Provider Network, Medical Benefits & Summary Plan Description (SPD)

The Out-of-Area Employee Health Plan offers a comprensive provider network to choose from.  Following is a description of the network and a link to the Summary Plan Description (SPD).

 

Provider Network 

The Health Plan offers a comprehensive provider network through UMR.  This network also includes the Cleveland Cleveland Clinic Quality Alliance network. To locate a provider, click here or on the "Find a Provider/Facility" button above.   It is your responsibility to verify and obtain the most current Tier participation each time services are obtained.  


TIER 1
NetworkUMR United Healthcare Choice Plus Network
Deductible0
Coverage100% after applicable co-pay or co-insurance
Emergency /
Urgent Care
100% coverage after applicable co-pay
($50 for Urgent Care / $250 for Emergency*)
* If the emergency visit results in an admission, the emergency visit co-payment will be waived and the inpatient admission co-payment will be applied.


The Cleveland Clinic EHP  Third Party Administrator (TPA) is UMR.  UMR's customer service department can be reached at 800.826.9781.  If your issue is not resolved to your satisfaction after calling the TPA directly, please call the Cleveland Clinic EHP Customer Service Unit at 216.448.2247 (Option 2).

Medical Benefits Information

To the right are documents designed to help navigate the health plan.  The Summary Plan Description (SPD) explains the health plan in great detail and the Summary of Benefits and Coverage (SBC) is a great snapshot of important questions and answers.