SAWS: Medical\Healthcare Benefit Plans
Aquifer Beaker

Edwards Aquifer

Aquifer Level 662.6'
11/17/17 - Official

The Edwards aquifer and its catchment area in the San Antonio region is about 8,000 square miles and includes all or part of 13 counties in south-central Texas.

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Year-Round Watering Hours

Watering with an irrigation system or sprinkler is allowed any day of the week before 11 a.m. or after 7 p.m.

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Aquifer Level 662.6 | Year-Round Watering Hours

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Benefits

Medical Plans

SAWS offers two medical plans, the PPO Economy (base plan) and the EPO (buy up plan). To determine which plan is best for you and your family, consider both the coverage you get when you use the plan and the premiums you have to pay each month.


PPO Economy: The in-network benefit plan design has a $1,500 deductible and out-of-pocket maximum of $4,600 per individual. Primary care physician co-pays will remain at $40 per office visit, and in network specialist physician co-pay at $60 per office visit.

2017 PPO Economy Medical Premiums
Hired Before Jan. 1, 2011 Hired After Jan. 1, 2011
Tier Selection SAWS Employee SAWS Employee
Employee Only $389 $15 $389 $15
Employee + Spouse $778 $70 $638 $210
Employee + Child(ren) $677 $50 $567 $160
Employee + Family $1,142 $110 $882 $370

EPO Plus: This in-network benefit plan has a deductible of $500 per individual and out-of-pocket maximum of $4,100 per individual. In-network primary care physician co-pays will remain at $25 per office visit, and specialists at $40 per office visit.

2017 EPO Plus Medical Premiums
Hired Before Jan. 1, 2011 Hired After Jan. 1, 2011
Tier Selection SAWS Employee SAWS Employee
Employee Only $434 $85 $434 $85
Employee + Spouse $864 $225 $724 $365
Employee + Child(ren) $754 $180 $649 $285
Employee + Family $1,278 $330 $1,003 $605

PPO Networks: Both plans will offer the same PPO network through UnitedHealthcare. Go online to list of participating providers, and select the "UnitedHealthcare Choice Plus" network (third option on the list), or call 1-888-651-7277 to get personal assistance from a UnitedHealthcare representative. If you register on myuhc.com, your will access your personal account, along with direct access to the provider network.

Summary of Coverage
PPO Economy EPO PLus
Plan Benefit In-Network Out of Network In-Network Out of Network
Deductible $1,500 individual $2,500 individual $500 individual Not Covered
$4,500 family $7,500 family $1,500 family Not Covered
Coinsurance 80% after deductible 60% after deductible 80% after deductible Not Covered
Out of Pocket* 4,600 individual $6,600 individual $4,100 individual Not Covered
$9,200 family $13,200 family $8,200 family Not Covered
Office Visit
PCP/SCP
$40/$60 60% after deductible $25/$40 Not Covered
Preventive Care 100% 60% after deductible 100% Not Covered
Urgent Care $40 60% after deductible $40 Not Covered
Emergency Room $150 per visit co-pay, plus deductible and coinsurance $150 per visit co-pay, plus deductible and coinsurance
EMERGENCY ONLY
Hospital Inpatient 80% after deductible 60% after deductible 80% after deductible Not Covered
*Note: Out-of-pocket maximums for both the PPO Economy and EPO Plus include medical and prescription copay, deductible, and coinsurance amounts.

For all of the coverage details, see the official plan documents below.


In this section:

Medical Plan - UnitedHealthCare Downloads

Employees have the choice between the PPO Economy and EPO Plus plans offered by UnitedHealthCare.

2017 Benefits Enrollment Form

2017 Plan Document - EPO Plus

This document describes the terms and conditions of coverage available under the EPO Plus Medical Plan.

2017 Plan Document - PPO Economy

This document describes the terms and conditions of coverage available under the PPO Economy Medical Plan.

2017 SAWS Medicare Part D Creditable Coverage Notice

SAWS has determined that the prescription drug coverage offered by SAWS through Express Script, Inc. is, on the average for all plan participants, expected to pay out as much as, or more than, what the standard Medicare prescription drug coverage will pay and is considered Creditable Coverage under Medicare.

2017 Summary of Benefits and Coverage - EPO Plan

2017 Summary of Benefits and Coverage - PPO Economy

2018 SAWS Medicare Part D Creditable Coverage Notice

SAWS has determined that the prescription drug coverage offered by SAWS through Express Script, Inc. is, on the average for all plan participants, expected to pay out as much as, or more than, what the standard Medicare prescription drug coverage will pay and is considered Creditable Coverage under Medicare.

Active Employee Premiums

Active employee premiums for medical, dental and vision coverage for 2017.

Cost-Saving Tips: Lab, X-Ray and Scan

Tips to save money on medical procedures.

Directory - Urgent Care Centers as of 3/1/2016

This directory provides a list of the Urgent Care Centers in the San Antonio area. Members can call either Nurseline at 800-846-4678 or Customer Services at 888-651-7277 for additional locations outside of San Antonio.

Frequently Asked Questions - 1095-C Form

This FAQ provides answers to the frequently asked questions regarding the new 1095-C Form required under by the federal health reform law. The 1095-C form is the employee's proof of insurance.

Health Insurance Marketplace Notice

Information on the Health Insurance Marketplace Option.

UHC - Advocate4Me

Trying to understand your health plan benefits can often be confusing. Whether you call or email us, you’ll be connected to an Advocate whose goal is to help you get the answers and information you need about your health plan. Call the member phone number listed on your health plan ID card, or email us at Advocate4Me@uhc.com. See attached.

UHC - Convenience Care Clinics

Sometimes, you may not be able to get to your doctor’s office, and your condition is not urgent or an emergency. In these situations, you may want to consider a Convenience Care Clinic. See attached for more info.

UHC - Directory of Laboratory Facilities

UHC - Directory of Radiology,MRI, X-Ray Centers

UHC - Glossary of Health Coverage & Medical Terms

This glossary contains many commonly used terms and definitions intended to be educational, but isn’t a full list.

UHC - Health4Me

Health4Me is an app designed to make managing health care a lot simpler. You can easily access your health plan ID card, benefit amounts, account balances, Personal Health Records, and much more.

UHC - Medical Provider Search Link

The attached document contains a link to help you find a medical doctor in the SAWS provider network.

UHC - myHealthcare Cost Estimator

Using your benefit information, myHealthcare Cost Estimator shows you the estimated cost for a treatment or procedure, and how that cost is impacted by your deductible, co-insurance and out-of-pocket maximum. This means that you’ll get an estimate of what you’ll be responsible for paying out of your pocket, providing you with useful information for planning and budgeting.

UHC - Nurseline

Nurseline services are provided to help you with: • Immediate answers to your health questions any time, anywhere — 24 hours a day, 7 days a week • Access to experienced registered nurses • Trusted, physician-approved information to guide your health care decision.

UHC - Ordering an ID Card

Instructions for ordering an ID card via www.myuhc.com.

UHC - Premium Program FAQs

Answers to frequently asked questions about the UHC Premium program.

UHC - Transition of Care

Transition of Care is a service which enables UnitedHealthcare new enrollees to receive time-limited care for specified medical conditions from a non-contracted physician at the benefit level associated with contracted physicians.

UHC - Welcome Handbook

This handbook contains helpful information on UHC's medical programs and services.

UHC - Where Should I Go for Care?

Doctor's office, convenience care clinic, urgent care center, or emergency room? This document will help you choose the right care.



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