Medical and Prescription Benefits

Medical and Prescription Benefits Overview

Selecting the right medical plan takes careful consideration.

For most full-time Discount Tire employees (except those in Michigan), as well as employees of Suburban Tire and Ellisville, the Company offers medical plan options through United Healthcare (UHC); these plans include pharmacy benefits through OptumRx. Qualified Essential Coverage (QEC) eligible part-time employees may enroll in the Health Savings Plan.

For Discount Tire employees in Michigan, as well as employees of Tire Rack, Dunn Tire, and Dunn Tire and Auto, the Company offers medical plan options hrough Blue Cross Blue Shield of Illinois (BCBSIL); these plans include pharmacy benefits through BCBSIL’s Prime Therapeutics. Qualified Essential Coverage (QEC) eligible part-time employees may enroll in the Health Savings Plan only.

UHC Plan Options

UNITED HEALTHCARE COVERAGE IS OFFERED TO EMPLOYEES AT DISCOUNT TIRE (ALL STATES EXCEPT MICHIGAN), ELLISVILLE, AND SUBURBAN TIRE.

If you are enrolled in a United Healthcare (UHC) plan, you have 24/7 access to your UHC account information at myuhc.com. You can also use the site to find medical and pharmacy providers, place orders with the Mail Service Pharmacy, request new cards and print temporary cards. If you haven’t signed up already, create your account today.

Recently hired or promoted to full-time? Learn more about your coverage choices through the Company’s plans through UHC below and via our Pre-Member Website.

Plan Details

With either plan option, in-network preventive care is usually covered with no cost sharing, including well child, routine physicals, OB/GYN exams, mammograms and prostate exams. Costs will only be incurred if additional non-preventive lab work is requested. Also, many prescription medications are considered preventive and are also covered with no cost sharing. Call the member number on your Medical Plan ID card to find out which preventive medications and services are covered at no cost.

Coverage through the Choice Plus Plan (Options Plan in Wisconsin) is a more traditional health care option with a deductible, set co-pays and coinsurance amounts.
With the Choice Plus Plan, you have the option to elect the Flexible Spending Account (FSA).
Prescription costs are not counted towards the annual deductible; co-pays apply. See the Prescription Coverage tab for more information.

The Health Savings Plan is a medical plan with a Health Savings Account (HSA).
The Company contributes to your HSA once your medical benefits go into effect: $500 for individual / $1,000 for family. Plus, you can contribute to your HSA tax free.
Use your HSA money to pay your out of pocket health care expenses. All medical and prescription costs are applied to your deductible; after you meet the deductible, the plan covers 80% with 20% employee coinsurance.
With the Health Savings Plan, full-time employees have the option to elect the Flexible Spending Account (FSA), but may only use FSA funds to pay for dental and vision expenses. FSA funds cannot be used to pay for medical expenses when enrolled in the Health Savings Account.
Your HSA goes where you go! Even if you change jobs, switch health plans, or retire, your HSA is yours—you own it, and the money carries over from year to year.

Additional Resources

State of Illinois – Ten Essential Health Benefits

Plan Coverage Details

	UHC Choice Plus / Options Plan Full-Time Only		UHC Health Savings Plan Full-Time and QEC
Company Contribution to Your HSA
Individual / Family	Does not apply		$500 / $1,000¹
Annual Deductible	In-Network	Out-of-Network²	In-Network	Out-of-Network²
Individual / Family	$700 / $2,100	$2,000 / $5,000	$2,000 / $4,0003	$4,000 / $8,0003
Maximums
Out-of-Pocket: Individual / Family	$3,500 / $7,000	$7,000 / $16,000	$3,500 / $7,000	$7,000 / $14,000
Lifetime	Unlimited
Co-Pays
Preventive Care: Routine physicals, immunizations, and more!	100%	Not covered	100%	Not covered
Get rewarded for your Annual Physical! See the Physician Affidavit form.
Physician's Services: Sickness and Injury
Medical Virtual Visit	FREE	N/A	80%⁴	N/A
Physician Office Visit	$20 / visit	60%⁴	80%⁴	60%⁴
Specialist Office Visit	$40 / visit	60%⁴	80%⁴	60%⁴
Mental Health / Substance Abuse / Addiction
Telemental Health	$20 / visit	60%⁴	80%⁴	60%⁴
Inpatient	80%⁴	60%⁴	80%⁴	60%⁴
Outpatient	$20 / visit	60%⁴	80%⁴	60%⁴
Emergency Care
Urgent Care	$40 / visit	60%⁴	80%⁴	60%⁴
Emergency Room	$200		80%⁴
Tests
Lab, X-Ray and Major Diagnostics (CT, PET, MRI, MRA and Nuclear Medicine) – Outpatient	80%⁴	60%⁴	80%⁴	60%⁴
Hospital Care
Inpatient / Outpatient Care and Surgery	80%⁴	60%⁴	80%⁴	60%⁴
Maternity Care
Prenatal Visit	$40 first visit; $0 after	60%⁴	80%⁴	60%⁴
Postnatal Visits / Surgery	80%⁴	60%⁴	80%⁴	60%⁴
Specialty Care
Acupuncture (max 20 visits per year)	$40 / visit	60%⁴	80%⁴	60%⁴

¹ When you receive out-of-network care, the plan covers its percentage up to the Reasonable and Customary (R&C) limit after you satisfy the Annual Deductible. You pay the remaining percentage up to the R&C limit plus any amount above the R&C limit.
² The Health Savings Plan requires the FULL family deductible (e.g. $4,000 for in-network) be met if you have enrolled any dependents.
³ The Company funds your HSA on the day Medical Benefits go into effect.
⁴ After deductible

United Healthcare creates and publishes the Machine-Readable Files on behalf of Discount Tire. To link to the Machine-Readable Files, please click on the URL provided: transparency-in-coverage.uhc.com

UHC Prescription Coverage

Consider home delivery for your 90-day prescriptions; it’s easy to get started! Request a prescription from your doctor for a three-month supply, with refills for up to one year (if appropriate), then contact OptumRx to fill your prescription.

Cost savings: With free standard shipping, the average savings is 50% or more when compared to retail pharmacy pricing.24/7 access to pharmacists
By fax / ePrescribe: Ask your doctor to call 800-791-7658 for instructions on how to fax your 90-day prescription directly to OptumRx Mail Service Pharmacy. Or your doctor can send an electronic prescription to OptumRx Mail Service Pharmacy.
Online: Log in or register at myuhc.com and select Manage My Prescriptions.
By phone: Call the Advocate4Me phone number on the back of your plan ID card to talk with a customer service representative. It’s helpful to have your plan ID card and medication bottle available. The representative can also contact your doctor directly if you need a new prescription.
Maximum convenience and peace of mind

Learn more about OptumRx.

Prescription Plan Coverage Details

	UHC Choice Plus / Options Plan Full-Time Only		UHC Health Savings Plan Full-Time and QEC
Prescriptions	Retail (30-day supply)	Mail Order (90-day supply)	Retail (30-day supply)	Mail Order (90-day supply)
Tier 1	$10	$20	80%*	80%*
Tier 2	$30	$60
Tier 3	$60	$120
Tier 4	$90	$180

* After deductible

BCBSIL Plan Options

BLUE CROSS BLUE SHIELD COVERAGE IS OFFERED TO EMPLOYEES AT DISCOUNT TIRE LOCATED IN MICHIGAN, TIRE RACK, DUNN TIRE, AND DUNN TIRE AND AUTO.

If you are enrolled in a Blue Cross Blue Shield of Illinois (BCBSIL) plan, you have 24/7 access to your BCBS account information at bcbsil.com.

Plan Details

Coverage through the PPO Plan is a more traditional health care option with a deductible, set co-pays and coinsurance amounts.
With the PPO Plan, you have the option to elect the Flexible Spending Account (FSA).
Prescription costs are not counted towards the annual deductible; co-pays apply. See the Prescription Coverage tab for more information.

The Health Savings Plan is a medical plan with a Health Savings Account (HSA).
The Company contributes to your HSA at the beginning of the plan year: $500 for individual / $1,000 for family. Plus, you can contribute to your HSA tax free.
Use your HSA money to pay your out of pocket health care expenses. All medical and prescription costs are applied to your deductible; after you meet the deductible, the plan covers 80% with 20% employee coinsurance.
With the Health Savings Plan, full-time employees have the option to elect the Flexible Spending Account (FSA), but may only use FSA funds to pay for dental and vision expenses. FSA funds cannot be used to pay for medical expenses when enrolled in the HSA.
Your HSA goes where you go! Even if you change jobs, switch health plans, or retire, your HSA is yours—you own it, and the money carries over from year to year.

Plan Coverage Details

	BCBSIL PPO Plan Full-Time Only		BCBSIL Health Savings Plan Full-Time and QEC
Company Contribution to Your HSA
Individual / Family	Does not apply		$500 / $1,000¹
Annual Deductible	In-Network	Out-of-Network²	In-Network	Out-of-Network²
Individual / Family	$700 / $2,100	$2,000 / $5,000	$2,000 / $4,000³	$4,000 / $8,000³
Maximums
Out-of-Pocket: Individual / Family	$3,500 / $7,000	$7,000 / $16,000	$3,500 / $7,000	$7,000 / $14,000
Lifetime	Unlimited
Co-Pays
Preventive Care: Routine physicals, immunizations, and more!	100%	Not covered	100%	Not covered
Get rewarded for your Annual Physical! See the Physician Affidavit form.
Physician's Services: Sickness and Injury
Medical Virtual Visit	FREE	N/A	80%⁴	N/A
Physician Office Visit	$20 / visit	60%⁴	80%⁴	60%⁴
Specialist Office Visit	$40 / visit	60%⁴	80%⁴	60%⁴
Mental Health / Substance Abuse / Addiction
Telemental Health	$20 / visit	60%⁴	80%⁴	60%⁴
Inpatient	80%⁴	60%⁴	80%⁴	60%⁴
Outpatient	$20 / visit	60%⁴	80%⁴	60%⁴
Emergency Care
Urgent Care	$40 / visit	60%⁴	80%⁴	60%⁴
Emergency Room	$200		80%⁴
Tests
Lab, X-Ray and Major Diagnostics (CT, PET, MRI, MRA and Nuclear Medicine) – Outpatient	80%⁴	60%⁴	80%⁴	60%⁴
Hospital Care
Inpatient / Outpatient Care and Surgery	80%⁴	60%⁴	80%⁴	60%⁴
Maternity Care
Prenatal Visit	$40 first visit; $0 after	60%⁴	80%⁴	60%⁴
Postnatal Visits / Surgery	80%⁴	60%⁴	80%⁴	60%⁴
Specialty Care
Acupuncture (max 20 visits per year)	$40 / visit	60%⁴	80%⁴	60%⁴

Blue Cross Blue Shield creates and publishes the Machine-Readable Files on behalf of Discount Tire. To link to the Machine-Readable Files, please click on the URL provided: bcbsil.com/asomrf?EIN=381889682

BCBSIL Prescription Coverage

BCBSIL medical plans include prescription benefits through BCBSIL’s Prime Therapeutics.

Prescription Plan Coverage Details

	BCBSIL PPO Plan Full-Time Only		BCBS Health Savings Plan Full-Time and QEC
Prescriptions	Retail (30-day supply)	Mail Order (90-day supply)	Retail (30-day supply)	Mail Order (90-day supply)
Tier 1	$10	$20	80%*	80%*
Tier 2	$30	$60
Tier 3	$60	$120
Tier 4	$90	$180

* After deductible

Main Menu

Benefits

All Employees

Full-Time Employees

Part-Time Employees

Important Information

Main Menu

Enrollment & Eligibility

Enrollment

Eligibility

Main Menu

Other Resources

Company & Employment Information

Privacy Policy

Medical and Prescription Benefits