Cover Page

Page numbers referenced within this brochure apply only to the printed brochure

UPMC Health Plan

www.upmchealthplan.com/FEHB
Customer Service 877-648-9641

2023



IMPORTANT:
  • Rates
  • Changes for 2023
  • Summary of Benefits
A Health Maintenance Organization (Standard Option) and a High Deductible Health Plan

This plan's health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. See page 8 for details. This plan is accredited. See page 14.

Service Area: Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Cameron, Centre, Clarion, Clearfield, Crawford, Elk, Erie, Fayette, Forest, Greene, Huntingdon, Indiana, Jefferson, Lawrence, McKean, Mercer, Potter, Somerset, Venango, Warren, Washington, and Westmoreland.

Enrollment in this plan is limited. You must live or work in our geographic service area to enroll. See page 18 for requirements.

Enrollment codes for this Plan: 
UW4 Standard Option – Self Only  
UW6 Standard Option – Self Plus One
UW5 Standard Option – Self and Family 
8W4 High Deductible Health Plan (HDHP) – Self Only 
8W6 High Deductible Health Plan (HDHP) – Self Plus One
8W5 High Deductible Health Plan (HDHP) – Self and Family

                                    

                                        

Federal Employees Health Benefits Program seal
OPM Logo