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** Medical Plan Changes Effective June 1, 2026 **
There are a few important changes to the medical plan effective June 1, 2026.
SPECIAL ENROLLMENT - MAY 1-14TH
If no changes are needed, no action is required.
1.Plan Type Change
The plan will change from a PPO (Preferred Provider Organization) to an EPO (Exclusive Provider Organization)
- This does not change the Network. Remains United Healthcare Choice Plus.
- Retirees with Medicare still must use a provider that accepts Medicare Assignment.
What this means:
- You must use in-network providers for care.
- Out-of-network care will NOT be covered unless it is an emergency.
- If you schedule an appointment or surgery with an out-of-network provider, you will be responsible for the full cost.
Emergency & Special Situations
- Emergency care will still be covered, even if the provider is out-of-network.
- For planned surgeries:
- If you choose an in-network doctor and facility, your care will be covered. This includes ancillary services (such as an anesthesiologist, pathologist), even if those providers are out-of-network and you did not have a choice.
2.Gap Exception Change (Distance Increase)
The distance requirement for a gap exception is increasing from 30 miles to 100 miles.
What this means:
- If no in-network provider is available within 100 miles of your home, you may be able to see an out-of-network provider at in-network benefit levels.
- The out-of-network provider must be closer than any available in-network provider beyond 100 miles.
- Your in-network doctor will work with the Claims Administrator to arrange this.
3. Special Enrollment Period
Because this change happens mid-year, there will be a special enrollment period for the medical plan only.
- May 1st - May 14th
- You may add or drop coverage during this time.
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