UPMC Health Plan Employer Groups Plan Options

Inside Advantage

UPMC Inside Advantage is a tiered benefit plan for northwest Pennsylvania that provides lower out-of-pocket costs when employees receive care at a UPMC-owned facility. Level 1 includes all UPMC providers and UPMC-owned facilities along with many community-owned providers and facilities, such as Grove City Medical Center and Warren General Hospital. UPMC facilities in northwest Pennsylvania include UPMC Hamot, UPMC Horizon, UPMC Kane, UPMC Jameson, and UPMC Northwest. At Level 2, out-of-pocket costs may increase. Level 2 includes the rest of Premium Network-contracted facilities and the services affiliated with those contracted facilities, such as lab, x-ray, MRI therapy services, and more.

Employers in these counties are eligible: Clarion, Crawford, Elk, Erie, Forest, McKean, Mercer, Potter, Venango, and Warren.

UPMC MyCare Advantage

UPMC MyCare Advantage is a tiered benefit plan designed to improve the health outcomes of employees with its focus on patient-centered care. It offers members in-network access to UPMC facilities with the opportunity for cost savings. With a choice of multiple plan designs and benefit levels, you can choose the option that best suits the needs of your employees and your business.

Employers located in these counties are eligible: Allegheny, Beaver, Bedford, Berks, Blair, Butler, Fayette, Lycoming, Tioga, Washington, and Westmoreland. MyCare Advantage is not available for small groups (2-50 employees) in Berks, Lycoming, and Tioga counties.

UPMC Self Assure Level Funding

UPMC Self Assure Level Funding is some administrative services only (ASO) plan that provides a solution to the rising cost of health insurance. UPMC Self Assure Level Funding offers businesses flexible options including a level funding arrangement, as well as stop loss protection, for groups with as few as 25 employees. Some of the Advantages of UPMC Self Assure Level Funding include lower operating costs, potential ACA Premium tax reductions, and avoiding certain benefit mandates. With UPMC Self Assure Level Funding, you pay for only the coverage you need, while having full in-network access to UPMC facilities.

UPMC Small Business Advantage

UPMC Small Business Advantage is designed for companies with fewer than 50 employees to give smaller businesses the opportunity to offer their employees a robust benefit package. In addition to our core wellness programs and tools, it provides Life Solutions, an employee assistance program to support employee total well-being. Other benefits include vision and dental discounts. To better help small businesses and their employees, UPMC Small Business Advantage benefits are built into all our plans.

UPMC Consumer Advantage

UPMC Consumer Advantage® is a plan design that qualifies your employees for a health savings account (HSA). An HSA is an account for current and future health care expenses. The employer may contribute to it along with the employee, but the employee owns the HSA, keeps it year after year as it grows, and can take it with them when they retire or leave the company.

UPMC HealthyU

HealthyU is an innovative plan that rewards your employees for making healthy choices. If you would like to implement an employee wellness program but do not have the administrative infrastructure to support it, HealthyU is a great option. Subscribers and their covered spouse or domestic partner access and use our secure member portal, MyHealth OnLine, to learn about healthy activities they can complete to earn reward dollars in a health incentive account (HIA) that helps to pay for their health care expenses. Every time they complete a recommended activity, UPMC Health Plan deposits those reward dollars into their HIA. The reward dollars they earn can help pay for out-of-pocket medical expenses, such as deductible, coinsurance, and pharmacy copayments. Both PPO and EPO plan options are available.

Employer groups of all sizes (two or more employees) are eligible for UPMC HealthyU.