How to Choose a Medical Plan

Review the medical plan design and out-of-pocket costs.

Check the provider network.

Compare the medical plan premiums.

Decide which medical plan is best for you.

Consider making contributions to a Health Care Spending Account.

If you enroll in the UHC High Deductible + HSA Plan, you may be eligible for a Health Savings Account.

The How to Choose a Medical Plan tool allows you to compare the medical plans offered by Travelers. Use the steps below to determine what differences exist between the plans and which plan may best fit your needs.

Step 1:

Compare the medical plans available to you – Bind, Blue Cross Blue Shield (BCBS), UnitedHealthcare Choice Plus (UHC) and High Deductible + HSA. Estimate what your out-of-pocket costs may be with each plan.

Step 2:

Check to see which doctors, hospitals and specialists are available in each plan.

Step 3:

Compare the costs of the medical plan premiums.

Step 4:

Decide which option is best for you.

Step 5:

Consider making contributions to a Health Care Spending Account.

Step 6:

If you enroll in the UHC High Deductible + HSA Plan, you may be eligible for a Health Savings Account.

Step 1. Review the medical plan design and out-of-pocket costs.
Step 2. Check the provider network.
Step 3. Compare the medical plan premiums.
Step 4. Decide which medical plan is best for you.
Step 5. Consider making contributions to a Health Care Spending Account.
Step 6. If you enroll in the UHC High Deductible + HSA Plan, you may be eligible for a Health Savings Account.

Step 1: Compare the medical plans available to you – Bind, Blue Cross Blue Shield (BCBS), UnitedHealthcare Choice Plus (UHC) and High Deductible + HSA. Estimate what your out-of-pocket costs may be with each plan.

Health Plan Plan Highlights
Bind, BCBS & UHC In-network benefits are available with the Bind plan, national BCBS BlueCard plan, BCBS Select Network plans in designated locations, and the UHC Choice Plus plan. Out-of-network benefits are also available, but are more expensive since there are no negotiated provider discounts and the out-of-network deductible and out-of-pocket maximum are higher.
UHC High Deductible + HSA There is no difference in benefits if you use an in-network or out-of-network provider. However, when you receive care from in-network providers, your plan costs are typically lower because UHC has negotiated discounts with in-network providers.

Bind Plan Blue Cross Blue Shield Plan and
UnitedHealthcare Choice Plus Plan
UHC High Deductible + HSA Plan
In-Network Out-of-Network In-Network Out-of-Network UHC High Deductible + HSA Plan
Deductible N/A N/A $750 per person/$1,500 per family maximum $1,500 per person/$3,000 per family maximum $1,400 for single coverage/$2,800 for family coverage*
Out-of-Pocket Maximum $3,300 per person/$6,600 per family $6,600 per person/$13,200 per family $3,800 per person/$7,600 per family $7,600 per person/$15,200 per family $4,300 for single coverage/$8,600 for family coverage** (combined medical and prescription drug out-of-pocket maximum)
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited
Retail Medical Clinic $15 copay No coverage $10 copay per visit 30% coinsurance after the deductible 20% coinsurance after the deductible
Virtual Visit (using prefered virtual provider network) Covered at 100% No coverage $10 copay per visit No Coverage 20% coinsurance after the deductible (must use UHC network provider)
Primary Care Office Visit $15-$60 copay $110 $35 copay per visit 30% coinsurance after the deductible 20% coinsurance after the deductible
Specialist Office Visit $15-$60 copay $110 $45 copay per visit 30% coinsurance after the deductible 20% coinsurance after the deductible
Maternity Office Visits (prenatal and postnatal) Covered at 100% No coverage $45 copay for initial visit, $0 copay thereafter 30% coinsurance after the deductible 20% coinsurance after the deductible
Childbirth / Delivery $400-$1,200 copay per stay $2,400 copay per stay 10% coinsurance after the deductible 30% coinsurance after the deductible 20% coinsurance after the deductible
Urgent Care Facility $100 copay $200 copay $45 copay per visit 30% coinsurance after the deductible 20% coinsurance after the deductible
Emergency Room $250 copay $250 copay $200 per visit; waived if admitted to a hospital $200 per visit; waived if admitted to a hospital 20% coinsurance after the deductible
MRI/CT Scans $125-$600 copay $1,200 copay 10% coinsurance after the deductible 30% coinsurance after the deductible 20% coinsurance after the deductible
Home Health Care $35 copay $110 copay 10% coinsurance after the deductible 30% coinsurance after the deductible 20% coinsurance after the deductible
Durable Medical Equipment (DME) $0-$1,000 copay $20-$2,000 copay 10% coinsurance after the deductible 30% coinsurance after the deductible 20% coinsurance after the deductible
Inpatient Hospital and Physician Services Up to $2,500 copay per stay Up to $4,100 copay per stay 10% coinsurance after the deductible 30% coinsurance after the deductible 20% coinsurance after the deductible
Outpatient Surgical Services Up to $2,500 copay Up to $3,000 copay 10% coinsurance after the deductible 30% coinsurance after the deductible 20% coinsurance after the deductible
Well Baby Covered at 100% No coverage Covered at 100% No coverage Covered at 100%
Physical Examinations and Immunizations Covered at 100% No coverage Covered at 100% No coverage Covered at 100%
Mammography Covered at 100% No coverage Covered at 100% No coverage Covered at 100%
Colonoscopy Covered at 100% No coverage Covered at 100% No coverage Covered at 100%
Vision screening (routine exam) Covered at 100% No coverage Covered at 100% No coverage Covered at 100%
Hearing screening (routine exam) Covered at 100% No coverage Covered at 100% No coverage Covered at 100%

When you enroll in any of the medical plans offered by the company, you will automatically receive prescription drug coverage through CVS Caremark. Review the out-of-pocket costs associated with the prescription drug coverage using the chart below.


Prescription Drug Overview


Bind Plan
Blue Cross Blue Shield Plan and
UnitedHealthcare Choice Plus Plan
UHC High Deductible + HSA Plan
Network Pharmacy Non-network Pharmacy Network Pharmacy Non-network Pharmacy Network Pharmacy Network Pharmacy
Prescriptions Preventative Medications*** Non-Preventive & Specialty
Medications
Generic You pay: If you fill a prescription at a non-participating pharmacy but had access to a participating pharmacy, you will be reimbursed for the negotiated pharmacy cost minus the applicable in-network coinsurance. If you did not have access to a participating pharmacy, the in-network coinsurance will apply. You pay: If you fill a prescription at a non-participating pharmacy but had access to a participating pharmacy, you will be reimbursed for the negotiated pharmacy cost minus the applicable in-network coinsurance. If you did not have access to a participating pharmacy, the in-network coinsurance will apply. You pay: 20% coinsurance after meeting the deductible
- 30-day supply at retail $12 copay $12 copay $12 copay
- 90-day supply at a retail CVS pharmacy or through CVS Caremark mail order $24 copay $24 copay $24 copay
Formulary Brand You pay 20% coinsurance: You pay 20% coinsurance: You pay 20% coinsurance:
- 30-day supply at retail $50 minimum, $175 maximum $50 minimum, $175 maximum $50 minimum, $175 maximum
- 90-day supply at a retail CVS pharmacy or through CVS Caremark mail order $100 minimum, $350 maximum $100 minimum, $350 maximum $100 minimum, $350 maximum
Non-Formulary Brand You pay 40% coinsurance: You pay 40% coinsurance: You pay 40% coinsurance:
- 30-day supply at retail $50 minimum, $175 maximum $50 minimum, $175 maximum $50 minimum, $175 maximum
- 90-day supply at a retail CVS pharmacy or through CVS Caremark mail order $100 minimum, $350 maximum $100 minimum, $350 maximum $100 minimum, $350 maximum
Specialty Drugs - exclusively available through CVS Specialty (limited to a 30-day supply) $0 copay if participating with PrudentRx; 30% coinsurance if not participating with PrudentRx $0 copay if participating with PrudentRx; 30% coinsurance if not participating with PrudentRx Specialty medications are covered at the generic/formulary/non-formulary benefit levels shown above, as applicable
Infertility Medications - those designated as Specialty must be sourced through CVS Specialty Pharmacy 50% coinsurance, no minimum or maximum copay

Your coinsurance does not apply towards the prescription drug out-of-pocket maximum or the medical plan out-of-pocket maximum.
Specialty infertility medications not sourced though CVS Specialty Pharmacy are not covered. 50% coinsurance, no minimum or maximum copay

Your coinsurance does not apply towards the prescription drug out-of-pocket maximum or the medical plan out-of-pocket maximum.
Specialty infertility medications not sourced though CVS Specialty Pharmacy are not covered. Infertility medications are not covered by this plan. Infertility medications are not covered by this plan.
Annual Prescription Out-of-Pocket Maximum $2,800 per person / $5,600 per family $2,800 per person / $5,600 per family There is no separate OOPM for prescriptions. Prescription drug cost sharing accumulates to the OOPM listed in the general section.

*For family coverage in the UHC High Deductible + HSA Plan, the plan does not begin to cost share until the full family deductible is met.

**There is a $7,900 out-of-pocket maximum per individual with family coverage in the UHC High Deductible + HSA Plan.

***Copays and coinsurance for preventive medications in the UHC High Deductible + HSA Plan do not count towards the plan deductible, but do count towards the out-of-pocket maximum.


Step 2: Check to see which doctors, hospitals and specialists are available in each plan.

Grand Rounds is a free service for Travelers medical plan members that matches you with doctors based on their quality and expertise. Grand Rounds can help you find a high quality doctor in your area, obtain a second opinion from a leading specialist, or access information about a new diagnosis. Go to grandrounds.com/travelers.

Health Plan Instructions Referrals Required
Bind Bind uses the UnitedHealthcare Choice Plus Network. Visit www.choosebind.com/travelers (access code TRV2022) to search for providers. Click “Search Coverage” on the top navigation. Enrollees do not have to select a primary care physician and referrals are not required to see a specialist.
BCBS Use the BCBS provider directory. Click “Find Care” in the top navigation.
UHC Use the UHC provider directory. Click “Find a Doctor” from the center navigation.
UHC High Deductible + HSA Plan UHC High Deductible + HSA Plan enrollees have a passive network arrangement. There is no difference in benefits if you use an in-network or out-of-network provider. However, when you receive care from in-network providers, your plan costs are typically lower because UHC has negotiated discounts with in-network providers.

Use the UHC provider directory. Click “Find a Doctor” from the center navigation.


Step 3: Compare the medical plan premiums.

You share the cost of your medical coverage with Travelers. Your share of the premium is based on:

You pay for your share of the premium with pre-tax dollars from your salary.

You can use the Rate Calculator to estimate your premiums.

Step 4: Decide which medical plan is best for you.

After you've compared the plan benefits, network and medical plan premiums you may be ready to enroll.

Note: If you have questions regarding your medical plan options or benefits, please contact the Employee Services Unit (ESU) at 4-ESU@travelers.com or 800.441.4378.


Step 5: Consider making contributions to a Health Care Spending Account.

Through pre-tax payroll deductions, the Health Care Spending Account provides an opportunity to fund qualifying health care expenses not covered by insurance, including deductibles, copays and coinsurance. Additional information can be found on the Health Care Spending Account page.*

Participants who elect to enroll in the UHC High Deductible + HSA Plan are not eligible to participate in a Health Care Spending Account (HCSA).

*This link is accessible only to employees logged into Travelers secure network.

Step 6. If you enroll in the UHC High Deductible + HSA Plan, you may be eligible for a Health Savings Account (HSA).

If you enroll in the UHC High Deductible + HSA Plan, you may be eligible to make pre-tax contributions into a Health Savings Account (HSA). For additional information on the HSA, visit the High Deductible + HSA overview page.*

*This link is accessible only to employees logged into Travelers secure network.