Medical Benefits
Medical plans are not all the same. Which one is right for you?
Medical plans are not all the same. Which one is right for you?
OneMain offers several medical plan options to meet the needs of you and your family, you might be on life's journey. From our Anthem PPO and HDHP plans to our regional HMOs and the UHC Surest CoPay Plan - we have a plan for you.
Each of these plans leverage the same broad, national network of providers. If you or one of your enrolled dependents utilizes the network, you will have lower out-of-pocket expenses. If seeking out-of-network services, your costs will be higher than in-network and you will be responsible for obtaining prior authorizations by calling the Anthem Plans before services are provided.
The Anthem PPO Plan allows you to enjoy the cost savings of an in-network benefit, while having the flexibility to see non-network providers when you choose. Primary Care Physician designation or referrals are not needed—you may freely move in and out-of-network accordingly. If seeking out-of-network services, your cost may be higher, and you may be responsible for obtaining prior authorization before services are provided. Eligible out-of-pocket costs (e.g. - medical and Rx costs) can be reimbursed with your own pre-tax dollars through your healthcare FSA.
Want to know more about this plan? Review the plan documents below.
The Anthem Enhanced HDHP Plan offers a lower premium-per-paycheck than the Anthem PPO plan but has a higher deductibles. Pairing a Health Savings Account (HSA) with a HDHP allows you to set aside pre-tax money to be used for qualified healthcare expenses.
Want to know more about this plan? Review the plan documents below.
The Anthem Base HDHP Savings Plan offers the lowest premium-per-paycheck, but has a higher deductible and out-of-pocket maximum than the Anthem Enhanced High Deductible Plan (HDHP). Pairing a Health Savings Account (HSA) with a HDHP allows you to set aside pre-tax money to be used for qualified healthcare expenses.
Want to know more about this plan? Review the plan documents below.
The UHC Surest CoPay Plan will remain available in 2027 for currently enrolled members. However, the plan will no longer be offered to new enrollees.
With the UHC Surest CoPay Plan, there are no deductibles or coinsurance—copays are used for services. The UHC Surest CoPay Plan allows you and/or your enrolled dependents to plan for your medical expenses by using the UHC Surest CoPay Plan app, where you can easily see the copay you will pay for in-network providers before making an appointment. The copay covers the services provided in that visit and may vary depending on the provider selected. Eligible out-of-pocket costs (e.g. - medical and Rx costs) can be reimbursed with your own pre-tax dollars through your healthcare FSA. The UHC Surest CoPay Plan is not eligible for new enrollees.
Want to know more about this plan? Review the plan documents below.
In addition to our Anthem options, the company offers two Health Maintenance Organization (HMO) plan options.
This option through Kaiser Permanente is for California residents only.
As a member of an HMO, you are required to choose a Primary Care Physician (PCP). Your PCP will take care of most of your healthcare needs; however, to see a specialist, you need to obtain a referral before your appointment. Eligible out-of-pocket costs (e.g. - medical and Rx costs) can be reimbursed with your own pre-tax dollars through your healthcare FSA.
Kaiser HMO
Want to know more about this plan? Review the plan documents below.
This option through Hawaii Medical Service (HMSA) is for Hawaii residents only.
As a member of an HMO, you are required to choose a Primary Care Physician (PCP). Your PCP will take care of most of your healthcare needs; however, to see a specialist, you need to obtain a referral before your appointment. Eligible out-of-pocket costs (e.g. - medical and Rx copays) can be reimbursed with your own pre-tax dollars through your healthcare FSA.
HMSA HMO
Want to know more about this plan? Review the plan documents below.
Policy/Group: 213081
Call: 855-353-0264
Website: anthem.com
Policy/Group: 78800553
Call: 866-683-6440
Website: surest.care/onemain
NCA Policy/Group: 603505
SCA Policy/Group: 230920
Call: 800-464-4000
Website: kp.org
Policy/Group: 18417-1-7
Call: 808-935-5441
Website: hmsa.com
In-Network
Anthem PPO Plan
Anthem Enhanced High Deductible Plan (HDHP)
Anthem Base High Deductible Plan (HDHP)
UHC Surest CoPay Plan
Calendar Year Deductible (Individual/Family)
$800/$1,600 (Embedded)
$2,700/$5,4001
$3,600/$7,0001
N/A (no deductible)
Your Coinsurance
20%
20%
25%
N/A (no deductible)
Out-of-Pocket Maximum (Individual/Family)
$3,000/$6,000 (Embedded)
$6,000/$12,000 (Embedded)
$7,500/$15,000 (Embedded)
$6,000/$12,000 (Embedded)
Physician Visit
(Primary Care/Specialist)
Deductible, then coinsurance
Deductible, then coinsurance
Deductible, then coinsurance
$35-$140 copay
Preventative Care Services
Covered 100%
Covered 100%
Covered 100%
Covered 100%
Hospital Services
Deductible, then coinsurance
Deductible, then coinsurance
Deductible, then coinsurance
$600-$4,500 copay
Urgent Care Visit
Deductible, then coinsurance
Deductible, then coinsurance
Deductible, then coinsurance
$90 copay
Emergency Room Visit
$250 copay and deductible, then coinsurance
$250 copay and deductible, then coinsurance
$250 copay and deductible, then coinsurance
$850 copay
Out-of-Network
Anthem PPO Plan
Anthem Enhanced High Deductible Plan (HDHP)
Anthem Base High Deductible Plan (HDHP)
UHC Surest CoPay Plan
Calendar Year Deductible (Individual/Family)
$1,750/$3,500
$5,400/$10,8001
$7,200/$14,0001
N/A (no deductible)
Your Coinsurance
40%
40%
50%
N/A (no coinsurance)
Out-of-Pocket Maximum (Individual/Family)
$6,000/$12,000
$12,000/$24,000
$15,000/$30,000
$12,000/$24,000
In-Network
Kaiser HMO Plan
HMSA HMO Plan
Calendar Year Deductible
(Individual/Family)
$500/$1,000 (Embedded)
N/A (no deductible)
Your Coinsurance
20%
N/A (no coinsurance)
Out-of-Pocket Maximum
(Individual/Family)
$3,000/$6,000 (Embedded)
$2,500/$7,500 (Embedded)
Physician Visit
(Primary Care/Specialist)
$30/$40 copay
$20 copay
Preventative Care Services
Covered 100%
Covered 100%
Hospital Services
Deductible, then coinsurance
10% coinsurance
Urgent Care Visit
$30 copay
$20 copay
Emergency Room Visit
Deductible, then coinsurance not to exceed $150
$100 copay
Out-of-Network
Kaiser HMO Plan
HMSA HMO Plan
Calendar Year Deductible
(Individual/Family)
Not Covered
Not Covered
Your Coinsurance
Not Covered
Not Covered
Out-of-Pocket Maximum
(Individual/Family)
Not Covered
Not Covered
1. Non-embedded deductible applies — the full family deductible must be satisfied before any plan cost-sharing begins for any covered family member. All other deductibles/OOPMs are embedded.
OneMain offers several medical plan options to meet the needs of you and your family, you might be on life's journey. From our Anthem PPO and HDHP plans to our regional HMOs and the UHC Surest CoPay Plan - we have a plan for you.
Each of these plans leverage the same broad, national network of providers. If you or one of your enrolled dependents utilizes the network, you will have lower out-of-pocket expenses. If seeking out-of-network services, your costs will be higher than in-network and you will be responsible for obtaining prior authorizations by calling the Anthem Plans before services are provided.
The Anthem PPO Plan allows you to enjoy the cost savings of an in-network benefit, while having the flexibility to see non-network providers when you choose. Primary Care Physician designation or referrals are not needed—you may freely move in and out-of-network accordingly. If seeking out-of-network services, your cost may be higher, and you may be responsible for obtaining prior authorization before services are provided. Eligible out-of-pocket costs (e.g. - medical and Rx costs) can be reimbursed with your own pre-tax dollars through your healthcare FSA.
Want to know more about this plan? Review the plan documents below.
The Anthem Enhanced HDHP Plan offers a lower premium-per-paycheck than the Anthem PPO plan but has a higher deductibles. Pairing a Health Savings Account (HSA) with a HDHP allows you to set aside pre-tax money to be used for qualified healthcare expenses.
Want to know more about this plan? Review the plan documents below.
The Anthem Base HDHP Savings Plan offers the lowest premium-per-paycheck, but has a higher deductible and out-of-pocket maximum than the Anthem Enhanced HDHP Value Plan. Pairing a Health Savings Account (HSA) with a HDHP allows you to set aside pre-tax money to be used for qualified healthcare expenses.
Want to know more about this plan? Review the plan documents below.
The UHC Surest CoPay Plan will remain available in 2027 for currently enrolled members. However, the plan will no longer be offered to new enrollees.
With the UHC Surest CoPay Plan, there are no deductibles or coinsurance—copays are used for services. The UHC Surest CoPay Plan allows you and/or your enrolled dependents to plan for your medical expenses by using the UHC Surest CoPay Plan app, where you can easily see the copay you will pay for in-network providers before making an appointment. The copay covers the services provided in that visit and may vary depending on the provider selected. Eligible out-of-pocket costs (e.g. - medical and Rx costs) can be reimbursed with your own pre-tax dollars through your healthcare FSA. The Surest CoPay plan is not eligible for new enrollees.
Want to know more about this plan? Review the plan documents below.
In addition to our Anthem options, the company offers two Health Maintenance Organization (HMO) plan options.
This option through Kaiser Permanente is for California residents only.
As a member of an HMO, you are required to choose a Primary Care Physician (PCP). Your PCP will take care of most of your healthcare needs; however, to see a specialist, you need to obtain a referral before your appointment. Eligible out-of-pocket costs (e.g. - medical and Rx costs) can be reimbursed with your own pre-tax dollars through your healthcare FSA.
Kaiser HMO
Want to know more about this plan? Review the plan documents below.
This option through Hawaii Medical Service (HMSA) is for Hawaii residents only.
As a member of an HMO, you are required to choose a Primary Care Physician (PCP). Your PCP will take care of most of your healthcare needs; however, to see a specialist, you need to obtain a referral before your appointment. Eligible out-of-pocket costs (e.g. - medical and Rx copays) can be reimbursed with your own pre-tax dollars through your healthcare FSA.
HMSA HMO
Want to know more about this plan? Review the plan documents below.
Policy/Group: 213081
Call: 855-353-0264
Website: anthem.com
Policy/Group: 78800553
Call: 866-683-6440
Website: surest.care/onemain
NCA Policy/Group: 603505
SCA Policy/Group: 230920
Call: 800-464-4000
Website: kp.org
Policy/Group: 18417-1-7
Call: 808-935-5441
Website: hmsa.com
In-Network
PPO
Enhanced CDHP Value
Base CDHP Savings
Surest Copay
Calendar Year Deductible (Individual/Family)
$800/$1,600 (Embedded)
$1,800/$3,600
$3,000/$6,000
N/A (no deductible)
Your Coinsurance
20%
20%
20%
N/A (no deductible)
Out-of-Pocket Maximum (Individual/Family)
$3,000/$6,000 (Embedded)
$4,500/$9,000 (Embedded)
$6,000/$12,000 (Embedded)
$6,000/$12,000 (Embedded)
Physician Visit
(Primary Care/Specialist)
Deductible, then coinsurance
Deductible, then coinsurance
Deductible, then coinsurance
$35-$140 copay
Preventative Care Services
Covered 100%
Covered 100%
Covered 100%
Covered 100%
Hospital Services
Deductible, then coinsurance
Deductible, then coinsurance
Deductible, then coinsurance
$600-$4,500 copay
Urgent Care Visit
Deductible, then coinsurance
Deductible, then coinsurance
Deductible, then coinsurance
$90 copay
Emergency Room Visit
$200 copay and deductible, then coinsurance
Deductible, then coinsurance
Deductible, then coinsurance
$850 copay
Out-of-Network
PPO
Enhanced CDHP Value
Base CDHP Savings
Surest Copay
Calendar Year Deductible (Individual/Family)
$1,750/$3,500
$3,500/$7,000
$6,000/$12,000
N/A (no deductible)
Your Coinsurance
40%
40%
40%
N/A (no coinsurance)
Out-of-Pocket Maximum (Individual/Family)
$6,000/$12,000
$9,000/$18,000
$10.000/$20,000
$12,000/$24,000
In-Network
Anthem PPO Plan
Anthem Enhanced High Deductible Plan (HDHP)
Anthem Base High Deductible Plan (HDHP)
UHC Surest CoPay Plan
Calendar Year Deductible (Individual/Family)
$800/$1,600 (Embedded)
$2,700/$5,4001
$3,600/$7,0001
N/A (no deductible)
Your Coinsurance
20%
20%
25%
N/A (no deductible)
Out-of-Pocket Maximum (Individual/Family)
$3,000/$6,000 (Embedded)
$6,000/$12,000 (Embedded)
$7,500/$15,000 (Embedded)
$6,000/$12,000 (Embedded)
Physician Visit
(Primary Care/Specialist)
Deductible, then coinsurance
Deductible, then coinsurance
Deductible, then coinsurance
$35-$140 copay
Preventative Care Services
Covered 100%
Covered 100%
Covered 100%
Covered 100%
Hospital Services
Deductible, then coinsurance
Deductible, then coinsurance
Deductible, then coinsurance
$600-$4,500 copay
Urgent Care Visit
Deductible, then coinsurance
Deductible, then coinsurance
Deductible, then coinsurance
$90 copay
Emergency Room Visit
$250 copay and deductible, then coinsurance
$250 copay and deductible, then coinsurance
$250 copay and deductible, then coinsurance
$850 copay
Out-of-Network
PPO
Enhanced CDHP Value
Base CDHP Savings
Surest CoPay
Calendar Year Deductible (Individual/Family)
$1,750/$3,500
$5,400/$10,8001
$7,200/$14,0001
N/A (no deductible)
Your Coinsurance
40%
40%
50%
N/A (no coinsurance)
Out-of-Pocket Maximum (Individual/Family)
$6,000/$12,000
$12,000/$24,000
$15,000/$30,000
$12,000/$24,000
In-Network
Kaiser HMO Plan
HMSA HMO Plan
Calendar Year Deductible
(Individual/Family)
$500/$1,000 (Embedded)
N/A (no deductible)
Your Coinsurance
20%
N/A (no coinsurance)
Out-of-Pocket Maximum
(Individual/Family)
$3,000/$6,000 (Embedded)
$2,500/$7,500 (Embedded)
Physician Visit
(Primary Care/Specialist)
$30/$40 copay
$20 copay
Preventative Care Services
Covered 100%
Covered 100%
Hospital Services
Deductible, then coinsurance
10% coinsurance
Urgent Care Visit
$30 copay
$20 copay
Emergency Room Visit
Deductible, then coinsurance not to exceed $150
$100 copay
Out-of-Network
Kaiser HMO Plan
HMSA HMO Plan
Calendar Year Deductible
(Individual/Family)
Not Covered
Not Covered
Your Coinsurance
Not Covered
Not Covered
Out-of-Pocket Maximum
(Individual/Family)
Not Covered
Not Covered
In-Network
Kaiser HMO Plan
HMSA HMO Plan
Calendar Year Deductible (Individual/Family)
N/A (no deductible)
N/A (no deductible)
Your Coinsurance
N/A (no coinsurance)
N/A (no coinsurance)
Out-of-Pocket Maximum (Individual/Family)
$3,000/$6,000 (Embedded)
$2,500/$7,500 (Embedded)
Physican Visit (Primary Care/Specialist)
$20/$40 copay
$20 copay
Preventative Care Services
Covered 100%
Covered 100%
Hospital Services
$250/day, up to $750/admission
10% coinsurance
Urgent Care Visit
$20 copay
$20 copay
Emergency Room Visit
$200 copay
$100 copay
Out-of-Network
Kaiser HMO Plan
HMSA HMO Plan
Calendar Year Deductible (Individual/Family)
N/A (no deductible)
N/A (no deductible)
Your Coinsurance
N/A (no coinsurance)
N/A (no coinsurance)
Out-of-Pocket Maximum (Individual/Family)
N/A (no deductible)
N/A (no deductible)
1. Non-embedded deductible applies — the full family deductible must be satisfied before any plan cost-sharing begins for any covered family member. All other deductibles/OOPMs are embedded.
The Benefits Service Center is made available to you through the HRConnect Self-Service Portal, providing support from dedicated professionals committed to helping you understand the benefit options available to you. Whether you have questions about your benefit plans, concerns about coverage, or just need guidance on which medical plan is right for you and your family, connect with the Benefits Service Center.
Contact HRConnectThis Digital Benefits Guide is intended to highlight available benefits and should not be relied upon to fully determine coverage. They are not complete descriptions of the benefits. The company may terminate or modify any benefits described on this website, at any time, for any reason. The descriptions listed on this website are not guarantees of coverage. If there is any conflict between this website and the official plan documents, the official plan documents and contracts will prevail.
Summary of Benefits Coverage are available within this Digital Benefits Guide as well as on MainStreet under Total REWARDS and Workday under My Benefits.
