Plan Options:

Conroe ISD offers three self-funded medical plan options administered by UnitedHealthcare for you to choose from: Charter Kelsey-Seybold, Nexus ACO R Memorial Hermann, and Choice Plus HDHP. With this arrangement, UnitedHealthcare does not insure employees, but rather processes and pays claims with money the district provides from premiums, coinsurance, copays, deductibles, and the school district contributions. This means Conroe ISD and its participating employees, as a group, pay for the entire cost of all our medical and prescription drug expenses.

Charter Kelsey-Seybold

Charter Kelsey-Seybold is an accountable care organization (ACO) plan that utilizes Kelsey-Seybold providers only. Cost sharing consists of copays, deductibles, and co-insurance, much like the Aetna Whole Health plan structure, but with one provider network and lower premiums. Plan members will automatically have Kelsey-Seybold assigned as the primary care physician (PCP), with the ability to go to any Kelsey-Seybold PCP. Referrals will not be required for Kelsey-Seybold specialists and mental health providers, but referrals will be required if care must be obtained outside the Kelsey-Seybold network.

Nexus ACO R Memorial Hermann

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. This arrangement is similar to the Aetna Whole Health plan, with no change in premiums, but will reflect increases in the Tier 1 copay, deductible, coinsurance, and out-of-pocket maximum amounts. Plan members will be required to designate a PCP and obtain a referral for specialist services that are not listed as direct access.

Choice Plus HDHP

Choice Plus HDHP is an exclusive provider organization that operates under a broad network called “Choice Plus,” and it takes the place of the HDHP. Cost sharing is based on deductibles and coinsurance, and there will be a slight decrease in premiums with an increase to the out-of-pocket maximums. Plan members will have direct access to providers for covered services and supplies (no referral required) and will pay lower
out-of-pocket costs when 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).

Group Health Benefits

Medical (Group #917439)

UnitedHealthcare Member Services

Charter Kelsey-Seybold Medical Plan
1-877-805-1970
Nexus ACO R Memorial Hermann Medical Plan
1-888-383-0132
Choice Plus HDHP Medical Plan
1-866-314-0335
Dependent OOA Medical Plan
1-866-633-2446
Personalized Member Website
www.myuhc.com
Myuhc.com Help Desk
1-877-844-4999
United Behavorial/Mental Health
1-888-331-3408
Maternity Support Program
1-888-201-5328
Virtual Visits
www.uhc.com/virtualvisits
Kelsey-Seybold Clinic
713-442-0000 / www.kelsey-seybold.com

BUYING HEALTH INSURANCE