Medical

Medical/Rx Plan Documents & Health Insurance Premiums

• 2025-2026 Health Insurance Premiums (Rates Include Medical, Rx, Dental, and Vision)  
• 2025-2026 Major Provisions and Plan Comparison Chart (Medical, Rx, Dental, & Vision)
• 7.1.2025 Comprehensive (PPO) Plan - Benefits Summary
• 7.1.2025 Comprehensive (PPO) Plan - Summary of Benefits and Coverage (SBC)
• 7.1.2025 Comprehensive (PPO) Plan - Summary Plan Description (SPD)
• 7.1.2025 Base Plan (HDHP with HSA) – Benefits Summary
• 7.1.2025 Base Plan (HDHP with HSA) – Summary of Benefits and Coverage (SBC)
• 7.1.2025 Base Plan (HDHP with HSA) – Summary Plan Description (SPD)
• 7.1.2025 Base Plan (HDHP with HSA) – Pharmacy Plan Benefits Summary

UHC OptumRx Pharmacy Drug Lists (PDL)

• (most current) OptumRx Pharmacy Drug List
• Base Plan (HDHP with HSA) PDL – UHC Expanded Drug List

Spousal Surcharge Fee Information 

• Spousal Surcharge Policy Highlights
• Spousal Surcharge Policy FAQ

UnitedHealthcare Programs and Resources

• Archdiocese Programs and Resources Through UHC
• UHC Resources Available to Archdiocese of St. Louis
• UHC “Digital Tools to Help Keep You Connected” Flier
• Virtual Visits – 24/7 Access Flyer
• Virtual Visits – Specialist Providers Flyer

ID Cards

• How To Print Benefit Plan ID Cards
• Digital ID Cards FAQ

Forms

• Disabled Dependent Child Certification Form
• OptumRx Home Delivery Mail Order Form

Annual Notices

• Medicare Part D Notice
• UHC HIPAA Notice of Privacy Practices
• UHC Annual Rights & Resource Disclosure Notice
• Marketplace Coverage Notice