UHC Medical Plan

2020 Plan Year Information

Medical Plans

The Morgan Stanley Medical Plan is designed to help you and your family maintain your health and well-being while managing medical expenses. U.S. benefits-eligible employees may select coverage administered by Cigna or UnitedHealthcare (UHC).

California
In addition to the national options through Cigna and UHC, employees who live in California may instead choose to participate in a regional medical plan option through Kaiser Permanente HMO (in-network coverage only). Note that there are separate options for Northern and Southern California, based on your ZIP code.

Hawaii
Employees who live in Hawaii may enroll in medical coverage through either HMSA Medical Plan or Kaiser Permanente HMO (both are in-network coverage only). Coverage through Cigna and UHC is not available in Hawaii.

Certain U.S. Expatriates and International Employees
The Cigna Global Health Medical Plan is available to certain employees. Contact HR Services for additional information.

Preexisting Conditions

The Medical Plan has no preexisting condition exclusions.

UHC Preferred National Health Plan Administrator

UHC is the preferred Medical Plan administrator in the following states and generally provides higher average negotiated discounts:

National Medical Plans: Cigna and UnitedHealthcare

Here’s a look at the benefits provided under the Options A, B and C of the Medical Plan. Please note that your deductible and out-of-pocket maximum reset each Plan year.

Option AOption BOption C
Note

The figures in the chart below reflect what the Plan pays, with the exception of deductibles and out-of-pocket maximums.

Individual Deductible

In-Network:
$600

Out-of-Network:
$1,200

In-Network:
$1,200

Out-of-Network:
$2,400

In-Network:
$2,300 (includes prescription drugs)

Out-of-Network:
$4,600 (includes prescription drugs)

Family Deductible

In-Network:
$1,250

Out-of-Network:
$2,500

In-Network:
$2,500

Out-of-Network:
$5,000

In-Network:
$4,600 (includes prescription drugs)

Out-of-Network:
$9,200 (includes prescription drugs)

Individual Out-of-Pocket Maximum

In-Network:
$2,000

Out-of-Network:
$4,000

In-Network:
$3,000

Out-of-Network:
$6,000

In-Network:
$5,500 (includes prescription drugs)

Out-of-Network:
$11,000 (includes prescription drugs)

Family Out-of-Pocket Maximum

In-Network:
$5,000

Out-of-Network:
$10,000

In-Network:
$7,500

Out-of-Network:
$15,000

In-Network:
$11,000 (includes prescription drugs)

Out-of-Network:
$20,000 (includes prescription drugs)

Diagnostic and Preventive Care

In-Network:
100% (no annual deductible)

Out-of-Network:
100% up to a maximum of $250 (no annual deductible) then 60% of eligible expenses (no annual deductible)

In-Network:
100% (no annual deductible)

Out-of-Network:
100% up to a maximum of $250 (no annual deductible) then 60% of eligible expenses (no annual deductible)

In-Network:
100% (no annual deductible)

Out-of-Network:
100% up to a maximum of $250 (no annual deductible) then 60% of eligible expenses (no annual deductible)

Most other services, including inpatient and outpatient hospital and specialist visits

In-Network:
80% after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Out-of-Network:
60% of eligible expenses after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

In-Network:
80% after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Out-of-Network:
60% of eligible expenses after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

In-Network:
80% after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Out-of-Network:
60% of eligible expenses after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Cancer Support Program

In-Network:
100% covered after annual deductible if enrolled in program within 30 days of diagnosis. 80% after annual deductible if not enrolled in program.

Out-of-Network:
60% after annual deductible

In-Network:
100% covered after annual deductible if enrolled in program within 30 days of diagnosis. 80% after annual deductible if not enrolled in program.

Out-of-Network:
60% after annual deductible

In-Network:
100% covered after annual deductible if enrolled in program within 30 days of diagnosis. 80% after annual deductible if not enrolled in program.

Out-of-Network:
60% after annual deductible

Bariatric Surgery

In-Network:
Cigna: 100% at Cigna Certified Hospitals for bariatric surgery; 80% after annual deductible at other in-network facilities.

UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

In-Network:
Cigna: 100% at Cigna Certified Hospitals for bariatric surgery; 80% after annual deductible at other in-network facilities.

UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

In-Network:
Cigna: 100% after annual deductible at Cigna Certified Hospitals for bariatric surgery; 80% after annual deductible at other in-network facilities.

UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

Maternity

In-Network:
80% after annual deductible

Out-of-Network:
60% of eligible expenses after annual deductible

In-Network:
80% after annual deductible

Out-of-Network:
60% of eligible expenses after annual deductible

In-Network:
80% after annual deductible

Out-of-Network:
60% of eligible expenses after annual deductible

Fertility Coverage (includes cryopreservation, artificial insemination, IVF, GIFT and ZIFT)

In-Network:
Cigna: 80% after annual deductible

UHC: Members must enroll in the Fertility Solutions program and treatment must be received at UHC’s Centers of Excellence; 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

In-Network:
Cigna: 80% after annual deductible

UHC: Members must enroll in the Fertility Solutions program and treatment must be received at UHC’s Centers of Excellence; 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

In-Network:
Cigna: 80% after annual deductible

UHC: Members must enroll in the Fertility Solutions program and treatment must be received at UHC’s Centers of Excellence; 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage