Health Insurance Health Insurance Highlights Geisinger Health Plan (GPH) – Third Party Administrator 3 Tiers of coverage Coverage begins your first day of work Premiums paid biweekly (per pay) Rates will be shown during Ultimate enrollment Health Insurance Deductibles Tiers Single Family Tier I $100 $200 Tier II $250 $500 Tier III $450 $900 For union-specific information, please refer to CONNECT. (viewable from any WVU Healthcare computer) Single: one individual meets deductible Family: one individual must meet the single deductible and family members can make up the rest Per calendar year Separate deductible per Tier Tier I Coverage For Inpatient & Outpatient: Out of Pocket Maximum: Office Visit: Tier I: WVUHS/UHA After Deductible 100% $1,350 / $2,700 After Deductible $15 - PCP $35 - SCP Ruby Memorial Physician Office Center Chestnut Ridge Center Family Medicine Mary Babb Randolph Cancer Center Cheat Lake Physicians WVU Urgent Care WVUHS WVUH East CamdenClark Potomac Valley Hospital UHA All Three Tiers Coverage For Inpatient & Outpatient: Out of Pocket Maximum: Office Visit: Tier I: WVUHS/UHA After Deductible 100% $1,350 / $2,700 After Deductible $15 - PCP $35 - SCP Tier II: Providers and HPN/Geisinger After Deductible 80% - Ancillary Services (x-ray, labs) (UCR) $5,000 / $10,000 After Deductible $25 - PCP $50 - SCP Tier III: Out-Of-Network Providers and HPN/Geisinger Network Facilities After Deductible 60% (UCR) $5,000 / $10,000 After Deductible 60% For union-specific information, please refer to CONNECT. (viewable from any WVU Healthcare computer) Preventative Services Applies to Tiers I and II only. Examples: Annual pap smears, mammograms, routine exams, prostate screening, well child care visits One per calendar year No deductible or co-pay for these visits No Tier III coverage for these services Seeing a Specialist Insurance does not require referrals to see a specialist Some test or procedures require pre-authorization MRI, CT scan, etc. Emergency & Urgent Care Emergency Room True Emergency copay: $100 for Tier I $100 for Tier II $100 for Tier III If admitted, no co-pay Examples: Acute allergic reactions Concussion Burns (2nd and 3rd degree) If you go to the Emergency Room, and your situation is not an emergency, there is no coverage. Urgent Care Co-pay after deductible paid: $25 for Tier I $50 for Tier II 60% of eligible expenses Examples: Strep Throat Pink Eye High Fever For more information about health insurance coverage, view our health insurance supplemental pdf.