Medical + Teladoc
Medical Plan
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Medical Plan Summary
All eligible employees may select the medical plan. This plan through UMR uses the United Healthcare Choice Plus network of providers. This plan offers you the choice of seeing doctors within or outside of network, but will receive a higher level of coverage when using in-network providers.
Your coverage will include visits to your doctor’s office, hospital stays, mental health and substance abuse services, chiropractic treatment, physical therapy and other services. When you need care, you have the option to choose any doctor, health professional, and/or facility that works best for you.
With UMR’s Network, you will be able to:
- Receive 24/7 emergency care worldwide, in or out-of-network.
- Get prescriptions filled at national and local pharmacies.
- Take steps to maintain good health with annual wellness checkups and screenings and other preventive care measures that are covered in-network at no additional cost to you.
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2024 Medical Benefits
In-Network Out-of-Network Calendar Year Deductible
Individual / Family$1,500 / $3,000 $3,000 / $6,000 Out-of-Pocket Maximum
Individual / Family$9,000 / $18,000 $18,000 / $36,000 Copays Teladoc Consultation $0 n/a Physician Office Visit (PCP/ Specialist) $15 / $30 50% after deductible PCP Office Visits for children to age 19 $0 50% after deductible Mental Health Office Visits/ Therapy $0 50% after deductible Urgent Care Center Visit $25 50% after deductible Hospital Services Inpatient 20% after deductible 50% after deductible Outpatient 20% after deductible 50% after deductible Emergency Care (Accident or Illness) $350 Copay $350 Copay Preventive Care Preventive Care Services $0 50% after deductible Diabetic Supplies $0 50% after deductible -
2025 Medical Benefits
In-Network Out-of-Network Calendar Year Deductible
Individual / Family$1,500 / $3,000 $3,000 / $6,000 Out-of-Pocket Maximum
Individual / Family$9,200 / $18,400 $18,400 / $36,800 Copays Teladoc Consultation $0 n/a Physician Office Visit (PCP/ Specialist) $15 / $30 50% after deductible PCP Office Visits for children to age 19 $0 50% after deductible Mental Health Office Visits/ Therapy $0 50% after deductible Urgent Care Center Visit $25 50% after deductible Hospital Services Inpatient 20% after deductible 50% after deductible Outpatient 20% after deductible 50% after deductible Emergency Care (Accident or Illness) $350 Copay $350 Copay Preventive Care Preventive Care Services $0 50% after deductible Diabetic Supplies $0 50% after deductible -
2024 Employee Weekly Contributions
Employee Only $25.91 Employee + Spouse $131.03 Employee + Child(ren) $107.11 Employee + Family $149.74 -
2025 Employee Weekly Contributions
You Pay
Your Employer Pays
Employee Only $31.09 $118.02 Employee + Spouse $157.23 $327.37 Employee + Child(ren) $128.53 $244.24 Employee + Family $179.70 $379.47 -
How to Find a Provider
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Visit www.umr.com and click “Find a Provider”
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Next to Provider network, type in or choose the Network Name: “UnitedHealthcare Choice Plus Network”
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Click on the “View Providers” button to search for a provider
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Make sure your Location is the city, state and zip where you want to search for a provider
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Then search by Provider, Service or Condition
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How to Create an Online Account with UMR
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All members will need to create a new online account with UMR
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Visit www.umr.com and click “New user? Register here” to create an account
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Make sure you have your ID card handy and follow steps to get started
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Terms to Know
Deductible - The amount you pay for covered services before the Plan will pay. Your deductible amount varies and is based on the Plan you enroll in.
Co-insurance - Your share of the cost for covered services, calculated as a percentage of the total eligible expenses.
Out-of-Pocket (OOP) Maximum - Protects you from major expenses with a maximum annual limit on the amount you pay for covered services. Your OOP max is calculated on your deductible and healthcare costs including co-insurance and co-payments, but not your employee contributions. Once you reach the OOP max, the Plan pays 100% of covered services for the remainder of the year.
Pharmacy Plan
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Pharmacy Benefits
Retail: In-Network Mail Order: In-Network Generic $5 $10 Brand Name $40 $80 Non Formulary $90 $180 Specialty $250 n/a Non-Preferred Specialty $350 n/a -
Specialty Medication
Specialty medications are high cost medications that treat complex, rare or chronic conditions. Members using specialty medications often need intensive, ongoing care coordination, support and intervention. Optum Specialty Pharmacy takes a hands-on approach to patient care that makes a meaningful imprint on the health and quality of life of each patient.
Patient care coordinators, pharmacists and nurses are available 24 hours a day, seven days a week for you to consult with a pharmacist, get training on injection techniques and handling your medication, or ask questions about your orders. You can call Optum Specialty Pharmacy toll-free at 1-855-427-4682.
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Mail Order
If your prescription is for a long-term (maintenance medication), consider using the mail-order pharmacy to save money. By utilizing mail order, you will receive up to a 90-day supply of medicine and you only pay for 2 months.
Log onto www.optumrx.com and register for further information about the prescription mail order program including an order form for your first prescription mail order. Complete the form and send it along with the written prescription from your physician.
Telehealth
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Conditions Covered
Call Teladoc to receive quality care for a $0 copay, without setting foot in a doctor’s office, for conditions such as:
- Cold
- Flu
- Bronchitis
- Respiratory/Sinus infection
- Allergies
- Urinary tract infection
- Pink eye,
- and more…
Use Teladoc:- If you’re considering the ER or urgent care center for a nonemergency
- When on vacation, a business trip, or away from home
- For short-term prescription refills
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24/7 Access
Get care when and where you need it when you enroll in the Jones medical plan. As a medical plan member, you have access to Teladoc’s national network of U.S. board-certified physicians, Whenever you need care, Teladoc doctors are available 24/7 by phone or video.
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Prescriptions Over the Phone
When appropriate, the doctor can call in a prescription to the pharmacy of your choice. Get on the road to recovery with no time off work, no need to pull the kids out of school, and no unnecessary exposure to a germ filled waiting room!
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How to Get Started
Employees already registered with Teladoc as of 1/1/23
1.Visit visit teladoc.com
Click “Get Started Now” instead of logging in as you did previously.
Once you’ve selected “Get Started Now”, you will be asked to tell Teladoc a bit about yourself - this is to confirm your coverage as of 1/1/2023 and is required whether you have had an account in the past or not.
- If Teladoc recognizes your account information, you will receive an alert that your “account already exists” or is “no longer active”. From this point, you will need to click the “create a new account” link at the bottom of the screen to set up a new profile for 2023 with a new username and password.
- Continue your registration process as directed by the on-screen prompts. Once finished, you will need to provide your medical history before being able to request a consultation.
Employees NOT registered with Teladoc as of 1/1/2023
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Set up an account: Visit www.teladoc.com, complete the required information, and click on Set up account. You can also call Teladoc at 1-855-847-3627 for help.
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Provide medical history: Your medical history provides Teladoc doctors with the information they need to make an accurate diagnosis. Web: Log in to www.teladoc.com and click Update medical history. Mobile: Visit www.teladoc.com/mobile to download the app. Log in and go to the menu icon on the top left to complete the “Medical Info” section. Phone: Teladoc can help you complete your medical history over the phone. Call 1-855-847-3627.
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Request a consult: Once your account is set up, request a consult anytime you need care.