US Benefits Enrollment Guide
Last updated: July 28, 2026
Applies to: US W-2 employees
Summary: For the July 1, 2026 – June 30, 2027 plan year, eligible US W-2 employees can enroll in UnitedHealthcare FlexWork medical, dental, and vision plans, plus supplemental accident, critical illness, hospital indemnity, and life insurance. This article summarizes what each plan covers and what it costs. Download the attached PDF Benefits Enrollment Guide for the full details.
The 2026/2027 Benefits Guide provides an overview of the healthcare benefits available for the plan year running from July 1, 2026 through June 30, 2027. Coverage is provided through UnitedHealthcare FlexWork. You can download the attached PDF for complete plan documents, and this article highlights the plans and costs most people ask about.
Note: Some supplemental plans (Critical Illness, Accident, Hospital Indemnity) are not minimum essential coverage and do not satisfy the ACA coverage mandate. Benefit summaries here are illustrative; always review your Summary of Benefits Coverage (SBC) and Certificate of Coverage for exact terms. FlexWork medical is not available in Hawaii or Puerto Rico, and some products are not available in every state.
Who is eligible
Benefits are available to employees and their eligible dependents. You must be enrolled yourself to elect dependent coverage.
Eligibility for the medical plans is based on your work status and hours. You are generally eligible if you are classified as a full-time employee and are regularly scheduled to work 30 or more hours per week.
Eligibility is reviewed on an ongoing (dynamic) basis and can change if your hours or employment status change.
Supplemental Life requires working at least 30 hours per week to enroll; late entrants may need to provide Evidence of Insurability.
How to enroll and get help
Make your elections through the Ascen portal
UnitedHealthcare FlexWork support: 1-855-892-2401, Monday–Friday, 7:30 a.m.–8 p.m. CT.
Find network providers and plan details at flexwork.uhc.com.
Medical plans
Three FlexWork medical options are offered. All use the UnitedHealthcare Choice network for medical and Optum Rx for pharmacy, cover ACA preventive care at 100% ($0) in network, and have no pre-existing condition exclusions and no annual or lifetime dollar limits. Benefits are effective on your first day of coverage. Pretax payroll deductions lower your taxable income.
Limited Medical (MEC) plans — Basic and Standard
Both MEC plans have a $0 deductible / 0% coinsurance and an out-of-pocket maximum of $9,200 individual / $18,400 family. They cover frequently used services at fixed copays but do not cover emergency room visits, hospital admissions, or outpatient surgery.
Benefit | Basic MEC | Standard MEC |
|---|---|---|
Physician office visit | $25 primary / $50 specialist — 4 combined visits/yr | $25 primary / $50 specialist — 4 combined visits/yr |
Urgent care | $150 copay — 2 visits | $150 copay — 2 visits |
Virtual care | $0 — unlimited | $0 — unlimited |
Emotional Support Line | $0 — unlimited | $0 — unlimited |
Diagnostic lab | $50 office / $150 hospital | $50 office / $150 hospital |
Imaging (X-ray, MRI, CT) | Not covered | $50 office / $150 hospital |
Chiropractic / acupuncture | Not covered | $15 copay — 10 visits |
ER, hospital admission, outpatient surgery | Not covered | Not covered |
Pharmacy (both MEC plans): $15 tier 1 / $30 tier 2 / 50% coinsurance tiers 3–4, plus an Optum Perks discount card.
Monthly payroll deductions:
Coverage | Basic MEC | Standard MEC |
|---|---|---|
Employee only | $103.79 | $166.12 |
Employee + spouse | $244.07 | $394.92 |
Employee + child(ren) | $183.81 | $296.63 |
Employee + family | $333.97 | $541.54 |
Edge Advantage Minimum Value Plan (MVP)
The MVP is the most robust option and, unlike the MEC plans, covers emergency room visits, hospital admissions, and outpatient surgery. It has a $0 deductible / 0% coinsurance (except ER visits and pharmacy tiers 3–4) and the same $9,200 individual / $18,400 family out-of-pocket maximum.
Benefit | MVP |
|---|---|
Physician office visit | $25 primary / $50 specialist — 6 combined visits/yr |
Urgent care | $100 copay — 4 visits |
Virtual care / Emotional Support Line | $0 — unlimited |
Emergency room | 50% coinsurance — 2 visits |
Hospital admission | $1,000 copay/admission ($35,000 max benefit per admission) |
Outpatient surgery | $500 office / $1,000 hospital — 1 visit |
Imaging (X-ray, MRI, CT) | $50 office / $150 hospital |
Chiropractic / acupuncture | $15 copay — 15 visits |
Outpatient mental health / substance use | $150/day (15-day limit per year) |
Home health care | $80/visit — 30 visits/yr |
Rehab (PT, OT, ST, cardiac, pulmonary) | $80/visit — 30 visits/yr |
Pharmacy: $15 tier 1 / $30 tier 2 / 50% coinsurance tiers 3–4, retail only (no mail order).
Monthly payroll deductions: Employee only $667.76 · +spouse $1,587.58 · +child(ren) $1,192.44 · +family $2,177.04. Employee-only contributions are based on your hourly rate of pay to meet affordability guidelines, and dependent coverage is available at full cost — check Benefit Harbor for your exact amounts.
Dental plan
UnitedHealthcare FlexWork Dental Plan (35P40) on the UnitedHealthcare Options PPO 30 network. Annual deductible $50 per person / $150 per family (basic and major services only); annual maximum benefit $1,000 per covered person.
Service level | Plan pays |
|---|---|
Preventive (exams & cleanings 2×/yr, X-rays, fluoride, sealants) | 100% |
Basic (fillings, extractions, periodontics, root canals) | 60% |
Major (crowns, dentures, bridges, oral surgery) | 50% |
Monthly payroll deductions: Employee only $22.78 · +spouse $45.56 · +child(ren) $55.74 · +family $82.91.
Vision plan
UnitedHealthcare FlexWork Vision Plan (V1W01) with a large national network (uhcglasses.com, 1-800 Contacts, LensCrafters, MyEyeDr, Costco Optical, Target Optical, Walmart, Warby Parker, and more).
Eye exam: $10 copay, once every 12 months ($0 diabetic retinal screening).
Frames: $25 copay, $100 allowance (30% off overage), once every 24 months.
Lenses: $25 copay, once every 12 months; children's polycarbonate lenses covered in full.
Contacts: $25 copay, $105 elective allowance, once every 12 months.
The plan covers either eyeglasses or contact lenses once per year.
Monthly payroll deductions: Employee only $7.91 · +spouse $14.65 · +child(ren) $18.31 · +family $25.63.
Supplemental protection plans
These pay cash benefits directly to you and can be used however you want (out-of-pocket medical costs, rent/mortgage, groceries, and other living expenses). They have no pre-existing condition exclusions, deductibles, or coinsurance for benefit payments. If you also have a UnitedHealthcare medical plan, Benefit Assist may proactively contact you to help file qualifying claims for faster payment.
Critical Illness Protection (elected separately from your medical plan): lump-sum benefit on diagnosis of a covered condition. Coverage amounts of $10,000 employee / $5,000 spouse / $5,000 child(ren). Covered conditions include stroke, aneurysm/benign brain tumor, cancer, chronic renal/major organ failure, coma/permanent paralysis, heart attack and heart failure, ALS, advanced Alzheimer's, MS, and Parkinson's. Guarantee Issue, with reoccurrence and additional-occurrence benefits. Premiums are age-banded.
Accident Protection: cash benefits for 80+ covered injuries and services — e.g. accidental death $20,000, dismemberment $2,000–$20,000, fractures/dislocations up to $4,500, concussions $150, ER/urgent care $100, hospital admission $1,000–$2,000. Monthly deductions: Employee only $3.90 · +spouse $6.21 · +child(ren) $8.81 · +family $13.27.
Hospital Indemnity Protection (HIPP, Mid plan): fixed daily cash benefits — hospital admission $1,000 (2 days/yr), hospital confinement $150/day, ICU confinement $150/day (up to 364 days/yr). Monthly deductions: Employee only $7.75 · +spouse $15.85 · +child(ren) $16.40 · +family $26.39.
Supplemental Life Insurance: term life paid to your beneficiaries. Employee coverage in $10,000 increments up to $500,000 or 5× annual earnings; spouse in $5,000 increments (up to 50% of your amount); child(ren) in $2,000 increments. Includes portability, a 30-day conversion option, accelerated death benefit, and waiver of premium; premiums are age-banded per $1,000 of coverage. Evidence of Insurability is required for late entrants.
Free health and wellness resources
Once your plan is active, these are included at no additional cost:
24/7 Virtual Visits for non-emergency care (healthiestyou.com, 1-866-703-1259).
24/7 Employee Assistance Program (EAP) confidential support line.
Optum Perks pharmacy discount card — up to 80% off many FDA-approved medications not covered by your plan.
MedCents Consumer Advocacy — help negotiating and reducing medical bills beyond what your plan covers.
UnitedHealthcare Discount Marketplace and hearing aid discounts.
Preventive care
Under the Affordable Care Act, in-network preventive services are covered at 100% with $0 cost-sharing — including annual wellness and well-child exams, immunizations, and recommended screenings (blood pressure, cholesterol, diabetes, colorectal and other cancer screenings, and expanded women's preventive services such as mammography, cervical cancer screening, contraception, and breastfeeding support). Diagnostic (non-preventive) services may require a copay, coinsurance, or deductible. See the attached PDF for the full preventive services list.
For anything not covered here, download the attached Benefits Enrollment Guide PDF or call UnitedHealthcare FlexWork at 1-855-892-2401.