Medical Plan Costs & Coverage

Your plan deductible is the amount you pay in medical expenses before the insurance company will cover any benefit costs for the year. There are two types of deductibles in Hertz medical plans:

• Embedded (PPO & Copay Plans): Each family member has an individual deductible, while the family also has a combined deductible. Each person gets their benefits as soon as they meet their individual deductible, no matter what the family total is.

As a reminder, visiting in-network providers and appropriate site of care can help you save money. If you need additional information on our medical plans, be sure to reach out to a Quantum Care Coordinator.

• True Family (CDHP with HSA Plan): This means that a family can meet the deductible by combining deductible expenses. There is no limit to the amount one member can pay toward the family deductible.

It’s important to remember that copays for office visits and prescription drugs do not count toward your plan deductible.

Rate or Premium: Like your 12-month gym membership, this is the base amount you pay every month for health care coverage, even if you don’t use it.

Out-of-Pocket Maximum: The most you would possibly pay for covered services in a year. Once you reach your out-of-pocket maximum, your plan covers all eligible expenses.

Coinsurance: The cost shared between you and the insurance company, always a percentage totaling 100%. For example, if the plan pays 80%, you are responsible for paying the remaining 20% of the cost.

Copay: A flat fee paid to your provider at the time of service, kind of the price to get in the door. You may spend more once you’re there if your doctor recommends blood tests, etc. The copay covers the core services included in the office visit.

In-Network: Providers in the network have agreed to charge discounted rates for services when you use them, which means you save money automatically. If you go to an out-of-network provider, they can charge you more and the insurance may cover less of the costs.

If you would like would like to see pricing information for covered items and services for UMR in-network and out-of-network provider rates, click here.

This link is being provided to you as a fulfillment of our requirement to you to provide transparent pricing information, effective July 1, 2022.