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Changes to your coverage for the 2023 benefit year are shown in blue.
Selecting the right medical plan takes careful consideration. For most full-time employees, the Company offers medical plan options through United Healthcare (UHC); these plans include pharmacy benefits through OptumRx. Qualified Essential Coverage (QEC) employees may enroll in the Health Savings Plan.
You have 24/7 access to your UHC account information at www.myuhc.com. You can also use the site to find medical and pharmacy providers, place orders with the Mail Service Pharmacy, request new cards and print temporary cards. If you haven’t signed up already, create your account today.
Recently hired or promoted to full-time? Learn more about your coverage choices through the Company’s plans through UHC below and via our Pre-Member Website.
Preventive Care at No Cost
With either plan option, in-network preventive care is usually covered with no cost sharing, including well child, routine physicals, OB/GYN exams, mammograms and prostate exams. Costs will only be incurred if additional non-preventive lab work is requested. Also, many prescription medications are considered preventive and are also covered with no cost sharing. Call the member number on your Medical Plan ID card to find out which preventive medications and services are covered at no cost.
Choice Plus Plan / Options Plan (available to Full-Time employees only)
- Coverage through the Choice Plus Plan (Options Plan in Wisconsin) is a more traditional health care option with a deductible, set co-pays and coinsurance amounts.
- With the Choice Plus Plan, you have the option to elect the Flexible Spending Account (FSA).
- Prescription costs are not counted towards the annual deductible; co-pays apply.
Health Savings Plan (available to Full-Time and Qualified Essential Coverage (QEC) employees)
- The Health Savings Plan is a medical plan with a Health Savings Account (HSA).
- The Company contributes to your HSA once your medical benefits go into effect: $500 for individual / $1,000 for family. Plus, you can contribute to your HSA tax free.
- Use your HSA money to pay your out of pocket health care expenses. All medical and prescription costs are applied to your deductible; after you meet the deductible, the plan covers 80% with 20% employee coinsurance.
- With the Health Savings Plan, you have the option to elect the Flexible Spending Account (FSA), but you may only use FSA funds to pay for dental and vision expenses. You cannot use FSA funds to pay for medical expenses when enrolled in the Health Savings Account.
- Your HSA goes where you go! Even if you change jobs, switch health plans, or retire, your HSA is yours—you own it, and the money carries over from year to year.
| Medical Plan Choice | UHC Choice Plus/Options Plan Full-Time Only |
UHC Health Savings Plan Full-Time and QEC |
||
|---|---|---|---|---|
| Company Contribution to Your HSA | ||||
| Individual/Family | (Does not apply) | $500/$1,000 ∑ | ||
| Annual Deductible | In-Network | Out-of-Network ∆ | In-Network | Out-of-Network ∆ |
| Individual/Family | $700/$2,100 | $2,000/$5,000 | $2,000/$4,000 Ω | $4,000/$8,000 Ω |
| Maximums | ||||
| Out-of-Pocket: Individual/Family 2022 | $3,500/$7,000 | $7,000/$16,000 | $3,500/$6,850 | $7,000/$14,000 |
| Out-of-Pocket: Individual/Family 2023 | $3,500/$7,000 | $7,000/$16,000 | $3,500/$7,000 | $7,000/$14,000 |
| Lifetime Maximum | Unlimited | Unlimited | Unlimited | Unlimited |
| Co-pays: | ||||
| Preventive Care | ||||
| Routine physicals, immunizations, and more! | 100% | Not Covered | 100% | Not Covered |
| Get rewarded for your Annual Physical! See the Physician Affidavit form | ||||
| Physician’s Services: Sickness and Injury | ||||
| Virtual Visit – Medical – via myuhc.com | FREE | N/A | 80%* | N/A |
| Physician Office Visit | $20/visit | 60%* | 80%* | 60%* |
| Specialist Office Visit | $40/visit | 60%* | 80%* | 60%* |
| Mental Health / Substance / Addiction | ||||
| Virtual Visit – Telemental Health – via myuhc.com | $20/visit | 60%* | 80%* | 60%* |
| Inpatient | 80%* | 60%* | 80%* | 60%* |
| Outpatient | $20/visit | 60%* | 80%* | 60%* |
| Emergency Care | ||||
| Urgent Care | $40/visit | 60%* | 80%* | 60%* |
| Emergency Room | $200 | $200 | 80%* | 80%* |
| Tests | ||||
| Lab, X-Ray and Major Diagnostics (CT, PET, MRI, MRA and Nuclear Medicine) – Outpatient | 80%* | 60%* | 80%* | 60%* |
| Hospital Care | ||||
| Inpatient / Outpatient Care and Surgery | 80%* | 60%* | 80%* | 60%* |
| Maternity Care | ||||
| Prenatal Visit | $40 first visit; $0 after | 60%* | 80%* | 60%* |
| Postnatal Visits/Surgery | 80%* | 60%* | 80%* | 60%* |
| Specialty Care | ||||
| Acupuncture (max 20 visits per year) | $40/visit | 60%* | 80%* | 60%* |
* = After deductible
∑ = The Company funds your HSA on the day Medical Benefits go into effect.
Ω = The Health Savings Plan requires the FULL family deductible (e.g. $4,000 for in network) be met if you have enrolled any dependents.
∆ = When you receive out-of-network care, the plan covers its percentage up to the Reasonable and Customary (R&C) limit after you satisfy the Annual Deductible. You pay the remaining percentage up to the R&C limit plus any amount above the R&C limit.
State of Illinois – Ten Essential Health Benefits
Summary of group health benefits – 2021
Summary of group health benefits – 2022
Virtual Doctor’s Visits
All United Health Care medical plans offer virtual visits. Please review the virtual visits tab for more information.
OptumRx Pharmacy Benefits
Visit our UHC Pharmacy Copay page for cost comparisons.
Consider home delivery for your 90-day prescriptions; it’s easy to get started! Request a prescription from your doctor for a three-month supply, with refills for up to one year (if appropriate), then contact OptumRx to fill your prescription.
- Cost savings: With free standard shipping, the average savings is 50% or more when compared to retail pharmacy pricing.
- 24/7 access to pharmacists
- By fax / ePrescribe: Ask your doctor to call 1-800-791-7658 for instructions on how to fax your 90-day prescription directly to OptumRx Mail Service Pharmacy. Or your doctor can send an electronic prescription to OptumRx Mail Service Pharmacy.
- Online: Log in or register at www.myuhc.comand select Manage My Prescriptions.
- By phone: Call the Advocate4Me phone number on the back of your plan ID card to talk with a customer service representative. It’s helpful to have your plan ID card and medication bottle available. The representative can also contact your doctor directly if you need a new prescription.
- Maximum convenience and peace of mind
Additional United Healthcare Information
UnitedHealthcare creates and publishes the Machine-Readable Files on behalf of Discount Tire.
To link to the Machine-Readable Files, please click on the URL provided: transparency-in-coverage.uhc.com
BLUE CROSS BLUE SHIELD COVERAGE IS OFFERED TO MICHIGAN EMPLOYEES ONLY
Selecting the right medical plan takes careful consideration. For full-time Michigan employees, the Company offers medical plan options through Blue Cross Blue Shield (BCBS) of Arizona; these plans include pharmacy benefits through Express Scripts. Qualified Essential Coverage (QEC) Employees may enroll in the Health Savings Plan.
You have 24/7 access to your BCBS account information at: www.mybenefitshome.com. You can also use the site to find medical and pharmacy providers, place mail orders for prescriptions, request new cards and print temporary cards. If you haven’t signed up already, create your account today.
Preventive Care at No Cost
With either plan option, in-network preventive care is usually covered with no cost sharing, including well child, routine physicals, OB/GYN exams, mammograms and prostate exams. Costs will only be incurred if additional non-preventive lab work is requested. Also, many prescription medications are considered preventive and also covered with no cost sharing. Call the member number on your Medical Plan ID card to find out which preventive medications and services are covered at no cost.
PPO Blue Plan (available to Full-Time employees only)
- Coverage through the PPO Blue Plan is a more traditional health care option with a deductible, set co-pays and coinsurance amounts.
- With the PPO Blue Plan, you have the option to elect the Flexible Spending Account (FSA).
- Prescription costs are not counted towards the annual deductible; co-pays apply.
Health Savings Plan (available to Full-Time and Qualified Essential Coverage (QEC) employees)
- The Health Savings Plan is a medical plan with a Health Savings Account (HSA).
- The Company contributes to your HSA at the beginning of the plan year: $500 for individual / $1,000 for family. Plus, you can contribute to your HSA tax free.
- Use your HSA money to pay your out of pocket health care expenses. All medical and prescription costs are applied to your deductible; after you meet the deductible, the plan covers 80% with 20% employee coinsurance.
- With the Health Savings Plan, you have the option to elect the Flexible Spending Account (FSA), but you may only use FSA funds to pay for dental and vision expenses. You cannot use FSA funds to pay for medical expenses when enrolled in the Health Savings Account.
- Your HSA goes where you go! Even if you change jobs, switch health plans, or retire, your HSA is yours—you own it, and the money carries over from year to year.
| Medical Plan Choice | BCBS PPO Blue Plan Full-Time Only |
BCBS Health Savings Plan Full-Time and QEC |
||
|---|---|---|---|---|
| Company Contribution to Your HSA | ||||
| Individual/Family | (Does not apply) | $500/$1,000 ∑ | ||
| Annual Deductible | In-Network | Out-of-Network ∆ | In-Network | Out-of-Network ∆ |
| Individual/Family | $700/$2,100 | $2,000/$5,000 | $2,000/$4,000 Ω | $4,000/$8,000 Ω |
| Maximums | ||||
| Out-of-Pocket: Individual/Family 2022 | $3,500/$7,000 | $7,000/$16,000 | $3,500/$6,850 | $7,000/$14,000 |
| Out-of-Pocket: Individual/Family 2023 | $3,500/$7,000 | $7,000/$16,000 | $3,500/$7,000 | $7,000/$14,000 |
| Lifetime Maximum | Unlimited | Unlimited | Unlimited | Unlimited |
| Co-pays: | ||||
| Preventive Care | ||||
| Routine physicals, immunizations, and more! | 100% | Not Covered | 100% | Not Covered |
| Get rewarded for your Annual Physical! See the Physician Affidavit form | ||||
| Physician’s Services: Sickness and Injury | ||||
| Virtual Visit – Medical – via mybenefitshome.com | FREE | N/A | 80%* | N/A |
| Physician Office Visit | $20/visit | 60%* | 80%* | 60%* |
| Specialist Office Visit | $40/visit | 60%* | 80%* | 60%* |
| Mental Health / Substance / Addiction | ||||
| Virtual Visit – Telemental Health – via mybenefitshome.com | $20/visit | 60%* | 80%* | 60%* |
| Inpatient | 80%* | 60%* | 80%* | 60%* |
| Outpatient | $20/visit | 60%* | 80%* | 60%* |
| Emergency Care | ||||
| Urgent Care | $40/visit | 60%* | 80%* | 60%* |
| Emergency Room | $200 | $200 | 80%* | 80%* |
| Tests | ||||
| Lab, X-Ray and Major Diagnostics (CT, PET, MRI, MRA and Nuclear Medicine) – Outpatient | 80%* | 60%* | 80%* | 60%* |
| Hospital Care | ||||
| Inpatient / Outpatient Care and Surgery | 80%* | 60%* | 80%* | 60%* |
| Maternity Care | ||||
| Prenatal Visit | $40 first visit; $0 after | 60%* | 80%* | 60%* |
| Postnatal Visits/Surgery | 80%* | 60%* | 80%* | 60%* |
| Specialty Care | ||||
| Acupuncture (max 20 visits per year) | $40/visit | 60%* | 80%* | 60%* |
* = After deductible
∑ = The Company funds your HSA on the day Medical Benefits go into effect.
Ω = The Health Savings Plan requires the FULL family deductible (e.g. $4,000 for in network) be met if you have enrolled any dependents.
∆ = When you receive out-of-network care, the plan covers its percentage up to the Reasonable and Customary (R&C) limit after you satisfy the Annual Deductible. You pay the remaining percentage up to the R&C limit plus any amount above the R&C limit.
Virtual Doctor’s Visits
All United Health Care medical plans offer virtual visits. Please review the virtual visits tab for more information.
Express Scripts Pharmacy Benefits
Visit our BCBS Pharmacy Copay page for cost comparisons.
Consider mail order through Express Scripts for your 90-day prescriptions
Express Scripts manages the home delivery pharmacy benefit for BCBS. Home delivery is a great option for maintenance medications – those you need on a long-term basis – for which your doctor can provide a 90-day prescription. (You should still use a retail pharmacy for medications you take on a short-term basis, such as antibiotics.)
- Cost savings: With free standard shipping, the average savings is 50% or more when compared to retail pharmacy pricing.
- Health and safety support: Pharmacists are available 24/7 to help answer medication questions.
- Coordination: Express Scripts can help coordinate with your doctor; let them know and they will contact your doctor to get a new 90-day prescription and follow up as necessary.
- Register and order online: Log in or register at mybenefitshome.com and select Prescriptions Services to get started.
- Or order by phone: Call 1-800-652-9451 to talk with a customer service representative. It’s helpful to have your plan ID card and medication bottle available.
Additional Blue Cross Blue Shield Information
BlueCross BlueShield creates and publishes the Machine-Readable Files on behalf of Discount Tire.
To link to the Machine-Readable Files, please click on the URL provided: mrfdata.hmhs.com
A virtual visit – Medical or Telemental Health – lets you see and talk to a doctor from your mobile device or computer. UnitedHealthcare and Blue Cross Blue Shield offer virtual visits as a provider choice for Discount Tire employees enrolled in medical benefits.
You have a choice of different provider groups depending on your plan’s virtual visit network. The cost of your visit will vary depending on your plan and whether the visit is Medical or Telemental Health. Check your plan documents (above) for more information about you plan’s specific costs.
Virtual Visits – Medical – for sickness or injury
- Available to all members of any of the UHC/BCBS plans above for certain non-emergency medical conditions like the flu, colds, pink eye, rashes and fevers.
- See and talk to a doctor from your mobile device or computer from a network of virtual provider groups, including Amwell and Doctor on Demand.
- Providers are expected to deliver care within 30 minutes or less from the time you put in a request for a visit.
- Visit the Virtual Visits – Medical page for more information
Virtual Visits – Telemental Health – for behavioral health
- Convenient appointments that may fit your lifestyle.
- The care you need sooner.
- Secure technology meets or exceeds HIPPA security standards.
- See and talk to a doctor from your mobile device or computer from a network of virtual provider groups.
- UHC participants visit the UHC – Telemental Health page for more information
- BCBS participants visit the BCBS – Telemental Health page for more information
Don’t wait until you throw your back out or have a 102° fever to sign up for Virtual Visits! Sign up now via your healthcare plan website to easily access virtual visits when you need them.