Medical & Pharmacy Plans
Quantum Health is your one stop resource for all your benefits. Starting on January 1, 2024, access all of your plan details at SoteraHealthBenefits.com or contact your Care Coordinators at 866.920.1968.
Don’t forget to download the Quantum Health app for on-the-go guidance whenever you need help with your healthcare and benefits.
There are four medical plans from which you can choose. Each plan offers a different deductible and out-of-pocket maximum, as well as different premiums (the amount taken pre-tax from your paycheck) so you can decide which plan works best with your budget and healthcare needs.
All medical plans have in and out-of-network benefits. You will experience lower out-of-pocket costs when choosing an in-network doctor or hospital. You can choose to select an out-of-network provider, but your out-of-pocket costs will be greater.
PLATINUM PPO PLAN
A traditional PPO medical plan that offers greater coverage when you select an in-network provider. Copays and coinsurance coverage is provided under this plan, please review the chart to follow. You are eligible to participate in a health care Flexible Spending Account (FSA).
GOLD PLAN
A High Deductible Health Plan (HDHP) with mid-range premiums and deductibles. This plan comes with a contribution into your Health Savings Account (HSA) from Sotera Health to help cover your medical costs.
SILVER PLAN
A High Deductible Health Plan similar to the Gold Plan but with lower premiums and higher deductibles. This plan comes with a contribution into your Health Savings Account (HSA) from Sotera Health.
BRONZE PLAN
A High Deductible Health Plan, the Bronze plan has the highest deductible and out-of-pocket costs with the lowest premiums. This plan comes with a contribution into your Health Savings Account (HSA) from Sotera Health.
Key Terms
Coinsurance - your share of the cost of a covered medical or prescription drug service after you’ve met your deductible for the calendar year. If you reach your out-of-pocket maximum, the medical and prescription plans pay 100% of the allowed amount of all covered services for the remainder of the calendar year.
Copay - a fixed amount you pay for a services like a doctor's office, urgent care, or emergency room visit, or prescription drugs.
Deductible - this is the amount you pay out of your own pocket before the plan will begin paying for care. You can use funds from your HSA to pay for eligible expenses and help meet your deductible.
Out-of-pocket maximum - the most you’ll spend on eligible medical and prescription drug expenses in a single year. Your plan covers all eligible expenses after this limit is reached in a calendar year.
Preventive care - the care you receive to prevent illnesses or diseases such as screenings and immunizations. Our health plans provide 100% coverage for recommended preventive medical care services.
The Premium Designated Provider program evaluates physicians in various specialties using evidence-based medicine and national standardized measures to help you locate quality and cost efficient doctors. Contact your Quantum Health Care Coordinator or look on SoteraHealthBenefits.com to find a Premium Designated Provider.
Lower cost sharing will apply if you use a premium designated provider. If you are enrolled in the Gold, Silver, or Bronze plan, the copays will apply after your deductible.
- $10 copay for PCP visits
- $40 for specialists
Choosing a network pharmacy may help you save on costs. You may contact your Quantum Health coordinator to help you find a pharmacy that will best support your needs at 866.920.1968 or go online to SoteraHealthBenefits.com. Your OptumRx Group Number is 76-416472.
New for 2024 is the Critical Drug Affordability Program. This program covers crucial medications for enrolled members at 100%. Covered drugs include insulins, glucagon, epinephrine, albuterol, and naloxone. Optum Rx Critical Drug Affordability Program
You have access to TalkSpace online therapy through any of Sotera Health's medical plans. With Talkspace online therapy, you can regularly communicate with a therapist, safely and securely from your phone or desktop. No office visit required. Talkspace is convenient, safe and secure.
2024 Summary of Benefits & Coverage (SBC)
2024 Summary Plan Description (All Plans)