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The Choice Plan

The Choice Plan is a traditional Preferred Provider Organization (PPO) plan. The administrator of this plan is UMR and the network is United Healthcare Choice Plus which is a national network.

This type of plan allows you to visit any United Healthcare in-network physician or provider you wish without first requiring a referral from a Primary Care Physician. What you pay depends on where you get your care. If your care is provided by a Cone Health or THN provider, your out of pocket costs are lower (see Cone Health Network column below) than if you go to a provider that is in the United Healthcare network but not part of Cone Health or THN (see United Healthcare Choice Plus Network column below). However, your total annual out-of-pocket maximum is the same.

Advantages of the Choice Plan

  • Large nationwide network of healthcare providers; good particularly if you live out of the local area or have children who go to school or live out of state
  • Lower costs for services at a Cone Health or THN physician or Cone Health facility
  • Low deductible
  • Predictable co-pays
    • No cost for e-Visits and Virtual Visits (video/phone). NOTE: A video visit with your personal physician is considered an office visit.
    • Deductible does not apply to prescription drugs

Disadvantages of the Choice Plan

  • Higher premiums
  • Higher Out-Of-Pocket Annual Maximum

Download Printable Chart

Choice Plan Specifics
United Healthcare Choice Plus Network
Cone Health Network
These discounts are an incentive to use the Cone Health Network
Calendar Year Deductible - CYD (Individual/Family)
$300/$600
$300/$600
Out-of-Pocket Maximum - OOP (Individual/Family)
$7,900 /$15,800
$7,900 /$15,800
Lifetime Maximum
Unlimited
Unlimited
Preventive Care - Annual wellness exams, Pap test, , bone density and/or vision care (eye exam)
No cost
No cost
Breast Health - Screening mammograms, ultrasound and/or MRI
No cost
No cost
Breast Health - Diagnostic mammograms, ultrasound and/or MRI
No cost after deductible
No cost after deductible
Hospital Admission Includes both medical and mental health inpatient admissions. All acute inpatient days require pre-authorization.
$1,000 copay and 40% after deductible
$500 copay and 20% after deductible
Maternity - Follows regular hospital admission and physician services
$1,000 copay and 40% after deductible
$500 copay and 20% after deductible
Outpatient Ambulatory Surgery
$500 copay and 40% after deductible
$250 copay and 20% after deductible
Radiology Services - ((Except CT, MRI and PET scans) Regardless of where they are done including physician offices
40% after deductible
20% after deductible
Select Radiology Services - (CT, MRI and PET scans) Regardless of where they are done including physician offices
$500 copay and 40% after deductible
$250 copay and 20% after deductible
Primary Care Office Visit - (Includes family practice, internal medicine physicians, and pediatricians)
$35 copay after deductible
$15 copay - NOT subject to deductible if Triad HealthCare Network or Cone Health provider
Specialist Office Visit - (Includes all specialty physicians such as surgeons, cardiologists, radiologists, OB/GYNs)
$60 copay after deductible
$50 copay if a Triad HealthCare Network specialist after deductible
e-Visits via MyChart
Not applicable
No cost
Connected Care Virtual Visit (video/phone)
Not applicable
No cost
Chiropractic Office Visit
$40 copay after deductible
Only available in the United Healthcare Choice Plus Network
Physician Services - Hospital inpatient or outpatient surgery
20% after deductible
20% after deductible
Emergency Room Visit
$500 copay after deductible
$500 copay after deductible
Urgent Care Visit
$100 copay after deductible
$75 co-pay after deductible
Laboratory Services (Medically necessary)
Routine wellness labs covered at 100% all other labs 20% after deductible
Routine wellness labs covered at 100% all other labs 20% after deductible
Therapeutic Services(Physical, occupational, speech therapy office visits)
$40 copay after deductible 24 visit maximum per year
$20 copay after deductible
Cardiac and Pulmonary Rehab Visits
$40 copay after deductible 24 visit maximum per year
No cost
Holistic Treatment
$40 copay with $500 maximum benefit per year after deductible
$40 copay with $500 max benefit per year after deductible
Mental Health Individual Counseling or Group Therapy
$35 copay after deductible
$15 copay - NOT subject to deductible if THN or CH provider

Choice Plan - Healthy Lifestyle Premiums (26 pay periods)

New employees and status changes, along with covered spouses, are required to complete the Health Assessment within 30 days or premiums will increase by $15.

Coverage Levels
Full-Time Rates Per Pay Period
Part-Time Rates Per Pay Period
Employee Only
$86.00
$146.00
Employee + Child(ren)
$150.00
$210.00
Employee + Spouse
$187.00
$246.00
Employee + Family
$243.00
$301.00
Employee + Spouse w/ Spousal Surcharge
$262.00
$321.00
Employee + Family w/ Spousal Surcharge
$318.00
$376.00

*Full-time is .75 to 1.0 FTE; Part-time is .30 - .74 FTE.
*Physicians in a profit and loss model will pay total cost of this plan.
*Spouse surcharge of $75 per pay period is required if your covered spouse is offered coverage with another employer and you opt to cover them on a Cone Health medical plan. You do not have to pay the surcharge if your spouse is unemployed, self-employed, retired, on Medicare, a student or also a Cone Health employee.

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For personal help by phone, please call the Benefits Call Center at (336) 832-8777 from 8:30 a.m. to 5 p.m. Monday through Friday.

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