HEALTH
Medical
Eaton offers three medical plan options—Basic Medical, Enhanced Medical and MyChoice Medical—so you can choose the plan that is best for your and your family’s needs.
While each medical plan option differs in various ways, all three options:
- Use the same UnitedHealthcare network of doctors and hospitals
- Cover eligible in-network preventive care services at 100%
- Offer discounts for using in-network providers
- Cover the same services, such as doctor visits, lab work and hospital stays
- Protect you from large medical expenses with out-of-pocket maximum spending limits
- Include prescription drug coverage through OptumRx.
Take a look below at each of the plans or review this high‑level comparison of the three options available to you. You can also refer to the Reference section below to access additional resources about your medical plan options. For a more detailed plan comparison and to see if your provider(s) are in-network, visit UnitedHealthcare.
Your monthly contributions for 2024 are shown below, assuming you (and your spouse/domestic partner if covered by the plan) earn both Healthy Incentives credits. To see the monthly contributions if you do not earn both Healthy Incentives credits, please click on the 2024 Employee Contributions link on JOE > Employee Center > My Benefits > Benefits Enrollment Information (at Fidelity) > Employee Contributions.
Note: To see contribution rates for 2025, go to the Annual Enrollment page.
| MYCHOICE | ENHANCED/BASIC | ||
|---|---|---|---|
| In-Network Preventive Care | It’s covered at 100% with no copay. | It’s covered at 100% with no deductible.
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| Other Care | Download the Surest app or go to join.surest.com/Eaton (access code: Eaton2024) to find the applicable copay. If you need one of the 42 plannable procedures, activate coverage at least three days before the procedure and pay additional payroll deductions. | You pay the full cost until you meet the deductible. You can use Eaton money in your HSA/HRA or your own money. After you meet the deductible, Eaton will pay 80% and you pay 20%—as long as you stay in-network.
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| If You Reach Your Out-of-Pocket Maximum | Eaton pays 100% of your eligible in-network costs, including medical and prescription expenses, for the rest of the year. Note: Additional paycheck contributions for activations do not count toward your out-of-pocket maximum. | Eaton pays 100% of your eligible in-network costs, including medical and prescription expenses, for the rest of the year.
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| Tax-Advantaged Accounts | You can contribute to an HCRA. Any money left in your account at year-end is forfeited. | Eaton will contribute $500 or $1,000 to your HSA, based on your coverage level. You can also contribute up to IRS limits. The money in your HSA is yours to keep forever.
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Have a question? Call a Health Advisor at 1-844-391-1889 about the Enhanced or Basic Plan. Call Surest at 1-866-683-6440 for questions about the MyChoice plan.
Adding a Dependent to Coverage
If you are adding dependents to your Eaton benefits, be on the lookout for a letter and/or email from Verify OS Health Management Systems (Gainwell). This letter/email will request you provide necessary documentation to verify your dependents are eligible for coverage under Eaton's plans; please respond as requested.
For individuals who have a court ordered Qualified Medical Child Support Order (QMCSO), questions regarding the QMCSO process should be directed to QDRO Consultants at 1-800-527-8481. Forms can also be securely uploaded to www.qdros.com.
UHC Basic and Enhanced Plan Details
With the Basic and Enhanced Medical Plans (administered by UnitedHealthcare), you can use any doctor, clinic, hospital or health care facility you want in the broad national network. In-network preventive care is covered 100%, meaning you don’t have to pay any out-of-pocket costs for age-appropriate preventive care when you use a participating provider.
If you use an out-of-network provider, the Basic and Enhanced Medical Plans provides coverage; however, seeing an out-of-network provider will likely cost you more. If you need to see a specialist, a referral is not required.
MyChoice Plan Details
With the MyChoice Medical Plan (administered by Surest, a UnitedHealthcare Company), you pay only for the coverage you need. This plan has no annual deductible and no coinsurance; however, you’ll pay a copay (which varies in cost based on quality and efficiency ratings) for services. To learn more about the Surest copays, watch this video.
Like the Enhanced and Basic plans, MyChoice uses the UnitedHealthcare (UHC) Choice Plus network for health care services and the Optum Behavioral Health network for mental health and substance use care. If you use an out-of-network provider, the MyChoice plan provides coverage; however, seeing an out-of-network provider will likely cost you more. If you need to see a specialist, a referral is not required. OptumRx is the prescription drug administrator.
Note: There are 42 services that require you to activate coverage for three days prior to receiving care. These are plannable procedures that are typically only needed by <3% of members. Activating one of these coverages will initiate additional pre-tax paycheck deductions over a set number of pay periods.
Visit the Surest pre-member website to test drive and learn more about the MyChoice plan—go to join.surest.com/eaton and enter access code: Eaton2024 or click here to watch a video explaining how the MyChoice plan works.
Medical Plan Selection Tool
When you choose a medical plan, it’s important to consider your current and future medical needs and which plan offers you the best value. Need help figuring out which plan would work best to meet you and your family’s needs? Use the Medical Plan Selection Tool to compare all three medical options available to you.
Visit eatonhcm.ssnc.cloud/2024 to access the Tool.
You can also review the People Like Me brochure to see real-life examples of how the different medical plans might work for you.
HealthCare HelpLine
The HealthCare HelpLine through Fidelity can help you resolve outstanding benefits questions, such as claims payment resolutions. To speak with a representative, dial 1-866-328-6601 and ask for the HelpLine.
Reference
Have a Question or Need Help With Issue Resolution?
| STEPS: | WHO TO CONTACT: | QUESTION OR ISSUE: |
|---|---|---|
| Step 1 | Health Advisors 1-844-391-1889 or chat/email Surest Member Services for the MyChoice Health Plan 1-866-683-6440 Eaton Service Center at Fidelity 1-866-EATON01 (1-866-328-6601) | First call a Health Advisor for any questions or issues regarding your health benefits, claims, or Healthy Incentives. You can also call the Eaton Service Center for questions or issues regarding the following: enrollment, reimbursement accounts (including HSAs), retirement planning, savings and benefits. |
| Step 2 | HealthCare HelpLine 1-866-EATON01 (1-866-328-6601) Call the Eaton Service Center and ask to be transferred to the HealthCare HelpLine | If a Health Advisor was unable to assist with an issue to your satisfaction, then reach out to the HealthCare HelpLine. |
| Step 3 | Eaton HR Services 1-412-893-3600 or HRServices@Eaton.com | If you have not been able to solve your issue, Eaton HR Services can help you escalate your issue to the Eaton Benefits team. |