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MTM HDHP w/HSA

(Administered by UMR)

 

At MTM, your health—and the health of your family—comes first. Our medical plans are designed to give you access to quality care, comprehensive coverage, and the wellness support you need to feel your best. From preventive services to everyday care and long‑term well‑being, MTM is here to support your whole health journey with compassion and care.

 

The MTM High‑Deductible Health Plan (HDHP), administered by UMR, gives you comprehensive medical coverage paired with the savings advantages of a Health Savings Account (HSA). An HDHP works differently from traditional medical plans—you pay more upfront through the deductible, but once it’s met, the plan begins sharing the cost of services.

How a High‑Deductible Health Plan (HDHP) Works

An HDHP combines a higher deductible with lower premiums, which can make it a cost‑effective choice—especially when paired with an HSA.

 

Here’s how it works:

  • You pay the full cost of most medical and pharmacy services upfront until you meet your deductible.
  • After the deductible is met, the plan begins paying its share through coinsurance.
  • You continue sharing costs until you reach the out‑of‑pocket maximum, after which the plan pays 100% for the rest of the plan year.
  • Preventive care is still covered at 100%, even before the deductible.

 

HDHPs give you more control over how you spend on healthcare and pair well with tax‑advantaged savings tools like HSAs.

Your Medical Network

MTM partners with UnitedHealthcare to give employees access to high‑quality providers, hospitals, and specialists across the country.  Like the Basic and Select EPOs, the HDHP requires you to use in‑network providers to receive benefits.
There is no coverage for out‑of‑network care, except for true emergencies.


Using in‑network doctors and facilities helps keep your costs lower and ensures services apply to your deductible.  Before scheduling care—especially if you’re new to MTM or visiting a new provider—be sure to check the UHC provider search tool to confirm the doctor or facility is in your designated network.

 

UnitedHealthcare Choice Plus Network

For most MTM employees, your medical coverage uses the UnitedHealthcare Choice Plus network. This large, nationwide network offers:

  • A wide selection of in‑network doctors and specialists
  • Access to major hospitals and care facilities
  • No referrals needed to see a specialist
  • Lower out‑of‑pocket costs when you stay in‑network

 

Madison, WI Employees – UnitedHealthcare Options PPO Network

If you work in Madison, Wisconsin, your medical plan uses the UnitedHealthcare Options PPO network. This network provides strong regional coverage and offers similar access to doctors, hospitals, and specialists within the Options network.

 

Why It Matters

Using in‑network providers gives you:

  • Lower costs and predictable copays
  • Full access to preventive services at 100%
  • Better coordination of care within the network

Plan Costs at a Glance

You can view your benefit premiums in Workday during the enrollment event. Since costs vary based on the plan, your coverage level, and who you enroll, your premium will be tailored to your specific selections. For general rate information at any time, search “Employee Premiums” in the Workday search bar. Be sure to review your elections to see your exact cost.

Preventive Care – Covered at 100%

Preventive services—including annual physicals, well‑child visits, recommended screenings, and immunizations—are covered at 100% when using in‑network providers. This means no deductible, no copay, and no cost to you.

 

Medical Deductible

The amount you pay out‑of‑pocket each year before the plan begins sharing costs:

  • Individual: $3,500
  • Family: $7,000

 

Medical Coinsurance

After meeting the deductible, the plan pays a percentage of the cost:

  • You pay: 30%
  • Plan pays: 70%

 

Medical Out of Pocket Maximum

The maximum amount you will pay each plan year for in-network services before the plan pays 100% of covered charges for the remainder of the year.  All allowed out-of-pocket expenses accumulate toward the annual out-of-pocket maximum.

  • Individual: $5,000
  • Family: $10,000

 

Pharmacy Benefits

Your prescription coverage is included with your medical plan.

Retail 30‑day supply:

  • Tier 1 (Generic): 30% after deductible
  • Tier 2 (Preferred Brand): 30% after deductible
  • Tier 3 (Non‑Preferred Brand): 30% after deductible

Mail Order 90‑day supply:

  • Tier 1 (Generic): 30% after deductible
  • Tier 2 (Preferred Brand): 30% after deductible
  • Tier 3 (Non‑Preferred Brand): 30% after deductible

Why Choose the HDHP w/ HSA

The MTM HDHP w/ HSA Plan is a strong fit for employees who want:

  • Lower payroll premiums
  • Control over their healthcare spending
  • Tax‑free savings for medical costs
  • 100% covered preventive care
  • The ability to save for future or retirement healthcare needs

Plan Comparison

Review the side‑by‑side comparison of the medical plans administered by UMR to get a quick, high‑level look at how the plans differ. For a more personalized comparison—based on your health care needs and those of your family—use the Decision Support Tool. This confidential tool helps you see how each plan may work for you and can be a helpful guide when deciding which option best fits your needs.

Learn More

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