTTIME RATES

 

CHOICE

SAVE

FOCUS

CHOICE

SAVE

FOCUS

Employee Only

$89

$55

$65

$150

$119

$130

Employee + Child(ren)

$155

$90

$100

$216

$155

$165

Employee + Spouse

$193

$100

$110

$253

$165

$175

Employee + Family

$250

$141

$151

$310

$207

$217

Employee + Spouse w/Surcharge

$293

$200

$210

$353

$265

$275

Employee + Family w/Surcharge

$350

$241

$251

$410

$307

$317

*Full time premium cost is .75 to 1.0 FTE – Part time rates  .30 to .74 FTE

*Physicians in a profit and loss business model will pay total cost of medical plan

*Employees who did not complete the Healthy Lifestyle Premium Discount program in 2021 will pay additional $15 per pay period.

*New hires and status change will pay additional $15 per pay period if Health Risk Assessment not completed within 30 days of enrollment

*Surcharge of $100 per pay period is required if your covered spouse has access to coverage with another employer and you opt to cover them on Cone Health’s medical plan. You do not have to pay the surcharge if your spouse is unemployed, self-employed, retired, on Medicare, or is also a benefit eligible Cone Health employee