MEDICAL & PRESCRIPTION
The Chefs' Warehouse will continue to offer two plan options, the OAP Plan and the HDHP HSA Plan. You will have the option to enroll in a Traditional Managed Care plan and have access to United Healthcare’s (UHC) Choice Plus network or enroll in a Reference Based Pricing plan.
The Prescription Drug program will continue to be administered through USRX Care.
WHO IS ELIGIBLE?
All full-time employees working 30 or more hours per week.
EMPLOYEE RESOURCES
Please note if you are enrolled in The Chefs' Warehouse Medical and Prescription plan and if you need assistance with a medical bill you do not understand, if you have questions about your medical and prescription coverage, if you need assistance with a medical or prescription claim, etc. you will continue to have access to an employee resource.
Please reach out directly to the Graham Company, The Chefs' Warehouse's insurance broker. The email address is CWBenefts@grahamco.com or you may call 888-229-6494. The service line is staffed Monday through Friday from 9:00 AM to 5:00PM EST.
Additionally, you can utilize the HealthJoy App's "Bill Review" feature. Please see additional details in the "HealthJoy" section.
What is Changing?
Nothing is changing! The medical plans will continue to be administered through UMR/HealthScope. You will have the option to enroll in a Traditional Managed Care plan and have access to United Healthcare’s (UHC) Choice Plus network or a Reference Based Pricing plan. You will have the option to choose from the OAP Plan and HDHP HSA Plan.
Traditional Managed Care
The Traditional Managed Care arrangement functions as a "traditional" health insurance model. You have the option to utilize providers in UHC's Choice Plus network to maximize your benefits, or you can utilize out of network providers. Keep in mind that using out of network providers will increase your out-of-pocket costs. Choosing a Traditional Managed Care plan decreases your chances of being balance billed, as all of the in-network provider's are contracted directly with United Healthcare. Please see the Member Resources page for more information on locating an in-network provider.
Reference Based Pricing
The Reference Based Pricing (RBP) arrangement allows you to utilize any provider you choose. You have the freedom to utilize the Multiplan network of physicians, however, if you see a provider that does not participate in the Multiplan network, you will still have access to the same level of benefits and will pay the same out-of-pocket costs. Providers and facilities are paid by the plan administrator based on the fair market value of the service. From there, providers can choose to accept this as payment in full, or they can choose to Balance Bill the member. There are instructions of how to identify a balance bill in the section "Balance Billing." If you receive a balance bill, you MUST contact UMR immediately (the customer service number on the back of your ID card). UMR will continue to work with ELAP to help you navigate balance billing and resolve on your behalf.
TRADITIONAL MANAGED CARE OPTION 1: HDHP with HSA
This is a high deductible health plan that is paired with a Health Savings Account (HSA). The HDHP with HSA is designed to be simple - You will be responsible for paying the UMR negotiated prices for services and prescription drugs until you meet the deductible. Once you meet the appropriate medical/prescription drug deductible, coverage is shared in a co-insurance arrangement until the out-of-pocket maximum is met, and prescription drug copays apply until the out of pocket is met.
Preventive care services are covered at 100% regardless of whether you have met the deductible.
To assist employees with their out of pocket medical expenses, The Chefs' Warehouse will contribute to the Health Savings Account (HSA). The Chefs' Warehouse will contribute $500 for employee only coverage and $1,000 for all other coverage tiers into the Health Savings Account. Employer HSA contributions will be prorated based on your date of hire.
TRADITIONAL MANAGED CARE OPTION 2: OAP Plan
This Open Access Plus (OAP) Plan contains a $500 single and $1,500 deductible for all other coverage tiers that will need to be satisfied before the plan's coinsurance level of 90% is triggered.
Select covered services such as Primary Care Physician visits, Specialist visits, and Emergency Room visits have fixed copays that do not apply to the deductible. Prescription drug copays under this plan do not apply to the deductible.
OAP Plan enrollees are not permitted to participate in a Health Savings Account (HSA).
REFERENCE BASED PRICING OPTION 1: HDHP with HSA
This is a high deductible health plan that is paired with a Health Savings Account (HSA). The HDHP with HSA is designed to be simple - You will be responsible for paying the UMR negotiated prices for services and prescription drugs until you meet the deductible. Once you meet the appropriate medical/prescription drug deductible, coverage is shared in a co-insurance arrangement until the out-of-pocket maximum is met, and prescription drug copays apply until the out of pocket is met.
Preventive care services are covered at 100% regardless of whether you have met the deductible.
To assist employees with their out of pocket medical expenses, The Chefs' Warehouse will contribute to the Health Savings Account (HSA). The Chefs' Warehouse will contribute $500 for employee only coverage and $1,000 for all other coverage tiers into the Health Savings Account. Employer HSA contributions will be prorated based on your date of hire.
REFERENCE BASED PRICING OPTION 2: OAP Plan
This Open Access Plus (OAP) Plan contains a $500 single and $1,500 deductible for all other coverage tiers that will need to be satisfied before the plan's coinsurance level of 90% is triggered.
Select covered services such as Primary Care Physician visits, Specialist visits, and Emergency Room visits have fixed copays that do not apply to the deductible. Prescription drug copays under this plan do not apply to the deductible.
OAP Plan enrollees are not permitted to participate in a Health Savings Account (HSA).
Preventive Care
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The Chefs' Warehouse has preventive services available at no cost to employees. Preventive care helps identify health problems when they are most treatable and before they become serious. Your doctor is able to provide proactive care and treatment when medical problems and illnesses are detected early through routine visits. The goal of preventive care is to help keep you as healthy as possible along with being mindful of your own health. These covered services may consist of flu shots, immunizations, annual physicals, certain tests, and screenings.
PRESCRIPTION DRUG
The Chefs' Warehouse Prescription Drug Program is administered through USRX Care. After you receive your medical/prescription ID card you can register for USRX portal access at usrxcare.com/member/. You will need the card information as well as your personal information to register. Once you are registered, you will see the "Main Menu" that includes your coverage, access to documents and forms, and prior authorization information.
If you need assistance locating a pharmacy, please view the instructions below.
If you would like to sign up for Mail Order, please view the instructions below.
TELEMEDICINE - TELADOC
When your primary doctor isn't available, Teladoc is available 24/7/365 for treatment of acute conditions.
The Teladoc Mobile App is available for Apple and Android devices, and gives you access to a board-certified doctor at any time of day.
The Chefs' Warehouse provides the telehealth benefit to all employees (and spouses/dependents) that are enrolled in a medical/prescription plan. Be sure to register in advance, so you can utilize the service immediately when needed.
Conditions treated include:
- Allergies
- Child medical conditions
- Cold/Flu
- Fever
- Infections
- Nausea and vomiting
- Pink eye
- Rashes
- Sore throat
