The Plan at a Glance
Plan feature
Coverage amount
Deductible
Out-of-pocket maximum
Hospital stay
  • Plan pays 80% after the Plan deductible has been met.
Surgery in a hospital
  • Plan pays 80% after the Plan deductible has been met.
Retail prescription drugs
  • Use a participating retail pharmacy in the Pharmacy Benefits Manager's network to receive a discounted price.
  • Generic:
    • Plan pays 80% of the Pharmacy Benefits Manager's negotiated price after the Plan deductible has been met. Note: Retail prescription claims are applicable to deductible and out-of-pocket limits.
  • Brand-Name:
    • In network: Plan pays 80% of the Pharmacy Benefits Manager's negotiated price after the Plan deductible has been met.
    • Out-of-Network: Plan pays 80% of the Pharmacy Benefits Manager's negotiated price.
  • You have a "grace period" during which you may fill long term prescriptions up to three times at a participating retail pharmacy and still pay the participating retail pharmacy copayment. Beginning with the fourth time you fill the prescription, you will pay coinsurance of 50% for each medication. You should continue to fill your short term prescriptions, such as antibiotics, at a participating retail pharmacy.
Mail-order drugs
  • The Plan covers 100% of the price after a $15 copayment for generic drugs and $30 copayment for brand name drugs. Note: Prescription mail order claims do not apply to deductible or out-of-pocket limits.
Wellness benefit
  • Not covered
Lifetime maximum
  • $2,000,000 for each person covered under the Plan
Contact Information
For Medical Services:
United HealthCare (Claims Administrator)
PO Box 740800
Atlanta, GA 30374-0800
Phone: +1 800 645 6555
Website: www.myuhc.com/groups/mmc
For Prescription Drug Coverage:
Medco (Pharmacy Benefits Manager)
Medco Customer Service: +1 800 987 8360
Website (for members): www.medco.com
Marsh & McLennan Companies (Company) does not administer claims under this Plan. For medical claims, UHC's decisions are final and binding; for prescription drug services, Medco's decisions are final and binding.