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2014 Unity Health Plans: A Comparison

See below for a coverage comparison or to download a PDF chart, click here 

Requires you to pay a co-pay for primary, in-network services such as PCP/Specialist office visits, urgent care, and prescriptions. A deductible must be met before coverage begins for other specific services, such as lab services, surgery, hospitalization. You’ll pay LOWER bi-weekly premiums for the Basic Plan in comparison to the Enhanced Plan, but you may pay more in out-of-pocket costs depending on the services you use. 

Unity Enhanced Health Plan
Requires you to pay a co-pay for most in-network services; you are not required to meet a deductible for any services. You’ll pay HIGHER bi-weekly premiums than the Basic Plan, but you may pay less in out-of-pocket costs depending on the services you use.
 

2014 Bi-Weekly Health Insurance Costs

  Unity Basic Plan Unity Enhanced Plan
Full-time (35-40 hrs/week) Employee $58.79 $93.08
Employee and Spouse/ Partner $123.75 $206.43
Employee and Child $123.75 $206.43
Employee and Children $134.88 $224.78
Family $141.84 $234.79
Part-time (20-34 hrs/week) Employee $93.20 $151.50
Employee and Spouse/ Partner $203.63 $344.19
Employee and Child $203.63 $344.19
Employee and Children $222.56 $375.39
Family $234.40 $392.41

Premiums are taken from your paycheck before taxes in most cases, meaning the portion of your pay that goes toward the cost of health insurance is not taxed. According to IRS rules, the amount Unity pays toward the cost of domestic partner benefits must be treated as taxable income.

Annual Deductible and Out-of-Pocket Maximum Amounts
  Unity Basic Plan Unity Enhanced Plan
Individual Deductible

$600
$200 for Unity-employed doctors and services

No deductible for
in-network services
Family Deductible

$1,800
$600 for Unity-employed doctors and services

No deductible for
in-network services
Individual Out-of-Pocket Maximum

$2,400
$800 for Unity-employed doctors and services

$1,500
$500 for Unity-employed doctors and services

Family Out-of-Pocket Maximum

$7,200
$2,400 for Unity-employed doctors and services

$4,500
$1,500 for Unity-employed doctors and services

Coverage
Adult Annual Physical No co-pay No co-pay
Adult Preventive Care such as immunizations, mammograms, routine OB/GYN, prostate screening, colonoscopy No co-pay No co-pay
Well-Child Visits No co-pay No co-pay
Adult Physician Office/Sick Visits

$40 co-pay
No co-pay for a Unity-employed doctor

$30 co-pay
No co-pay for a Unity-employed doctor

Child Primary Care Sick Visits
$40 co-pay
No co-pay for a Unity-employed doctor
No-copay
Specialist (Adults and Children)

$60 co-pay
No co-pay for a Unity-employed doctor

$50 co-pay
No co-pay for a Unity-employed doctor

Prescription Drugs

Tier 1: $10/$5 at Unity pharmacy
Tier 2: $45/$20 at Unity pharmacy
Tier 3: $90/$30 at Unity pharmacy
Mail order Rx: 2 co-pays for 90 day supply

Tier 1: $10/$5 at Unity pharmacy
Tier 2: $30/$15 at Unity pharmacy
Tier 3: $50/$25 at Unity pharmacy
Mail order Rx: 2 co-pays for 90 day supply

Diabetes Medication and Supplies No-copay No-copay
Routine Vision Care
(Adults and Children over 19)
$40 co-pay one exam every two years $30 co-pay once per year
Eyewear
(Adults and Children over 19)
$60 allowance once every two years $60 allowance once every two years
Routine Vision Care
(Children 19 and under)
$40 co-pay for one exam per year

No co-pay for one exam per year

Eyewear (Children 19 and under) $60 allowance annually $60 allowance annually
Emergency Care

$350 co-pay unless admitted to hospital within 24 hours
$100 co-pay for children <age 19
No co-pay for Unity’s
Emergency Center

$250 co-pay unless admitted to hospital within 24 hours
$75 co-pay for children <age 19
No co-pay for Unity’s
Emergency Center

Urgent Care

$75 co-pay
No co-pay for Unity’s
Walk-In Care Center

$50 co-pay
No co-pay for Unity’s
Walk-in Care Center

X-Rays

80% after deductible
90% after deductible for
Unity services

$50 co-pay
No co-pay for Unity services

Diagnostic Lab & Pathology

80% after deductible
90% after deductible for
Unity services

$30 co-pay
No co-pay for ACM Medical Laboratory
Maternity Hospital Care/
Newborn Nursery

80% after deductible
90% after deductible for
Unity services

Prenatal & postpartum care: covered in full
Hospital for mother: $350 co-pay, physician $350 co-pay 
Newborn nursery:
covered in full
All Unity maternity doctors/services: no co-pay or co-insurance

Inpatient Hospital Care

80% after deductible
90% after deductible for
Unity services

$350 co-pay per admission
No co-pay for Unity Hospital

Mental Health/
Chemical Dependency: Outpatient

$60 co-pay per visit
No co-pay for
Unity services

$50 co-pay per visit
No co-pay for Unity-employed
doctor or service

Mental Health/
Chemical Dependency: Inpatient

80% after deductible
90% after deductible for
Unity services

$350 co-pay for admission
No co-pay for Unity services

Lifestyle Allowance: Reimbursement for healthy activities such as fitness club memberships and excercise classes.
Click here for details.
$250 total annual reimbursement $500 total annual reimbursement
Dependent Coverage To age 26 To age 26