Work Desk

Resources

Find helpful resources, forms and plan information below. 

Medicare

Getting The Most From Medicare

Priority Health Medicare Advantage Plan Guide

Priority Health Medicare Advantage Summary of Benefits

Priority Health Medicare Drug Formulary

Blue Cross Medicare Plan Guide

Blue Cross Medicare Drug Formulary

HAP West Michigan Medicare Advantage Plan Guide

HAP Medicare Drug Formulary

Individual & Family Insurance

MyPriority Plan Guide

MyPriority Dental Coverage

MyPriority Vision Coverage

MyPriority Drug Formulary

MyBlue Plan Guide

MyBlue Dental & Vision Plan Guide

MyBlue Drug Formulary

ACA Essential Health Benefits Information

HR Tools & Resources

ThinkHR "Learn Course" Catalog

ThinkHR Risk Management Brochure

About Employee Navigator

Glossary of Terms

Use these definitions of common terms to help you navigate your benefits options.

Coinsurance

The amount of percentage that you pay for certain covered health care services under your health plan. This is typically the amount paid after a deductible is met, and can vary based on the plan design.

Co-payment

A flat fee that you pay toward the cost of covered medical services.

Deductible

A specific dollar amount you pay out-of-pocket before benefits are available through a health plan. Under some plans, the deductible is waived for certain services.

Dependent

Individuals who meet eligibility requirements under a health plan and are enrolled in the plan as a qualified dependent.

In-Network

Health care received from your primary care physician or from a specialist within an outlined list of health care practitioners.

Member

You and those covered become members when you enroll in a health plan. This includes eligible employees, their dependents, COBRA beneficiaries and surviving spouses.

Out-Of-Network

Health care you receive without a physician referral, or services received by a non-network service provider. Out-of-Network health care and plan payments are subject to deductibles and co-payments.

Out-of-Pocket Expense

Amount that you must pay toward the cost of health care services. This includes deductibles, copayments and coinsurance.

Out-Of-Pocket Maximum (OOPM)

The highest out-of-pocket amount paid for covered services during a benefit period.

Premium

The amount you pay for a health plan in exchange for coverage. Health plans with higher deductibles typically have lower premiums.

Primary Care Physician (PCP)

A doctor who is selected to coordinate treatment under your health plan. This generally includes family practice physicians, general practitioners, internists, pediatricians, etc.

Usual, Customary and Reasonable (UCR) Allowance

The fee paid for covered services that is: (1) a similar amount to the fee charged from a health care provider to the majority of patients for the same procedure; (2) the customary fee paid to providers with similar training and expertise in a similar geographic area, and (3) reasonable in light of any unusual clinical circumstances.