SignatureValue HMO
(CA only)
Administered by: UHC
Receive coverage for In-Network care only, coordinated by your Primary Care Physician (PCP). This plan is only available in California.
Medical coverage offers health care protection for you and your family. You may visit any medical provider you choose, but In-Network providers offer the highest level of benefits and lower out-of-pocket costs.
Network providers charge members reduced, contracted fees instead of their typical fees. Providers outside the plan’s network set their own rates, so you may be responsible for the full cost of Out-Of-Network services (HMO plans) or the difference if a provider’s fees are above the Reasonable and Customary (R&C) limits (PPO and CDHP plans). Additionally, several Out-Of-Network services require pre-authorization.
Administered by: UHC
Receive coverage for In-Network care only, coordinated by your Primary Care Physician (PCP). This plan is only available in California.
Administered by: UHC
Receive the same benefits and coverage as the Signature Value HMO plan, but with lower employee contributions. This plan has a narrower network of participating providers and is only available in Southern California.
Administered by: UHC
This plan has a higher deductible and the opportunity to enroll in a tax-free Health Savings Account (HSA).
Administered by: UHC
You’ll save money when you choose network providers, though you can choose any provider you’d like.
Before you pick your medical plan for 2023, here’s a quick look at how the plans line up side by side.
SignatureValue HMO (CA only) | SignatureValue Harmony HMO (Southern CA only) | Select Plus HSA Compatible CDHP | Select Plus PPO | |||
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In-Network | In-Network | In-Network | Out-Of-Network | In-Network | Out-Of-Network | |
Calendar Year Deductible | ||||||
Individual | $0 | $0 | $1,500 | $3,000 | $500 | $1,000 |
Family* | $0 | $0 | $3,000 | $6,550 | $1,500 | $3,000 |
Calendar Year Out-of-Pocket Maximum (Includes Deductible) | ||||||
Individual | $2,000 | $2,000 | $6,000 | $6,550 | $3,000 | $6,000 |
Family | $4,000 | $4,000 | $6,000 | $6,550 | $6,000 | $12,000 |
You pay | You pay | You pay | You pay | |||
Coinsurance | ||||||
Preventive Care | No Charge | No Charge | No Charge | Not Covered | No Charge | Not Covered |
Primary Care Physician | $20 copay | $20 copay | 20%* | 40%* | $20 | 40%* |
Specialist | $40 copay | $40 copay | 20%* | 40%* | $40 | 40%* |
Urgent Care | $20 (in area) | $20 (in area) | 20%* | 40%* | $20 copay per visit | 40%* |
Emergency Room | $150 copay (waived if admitted) | $150 copay (waived if admitted) | 20%* | 20%* | $200 copay (waived if admitted) | $200 copay (waived if admitted) |
Pharmacy** | ||||||
Retail RX (up to 31-day supply) | ||||||
Tier 1 | $10 copay | $10 copay | $10* | Copay plus the difference between non-network and network cost* | $10 | Copay plus the difference between non-network and network cost* |
Tier 2 | $30 copay | $30 copay | $30* | Copay plus the difference between non-network and network cost* | $30 | Copay plus the difference between non-network and network cost* |
Tier 3 | $50 copay | $50 copay | $50* | Copay plus the difference between non-network and network cost* | $50 | Copay plus the difference between non-network and network cost* |
Mail Order RX (up to 90-day supply) | ||||||
Tier 1 | $20 copay | $20 copay | $20* | Copay plus the difference between non-network and network cost* | $20 | Copay plus the difference between non-network and network cost* |
Tier 2 | $60 copay | $60 copay | $60* | Copay plus the difference between non-network and network cost* | $60 | Copay plus the difference between non-network and network cost* |
Tier 3 | $100 copay | $100 copay | $100* | Copay plus the difference between non-network and network cost* | $100 | Copay plus the difference between non-network and network cost* |
*After deductible
**Specialty covered at applicable Tier
(Available to eligible employees in California only)
HMO plans are designed for you to visit in-network providers. You will need to choose a Primary Care Physician (PCP) and coordinate care with any specialists through this PCP. Note that services received outside the network are not covered, except for emergency services.
(Available to eligible employees in Southern California only)
The SignatureValue Harmony HMO Plan has the same benefits and coverage as our Signature Value HMO plan, but with lower bi-weekly employee contributions. The plan has a narrower network of participating providers. The SignatureValue Harmony HMO network includes the physician groups shown below. To find a SignatureValue Harmony HMO provider, go to “Find A Doctor” at www.myuhc.com and search under SignatureValue Plans > SignatureValue Harmony.
A Consumer Directed Health Plan (CDHP) is made up of two unique components:
The CDHP works much like a PPO plan in that you have access to a broad network of providers and you may choose any provider when you need care. However, in exchange for a lower per-paycheck cost, you must satisfy a higher deductible that applies to almost all health care expenses, including those for prescription drugs. Remember, that higher deductible is offset by lower premiums and the ability to use a Health Savings Account (HSA). Once your deductible has been met, you will continue to pay a coinsurance and/or medical and prescription copays until your out-of-pocket maximum is met, then the plan pays 100%.
A CDHP could be a good fit for you if you prefer:
For more information about the UHC CDHP, call UHC at (866) 314-0335 or go to www.myuhc.com.
If you select the CDHP health plan, you may elect to contribute to your HSA on a pre-tax basis for your current or future health care expenses. Belkin will also contribute to your account each year. You decide when and how to use these funds; you can choose to save them to pay future health care expenses – even into retirement. There isn’t a “use it or lose it” rule, as there is with a Flexible Spending Accounts (FSAs). Any amount remaining in your account at the end of the year will carry over into following years until you need it. And if you leave Belkin for any reason (including retirement), you can take your funds with you.
Having an HSA offers a triple tax advantage:
This plan lets you visit the doctor of your choice. Although you may see a provider who does not participate in the plan’s network, in most cases your benefits are greater (and your out-of-pocket expenses smaller) when you see a network provider. You are not required to select a Primary Care Physician under this option. Once you reach the deductible, you will pay coinsurance until the out-of-pocket maximum is met, then the plan will pay 100% in-network.
For more information about the UHC PPO Plan, call UHC at (866) 633-2446 or go to www.myuhc.com.
To find an in-network provider in any of the UHC Select Plus medical plans, go to www.myuhc.com, scroll down and click on “Find a provider.” Select either the Medical or Mental Health Directory and then click on “All UnitedHealthcare Plans.” Scroll down the page and select the “Select Plus” plans. Enter the requested information to complete your search. You can also visit www.myuhc.com for many of your other needs, like downloading a temporary ID card, viewing your claims history, and more. See the UHC Portal section for more about what www.myuhc.com has to offer.
Because health care has evolved over time, it’s important to be an active participant in your own health care management. That means being proactive, cost-conscious and selective about your health care choices, which can help save money, time and frustration.
Virtual Visit | Doctor’s office | Urgent care clinic | Emergency room |
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Use it for | |||
A non-emergency medical or mental health issue that can be diagnosed by phone or online | A condition that doesn’t need immediate attention and can wait until the next day | A condition that needs immediate care but is not life- or limb-threatening | A life-threatening or potentially crippling condition that needs immediate attention |
Examples | |||
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Cost | |||
You pay: $ | You pay: $ | You pay: $$ | You pay: $$$ |
Find it | |||
Visit www.myuhc.com to register | Call your regular doctor or search for an in-network provider on your medical plan carrier’s website | Search for urgent care clinics near you at www.myuhc.com | Call 911 or search online for the nearest hospital |