Metal Plans

Metal Plan Highlights.

  • Available to groups with 2 – 50 enrolling employees.
  • 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 the level of coverage (90% Platinum) represents the approximate percentage of health care costs which would be covered for the average person by the plan.
  • The Platinum Copay Plan features a member in-network cost sharing maximum of $7,350 (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.
  • 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.

* 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.

Metal Plans

Options for Employers in
Illinois, Indiana, Michigan, Ohio and Wisconsin

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Plan NameHighlightsDeductiblesCopays
Platinum Copay
  • Features combined Medical and Rx deductible.
  • Includes coinsurance, with maximums ranging from $7,350 to $14,700
  • Enjoy 95% coverage with in-network providers, and 80% coverage out-of-network.
  • Prescription Drug coverage: preferred and other level drugs covered by coinsurance and deductibles.
  • Includes first-dollar preventive coverage and coverage for Essential Health Benefits* (EHB)
Range from $250 to $500 for individuals and $500 to $1,000 for family plans$15 for Primary Care Office Visits
$30 for Specialist Office Visits
$150 for ER Visits
$15 for Generic Prescription Drug

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