Medical Plan Options


We understand that employers want to control health care costs while keeping their employees healthy. Our current portfolio offers a variety of plan options to meet the needs of our diverse employer groups.

We offer both fully insured and administrative services only (ASO) contracts. UPMC Health Plan programs and services are customizable for larger employers. Employers with 51 or more eligible employees can bundle Dental Advantage and/or Vision Care plans with Medical and receive a discount on the medical premium.

UPMC Small Business Advantage gives all small businesses a robust benefit package to address their employees’ total health and well-being. Included with every plan is an employee assistance program, online wellness tools, and vision and dental discounts. Companies with fewer than 50 employees are eligible for UPMC Small Business Advantage.

UPMC HealthyU combines a rich benefit plan with a healthy living incentive program. The plan allows subscribers and their covered spouse or domestic partner to earn funds to pay deductibles, copayments, and coinsurance by participating in healthy activities. It is available to employer groups of any size.

Subscribers and covered spouse or domestic partner can earn reward dollars in their health incentive account for completing incentivized activities. Dependent children (including adult children) are not eligible to earn reward dollars.

Inside Advantage is a tiered benefit plan offered in Northwest Pennsylvania that provides employees with the same type of coverage as other UPMC Health Plan offerings — but with lower out-of-pocket costs when they receive care at select Level 1 facilities. 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-pock costs may increase. Level 2 includes many UPMC-contracted facilities and the services affiliated with those contracted facilities, such as lab, x-ray, MRI therapy, and more. It is available to employer groups with two or more employees in the following counties: Clarion, Crawford, Elk, Erie, Forest, McKean, Mercer, Potter, Venango, and Warren.

UPMC MyCare Advantage is another tiered benefit plan, with its focus on patient-centered care to improve the health outcomes of its members. It offers the same type of coverage as other UPMC Health Plan products but maximizes in-network savings with lower cost sharing when members receive care from level 1 facilities and providers. It is available to employer groups with two or more employees. Employer groups of all sizes in the following counties are eligible to purchase: Allegheny, Beaver, Bedford, Blair, Butler, Erie, Lawrence, Mercer, Venango, Washington, or Westmoreland. Employer groups with 51 or more eligible employees located Berks, Lycoming and Tyoga counties are also able to purchase MyCare Advantage.

UPMC Consumer Advantage offers many plan options for groups looking to add a qualified high –deductible plan (QHDHP) to their medical plan offerings. A GHDHP qualifies members for a health savings account (HSA) or flexible spending account (FSA). These accounts help them pay for current and future health care expenses. Depending on the account selected, the employer and employee may contribute to the account, and the employee may be able to take the funds along when changing employers or at retirement.

For more information on our plans, call 1-888-383-8762.

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