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Health Plans

Unity offers you the choice of two health insurance plans through Excellus BCBS:

  • Unity Basic Health Plan
  • Unity Enhanced Health Plan

What You Get with Either Plan

  • Coverage for your spouse, children up to age 26, and domestic partner
  • Freedom to choose any health care provider you like
  • Access to BlueCross BlueShield PPO Network
  • No requirement to select a primary care physician or get referrals for specialists
  • 3-tier prescription drug benefit, with even lower prices at a Unity Pharmacy
  • Unity Services Discount
  • 100% coverage for diabetic medication and supplies
  • Free “well physician visits” for children, free routine preventive care for adults, and flat co-pays for physician office visits
  • Annual “lifestyle allowance” for a wide range of wellness activities and services, such as gym membership and weight management programs
  • Both plans are considered “creditable" under the Medicare Part D guidelines

General Plan Differences

Requires you to pay a deductible and co-insurance for some services and co-pays for other services. You’ll pay LESS in premiums than the Enhanced Plan, but you may pay more in out-of-pocket costs. 
  • For example, physician office visits and emergency room visits require only a co-pay; lab work, diagnostic X-rays, outpatient surgery and other similar services require you to reach a deductible before the services are covered. After that, you are responsible for paying a percentage of the remaining cost (co-insurance).
  • The Basic Plan has an out-of-pocket maximum of $2,400 for individuals and $7,200 for families. Once this has been reached, the Plan will pay 100% of all remaining covered services for the rest of the year.
Requires you to pay co-pays for most in-network services. You’ll pay MORE in premiums than the Basic Plan, but you may pay less in out-of-pocket costs.

 

How to Choose

Either plan might provide the best coverage and value for you and your family.

  • View a side-by-side comparison to see the plans’ premiums and out-of-pocket payments for many services.
  • Review Choosing A Health Plan to determine how each plan could support your health care needs.
  • Visit Excellus BCBS’s Healthcare Advisor, an online tool that provides information on health conditions and treatment option and compares costs of procedures and medications.
  • To reach the tool, click “Get Started Now” and log in or register. You’ll need your insurance ID number to register for the first time.

Note: If you are unable to afford health insurance through Unity’s plans, you may meet the eligibility requirements for Child or Family Health Plus. For more information, call Unity’s Facilitated Enrollment Department at 368-4401.
 

Waiving Unity Health Plan Coverage 

If you have coverage from another source, such as through your spouse, you may choose not to enroll in a Unity Health Plan. You’ll still save money if you use Unity doctors or services, through the Unity Services Discount.




Health Plan FAQs

How do I request a replacement insurance ID card?
What is the cost of Unity's health coverage?
Who can I cover on my health insurance?

How many hours do I have to work to be eligible for health insurance?
Do I have to submit eligibility documentation for my dependents?
What doctors can I see with Unity’s health plans?
If I have family coverage, how do the individual and family deductibles work?
What’s the relationship between individual and family deductibles and individual and family out-of-pocket maximums?
What is the difference between in-network and out-of-network, or the differences between co-pays, co-deductibles, deductibles and premiums?


How do I request a replacement insurance ID card?

For lost cards, contact customer service at 1-877-668-7636.   

To request additional cards for covered family members, contact customer service, OR go to www.excellusbcbs.com/unity (must have subscriber id # for this service).

Note regarding health and dental insurance cards - dependent names do not appear on ID cards, they are printed with member names only.

 

What is the cost of Unity’s health coverage?

(link to comparison document)

Numbers on how much per pay period?

 

Who can I cover on my health insurance?

You may insure yourself, your legal spouse or domestic partner, children up to age 26 and disabled adult dependent children. Eligible children can include your children by birth, adoption and legal guardianship, stepchildren, foster children, and children of your domestic partners. Special rules apply to enrollment of domestic partners and the children. Click here for more information.

 

How many hours do I have to work to be eligible for health insurance?

According to federal law, you are considered a full-time employee when you work 30 hours or more per week. All full-time employees are eligible for health insurance. For more information on benefit eligibility and how it varies by work hours, read the Benefit Eligibility page.

 

Do I have to submit eligibility documentation for my dependents?

Yes, if you are enrolling them for the first time. Click here for more information. If your dependent is already enrolled, there is no need to submit additional documents.

 

What doctors can I see with Unity’s health plans?

You can see any doctor you would like, although you’ll save money if you see a doctor who is employed by Unity (link to updated doc listing). The costs for doctor visits and other services that are listed on the Health Plan Comparison page refer to doctors and services within the BlueCross BlueShield PPO Network. Almost all doctors and services in our local area  are part of this network, and many others throughout the United States are also part of this network. (If you want to make sure a local doctor is part of the Blue Cross Blue Shield PPO Network, click here. Click on “Upstate New York Provider Network” and choose Excellus BluePPO Network from the drop-down menu.)

You may occasionally want or need to see a doctor that is not part of the BlueCross BlueShield PPO Network, in which case you will pay a higher cost for services.

 

If I have family coverage, how do the individual and family deductibles work?

If you decide to cover your family under the Unity Basic Health Plan, you will be required to meet a deductible before the plan will contribute to the cost of certain services. The deductible for each individual family member is $600. However, there is also a total family deductible of $1,800; once this has been met, additional family members are not required to meet an individual deductible. Plus, if you use Unity services, the deductibles are even lower: $200 for each individual and $600 for the family.

I only need to cover myself and one other person in my family. Does the family deductible apply?

The family deductible does not apply to two-person contracts. Each of you must meet your own individual deductible before the Plan will begin paying its portion for services where a deductible applies.

 

What’s the relationship between individual and family deductibles and individual and family out-of-pocket maximums?

If you enroll in the Unity Basic Health Plan for yourself and at least two other dependents, you’ll each have an individual deductible and a combined family deductible, as well as individual and family out-of-pocket maximums that apply to certain services. Any one individual in your family will begin to receive 80% coverage for these services once he or she meets the individual deductible. However, once the first three covered family members’ combined use of these services meets the family deductible, additional family members will begin to receive 80% coverage for services without meeting their own individual deductibles.

Similarly, when an individual reaches his or her annual out-of-pocket maximum ($2,400 for non-Unity doctors), services for that individual are covered at 100% for the remainder of the calendar year. Once three individuals in the family have each reached their individual out-of-pocket maximum, the family out-of-pocket maximum will have been reached ($7,200 for non-Unity doctors), and services for all family members will be covered at 100% for the remainder of the calendar year. Remember, out-of-pocket maximums apply to services that require co-insurance and deductibles; they do not apply to services that require co-pays.

 

What is the difference between in-network and out-of-network, or the differences between co-pays, co-deductibles, deductibles and premiums?

Please view our Glossary for definitions for these terms and more.

Resources

Basic Health Plan Summary

Enhanced Health Plan Summary

Health Plan Comparison

Eligibility

Lifestyle Allowance (link)

Unity Services Discount

List of Unity Doctors (link)