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Medical Plan

The Medical Plan provides comprehensive coverage for enrolled employees and their eligible family members that supports health and holistic well-being. It offers unique features including preventive care; hospital, medical/surgical, and mental health benefits; and prescription drug coverage. The following information is intended to help plan members understand and use their medical benefits.

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Connect with Quantum Health

For members enrolled in any medical option, care navigation through Quantum Health provides a personal support team to guide you on your healthcare journey.

Read more about care navigation

Medical options

Beginning Jan. 1, 2027, there are some important changes which continue to support your health and holistic well-being:

  • The existing PPO, EPO, and HDHP options will be renamed PPO Premier, EPO Premier, and HDHP Premier. While the names are different, the benefits provided remain the same.
  • New PPO Select, EPO Select, and HDHP Select options will be introduced.

Depending on the benefits offered by your employer, you may elect one of the six medical options. Your employer will communicate if there are any new medical options being made available to you.

Medical Plan special features

In addition to providing benefits when you’re sick or injured, the Medical Plan through the Board of Pensions includes many features and resources to help you maintain and improve your health and well-being:   

Preventive care

Care navigation

Prescription drug benefits

Call to Health

Telemedicine

Mental Well-Being and Employee Assistance Plan (EAP)

Centers of Excellence

A virtual physical therapy program

A diabetes management program

International medical care

Vision exam benefit

Nicotine-free living     

Using medical coverage

You can get the most from your medical coverage by choosing network providers, using the emergency room only when appropriate, and getting advance approval, when required, for nonurgent hospital admissions and certain tests.

Locating network providers

Emergency care and urgent care

Precertifying care      

Working with a Personal Care Guide nurse     

How to enroll in the Medical Plan

You and your eligible family members may enroll in the Medical Plan when you first become eligible or during Annual Enrollment in the fall.

Enrolling for medical benefits

Medical costs

Waiving medical coverage

Continuing coverage after eligibility is lost

If your coverage under the Medical Plan is ending, you and/or your eligible family members may be able to extend your coverage for a limited time.

Medical continuation

Ministers Bridge Coverage