Univera Presentation on Opening Day, August 27, 2024: Univera Transition Presentation 8/27/2024

Univera Presentation on Early Release Day, October 15: Univera Transition Presentation 10/15/2024

Special Open Enrollment Period: With the unique mid-year transition and the change in carriers, we conducted a special Open Enrollment period from October 28, 2024, through Friday, November 15, 2024. The special open enrollment period only extended to health benefits (not dental or life).

All changes to benefits, outside an open enrollment period, require a qualifying life event. 

Benefit plan summaries are contractual and will not change with the transition to Univera. To review plan summaries: 

Plan A: POS 200 $0/$0

Plan B: POS 200 $5/$10

Plan C: POS 200 $25/$40

Plan D: POS 7200 HDHP

Vision coverage is through Davis Vision, and inclusive with health insurance. Please note: There is now a separate ID card for vision benefits. The new Vision ID card is in your (the subscriver's) name only. Please update your vision care provider with your new Davis Vision insurance information.

Sample Vision Card: 

Pharmacy (prescription) coverage will continue through Pharmacy Benefits Dimensions  (PBD). You have received a new PBD ID card, which updated your member and group number to align with your new Univera information; All covered dependents are listed on your PBD ID card, but you receive one set per family. Please update your pharmacy with your new PBD insurance information.  

• If you ever need a new PBD card, go to the PBD website to print one, or to request a new one.

Cost structures (including district and employee contribution rates) are contractual, per unit, and remain the same for 2024-2025. Each employee received these rates on May 6, 2024, via email (Open Enrollment 2024-2025). A copy of the rate sheet for your unit is available upon request from your union building rep, or by contacting Jodee Riordan: jriordan@lew-port.com

Univera requires you to Assign a Primary Care Physician (PCP): 

All LMHF members enrolled in a Point of Service plan must assign a Primary Care Physician (PCP). PCP information was not transferred from Highmark to Univera Healthcare. Once members receive the letter from Univera instructing them to assign a PCP, they are able to visit the Univera website at (univerahealthcare.com) and create an account using the Member I.D. number indicated below their name on the letter.  However, if completed on the Univera website, the assignment of their PCP must be done on or after January 1, 2025 – not before.  If they would like to assign their PCP prior to January 1, they can call the LMHF dedicated Customer Care line at 1-855-392-3558. If a member does not elect a PCP, they will be charged a “specialist” copay when visiting a physician. 

Being connected to a Primary Care Physician (PCP) is important for staying healthy and getting the care you need. We care about your health and want to make sure you get the most out of your Univera Healthcare plan.

There are several benefits to having a PCP:
• Consistent care from a doctor who knows you and your health history
• Easier access to routine and preventive care and important screening that can keep you healthy
• Note: Females 15 years or older can choose an OB/GYN in addition to a PCP
• Your medical claims are processed more efficiently

If you have not yet selected a PCP we can help!
• Visit www.univerahealthcare.com/member or go to the Univera Healthcare mobile app and select “Find a Doctor” on or after your policy start date
• Or, call Univera at the number on the back of your member card.