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Metal Plan Highlights.

  • Available to groups with 2 - 50 enrolling employees.
  • Within each metal category (Platinum, Gold, Silver and Bronze) three plan structures are available*:
    • Deductible and Coinsurance Plans have a deductible and a coinsurance percentage cost sharing.
    • Copay Plans have a deductible, a coinsurance with percentage cost sharing, and copays on common categories.
    • High Deductible Health Plans (HDHPs) have a deductible and a coinsurance cost sharing thereafter up to the maximum cost sharing limit.
  • Proven provider networks are offered with high levels of participation in their respective areas and significant discounts.
  • Out-of-state members are assigned a provider network yielding high provider participation and discounts.
  • The actuarial values (AV) stated for each level of coverage (90% Platinum, 80% Gold, 70% Silver and 60% Bronze) represent the approximate percentage of health care costs which would be covered for the average person by the plan.
  • All USHL Metal Plans feature a member in-network cost sharing maximum of $6,350 (deductible, coinsurance & copays) and include first-dollar preventive coverage and coverage for Essential Health Benefits** (EHBs). Deductibles and all maximums including cost-sharing are calculated on a calendar-year basis.
  • Guaranteed-issue rates.
  • Dual plans available (minimum two contracts per plan offered).
  • A staff of more than 170 professionals in claims, billing and client services stand behind USHL plans, and provide unparalleled levels of service to members and groups.
  • Online resources assist members 24/7 with needs including Explanation of Benefits (EOB) copies, provider lookups, identification cards, claim tracking, answers to coverage questions, and more.
  • USHL Dental Plans cannot be sold with USHL Metal Plan coverage.

* Platinum-level HDHP and Bronze-level Copay plans are not available.

** EHBs include the following: Ambulatory patient services, such as doctor's visits and outpatient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; pediatric dental and pediatric vision.

This information summary is provided for marketing purposes only and does not represent a guarantee of coverage. For a complete list of policy provisions and exclusions, please refer to the USHL Medical Policy or Prescription Drug Rider.