HDHP UHC
Health & Pharmacy HDHP
2018 Benefits Guide
What is New for 2018
The deductible for the HDHP Choice Base has been increased due to IRS regulation to $1,350 EE and $2,700 EE+Dependents.
The deductible for the HDHP Choice plus In & Out of Network is $1,500 EE and $3,000 EE+Dependents.
County is fully funding the deductible for HDHP Base plan upon completion of the Engagement Incentive. The funding for the HDHP Choice plus In & Out of Network is the same as the HDHP Base amount $1,350 EE and $2,700 EE+Dependents.
 
Hig​hlights of HDHP's 
  • All health and prescription services are subject to the annual deductible and coinsurance based on tier of coverage with the exception of mandated preventive services or designated preventive prescriptions (see Preventive Rx list​).
  • Medical and prescription expenses will be applied toward meeting the annual deductible and coinsurance amount based on tier of coverage (Member Only coverage or Member + Dependents coverage).
  • Once the annual deductible is met, the health and pharmacy plan pays 80% and you pay 20% coinsurance of the eligible discounted costs (in-network).
  • When you reach the out-of-pocket maximum, the Plan pays 100% of eligible in-network health and prescription expenses.
  • Preventive services (see Complete Summary book​) and designated preventive prescriptions are covered at 100%.
  • Annual eye exam at no cost at a participating optometrist
  • Discount dental plan included at participating dental providers​
Pharmacy
Your pharmacy benefits are provided under the County's self-insured pharmacy plan through Catamaran/OptumRx. Some of the plan features include: a large network of participating pharmacies and a 90-day mandatory maintenance medication program (excludes specialty).​ 

Non-Preventive Prescription Drugs
  1. ​The discounted drug cost is applied to the deductible.
  2. After the annual health deductible is met, the plan pays 80% and the member pays 20% coinsurance of the discounted drug cost.100% Coverage after the annual health out-of​-pocket is met; prescription drugs are paid in full by the plan.​
Clinical Prior Authorization Program
Certain prescriptions require “clinical prior authorization,” or approval from your plan, before they will be covered. The categories/medications that require clinical prior authorization may include, but are not limited to: Acne (topical-after age 24), ADHD/Narcolepsy (after age 19), Botulinum Toxins, Lamisil/Sporanox, Obesity and Peniac. Upon receipt of a prescription falling into a covered category, Catamaran will contact your doctor’s office and request the documentation needed for Prior Authorization.
To verify in advance, members may contact Catamaran/OptumRx​.
Frequently Asked Questions - Prior Authorization Program​
Contact Info:
Member Services: 1-855-356-3216​​
S​pecialty Pharmacy
BriovaRx​ is Catamaran/OptumRx’s specialty pharmacy provider. They will assist members with their specialty medications to ensure safe and effective administration. BriovaRx provides free home delivery to your home/work address. Please contact BriovaRx for more information regarding specialty pharmacy.

 
For Rx Call: 1-855-427-4682

 
For other info Call: 1-855-577-6521