Medical Insurance
The Moore Stephens Tiller offers employees two medical plan options through UMR. The rising cost of health care continues to make it harder to find affordable medical benefits. Our goal is to offer affordable benefit options that also ensure you have access to high-quality services.
You have two deductible plans to choose from:
- The first option has a deductible expense of $500 for employee only coverage, $1,000 for employee plus spouse coverage or employee plus child coverage, and $1,500 for family coverage.
- The second option has a deductible expense of $1,500 for employee only coverage, $3,000 for employee plus spouse coverage or employee plus child coverage, and $4,500 for family coverage.
Once you have incurred an out-of-pocket of either $500 or $1,500 (per covered member) the Moore Stephens Tiller will cover all remaining eligible in-network medical expenses.
The UMR Choice Plus POS is a traditional health plan. Employees pay a $25 – $35 office visit copay for in-network doctor visits participating in the UHC Choice Plus POS Network. Employees can also access care from a UMR/UHC Premium Designated Provider. This program recognizes doctors who meet standards for quality and cost efficiency. By utilizing these premium doctors, you will also receive a $10 discount on your PCP and Specialist office visit copays. Certain other services are covered after the deductible is reached. This plan allows you to visit any in-network provider without a referral.
If you use out-of-network providers, you may have to file your benefit claims yourself or pay for services and wait to be reimbursed by UMR.
The information contained in this presentation is an overview of your benefits. If you have specific questions regarding a provider or procedure, please call UMR Customer Service at the number listed on the back of your ID Card. If you do not have an ID card, please call (800) 826-9781 or refer to the Medical & Rx SPD.
Premium – $500 POS Plan Benefits
| In-Network | Out-of-Network | |
| Deductible (Calendar Year) | ||
| Single | $500 | $6,000 |
| Family | $1,500 | $18,000 |
| Lifetime Maximum | Unlimited | Unlimited |
| Coinsurance (Plan/Member) | 100% / 0% | 60% / 40% |
| Max Out-of-Pocket (Including Deductible) | ||
| Single | $500 | $14,000 |
| Family | $1,500 | $42,000 |
| Hospital Facility Services | ||
| Inpatient | Deductible and $250 Copay | Plan Pays 60% after Deductible |
| Outpatient | Deductible and $250 Copay | Plan Pays 60% after Deductible |
| Emergency Room | $150 Copay | $150 Copay |
| Physician Office Visits | ||
| Primary Care | $25 Copay / $15 with Premium Designation | Plan Pays 60% after Deductible |
| Specialist | $35 Copay / $25 with Premium Designation | Plan Pays 60% after Deductible |
| Prescription Drug Coverage* | ||
| Tier 1 Drugs | $15 Copay | Plan Pays 60% after Deductible |
| Tier 2 Drugs | $30 Copay | Plan Pays 60% after Deductible |
| Tier 3 Drugs | $60 Copay | Plan Pays 60% after Deductible |
| Mail Order | $15/$60/$120 | Not Covered |
* Please refer to the benefit summary for Rx Tier descriptions
Basic – $1,500 POS Plan Benefits
| In-Network | Out-of-Network | |
| Deductible (Calendar Year) | ||
| Single | $1,500 | $6,000 |
| Family | $4,500 | $18,000 |
| Lifetime Maximum | Unlimited | Unlimited |
| Coinsurance (Plan/Member) | 100% / 0% | 60% / 40% |
| Max Out-of-Pocket (Including Deductible) | ||
| Single | $1,500 | $14,000 |
| Family | $4,500 | $42,000 |
| Hospital Facility Services | ||
| Inpatient | Deductible and $250 Copay | Plan Pays 60% after Deductible |
| Outpatient | Deductible and $250 Copay | Plan Pays 60% after Deductible |
| Emergency Room | $150 Copay | $150 Copay |
| Physician Office Visits | ||
| Primary Care | $25 Copay / $15 with Premium Designation | Plan Pays 60% after Deductible |
| Specialist | $35 Copay / $25 with Premium Designation | Plan Pays 60% after Deductible |
| Prescription Drug Coverage* | ||
| Tier 1 Drugs | $15 Copay | Plan Pays 60% after Deductible |
| Tier 2 Drugs | $30 Copay | Plan Pays 60% after Deductible |
| Tier 3 Drugs | $60 Copay | Plan Pays 60% after Deductible |
| Mail Order | $15/$60/$120 | Not Covered |
* Please refer to the benefit summary for Rx Tier descriptions
Medical Payroll Deductions
| Tier of Coverage | Rates Per Pay Period (26) Basic Plan | Rates Per Pay Period (26) Premium Plan |
|---|---|---|
| Medical | POS – $1500 Deductible | POS – $500 Deductible |
| Employee Only | $11.54 | $20.77 |
| Employee + Spouse | $69.23 | $83.08 |
| Employee + Children | $66.92 | $80.77 |
| Family | $138.46 | $161.54 |
| Medical Non-Participating in Wellness | POS – $1500 Deductible | POS – $500 Deductible |
| Employee Only | $46.15 | $55.38 |
| Employee + Spouse | $103.85 | $117.69 |
| Employee + Children | $101.54 | $115.38 |
| Family | $173.08 | $196.15 |
| Medical Tobacco User | POS – $1500 Deductible | POS – $500 Deductible |
| Employee Only | $46.15 | $55.38 |
| Employee + Spouse | $103.85 | $117.69 |
| Employee + Children | $101.54 | $115.38 |
| Family | $173.08 | $196.15 |
| Medical Non-Participating in Wellness/ Tobacco User | POS – $1500 Deductible | POS – $500 Deductible |
| Employee Only | $80.77 | $90.01 |
| Employee + Spouse | $138.46 | $152.31 |
| Employee + Children | $136.15 | $150.00 |
| Family | $207.69 | $230.77 |
Finding Providers
How do you find a Choice Plus POS in-network provider?
It’s easy! There are several ways:
- Contact your provider and ask:
“Do you participate in the UHC Choice Plus POS network” - Contact UMR at the number provided on your ID card
- Via the internet at www.umr.com
