2025 New Medical Plan Vendor
As of January 1, 2025, Pinellas County’s medical plan coverage will be changing vendors from Cigna to UMR, a UnitedHealthcare company, for employee medical, behavioral/mental health, and Employee Assistance Program (EAP) plans.
There will be no premium increases in 2025.
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What is changing?
As of January 1, 2025, the following employee benefits will be provided by UMR (UnitedHealthcare) instead of Cigna:
- Medical Plan
- Behavioral/Mental Health Program
- Employee Assistance Program (EAP)
Why is this change being made?
UnitedHealthcare was our medical plan vendor prior to our transition to Cigna in 2022. As a result of ongoing employee feedback, we made the decision to move back to the UnitedHealthcare family, which was rated second place during the previous RFP process. This change is expected to cause minimal disruption and to provide larger provider networks.
What is the difference between UMR and UnitedHealthcare?
UMR (which stands for United Medical Resources) is a subsidiary of UnitedHealthcare. UMR serves as the administrator for self-funded medical plans. UMR will administer the plans and the network of health care providers will be the UnitedHealthcare Choice Plus network.
Will I pay more?
Your premium rates will remain the same in 2025 for medical (includes prescription and vision) and dental.
Will I have a choice of two medical plans?
Yes. We will continue to offer a Point of Service plan and a high-deductible plan with a Health Savings Account.
Will my doctor be in the new network?
We anticipate that almost all of your current providers will be in UMR’s UnitedHealthcare Choice Plus network. To verify if your doctor is in-network:
- Visit www.UMR.com and select Find a Provider.
- Scroll down and in the search bar, type UnitedHealthcare Choice Plus for the network name and click Search.
- Scroll down and click the blue View Providers button for medical providers.
- Type the name of your doctor, medical group, or hospital in the search box.
- If you see In-Network Provider and a green checkmark below the name, they are included in the network.
- If your doctor is not listed, call their office and ask, “Do you accept UnitedHealthcare Choice Plus network?” If your doctor is not participating, you can encourage them to join the network.
- If you need help, contact Employee Benefits by email at employee.benefits@pinellas.gov or by phone at (727) 464-3367, option 1.
Note that the same network applies to both medical plans.
Will my behavioral/mental health provider be in the new network?
To verify that your behavioral/mental health provider is in network:
- Visit www.UMR.com and select Find a Provider.
- Scroll down and in the search bar, type UnitedHealthcare Choice Plus for the network name and click Search.
- Scroll down and click the Behavioral Health Directory button for mental health and substance use providers such as therapists, psychiatrists, and clinics.
- You will be redirected to Optum’s Live and Work Well website. Type the provider name in the search box and click Search.
- If the name is listed, they are included in the network.
- If your provider is not listed, call their office and ask, “Do you accept UnitedHealthcare Choice Plus network?” If they are not participating, you can encourage them to join the network.
- If you need help, contact Employee Benefits by email at employee.benefits@pinellas.gov or by phone at (727) 464-3367, option 1.
Note that the same network applies to both medical plans.
What if I don’t see UMR listed on my doctor’s website as an accepted insurance?
Look for UnitedHealthcare on your doctor’s website. UMR is unlikely to be listed as it is the third-party administrator for UnitedHealthcare.
Will we get ID cards?
Yes. You will receive new medical ID cards from UMR (two copies) which include your dependents’ names. You can request additional copies if needed. If you have more than 4 dependents, you will get two cards since there is a limit of 4 dependent names per card.
What if I’m currently under treatment for a health condition?
If you are currently under treatment for specific conditions such as cancer and it would be a hardship to change providers in the middle of treatment, there will be a 90-day transition period from January 1 to March 31, 2025 so that your care plan is not interrupted.
Will vision and prescription coverage still be included with medical plan coverage?
Yes. Your medical premium will still include medical care, vision care, and prescription coverage. Although the medical plan vendor is changing from Cigna to UMR (UnitedHealthcare), the prescription and vision vendors will not change.
Will there be vendor changes for our other benefits?
No. The only benefits plans with a new administrator in 2025 are the medical plan, behavioral/mental health program, and Employee Assistance Program (EAP).
Benefit | 2024 Vendor | 2025 Vendor |
---|---|---|
Medical | Cigna | UMR (UnitedHealthcare) |
Behavioral/Mental Health | Cigna | UMR (UnitedHealthcare) |
Employee Assistance Program (EAP) | Cigna | UMR (UnitedHealthcare) |
Dental | Cigna | Cigna |
Prescription | ExpressScripts | ExpressScripts |
Vision | EyeMed | EyeMed |
Life Insurance | Securian | Securian |
Flexible Spending Accounts (FSA) | TASC | TASC |
Short and Long Term Disability | UnitedHealthcare | UnitedHealthcare |
FMLA | UnitedHealthcare | UnitedHealthcare |
COBRA | iTedium | iTedium |
Will we have onsite UMR representatives?
Yes. We will have the following onsite reps, although it is too soon to say if our current Cigna reps will transition to UMR:
- Claims Representative
- Dietician Health Coach
- EAP Representative (part-time)
Will virtual visits be available?
Yes. UMR (UnitedHealthcare) partners with Teladoc to offer 24/7 access to expert virtual care using a phone, tablet, or computer for your non-emergency medical and behavioral/mental health needs, including prescriptions.
Will there still be a Hinge Health Program?
Yes. We will continue to offer the Hinge Health Program for employees enrolled in a Pinellas County medical plan. This free digital exercise therapy program supports muscle and joint health. Hinge Health provides a personalized therapy program and care team (via video).
What will happen with rewards points for wellness?
Employees will continue to accrue points for wellness activities, service anniversaries, and retirement. Our Rewards Program will not change (login to SharePoint required). You will keep the points you’ve earned and may redeem them as desired. Starting in 2025, wellness rewards points will be tracked in a UMR (UnitedHealthcare) portal instead of MyCigna.
Will there still be a Wellness Incentive Program?
Yes. We will offer a Wellness Incentive Program through UMR (UnitedHealthcare), as we did with Cigna. The total rewards possible in 2025 will be the same – 50,000 Rewards Program points or $200 cash.
Will retiree medical plans be changing?
There will be a vendor change for non-Medicare eligible retirees who will be covered by UMR (UnitedHealthcare) instead of Cigna as of January 1, 2025. Our Medicare-eligible retirees will continue to be covered by Aetna’s Medicare Advantage plan.
What if I have more questions?
Please contact Employee Benefits by email at employee.benefits@pinellas.gov or by phone at (727) 464-3367, option 1
10/23/24