UnitedHealthcare

Charter Kelsey-Seybold is an accountable care organization (ACO) plan that utilizes Kelsey-Seybold providers only. Cost sharing consists of copays, deductibles, and coinsurance. Plan members automatically have Kelsey-Seybold assigned as the primary care physician (PCP), with the ability to go to any Kelsey-Seybold PCP. Referrals are not required for Kelsey-Seybold specialists and mental health providers, but referrals are required if care must be obtained outside the Kelsey-Seybold network.

Nexus ACO R Memorial Hermann is an ACO plan that uses a tiered design of Memorial Hermann (Tier 1) and UHC Choice (Tier 2) networks. Cost sharing consists of copays, deductibles, and coinsurance, and benefits are for in-network providers only. Plan members are required to designate a PCP and obtain a referral for specialist services that are not listed as direct access.

Choice Plus HDHP is an exclusive provider organization that operates under a broad network called “Choice Plus.” Cost sharing is based on deductibles and coinsurance, and plan members have direct access to providers for covered services and supplies (no referral required). Lower out-of-pocket costs are achieved by using in-network providers. This plan qualifies as a high deductible health plan, so participants are eligible to contribute to a health savings account (HSA).