HSA Medical Plan Information

Foth offers a Health Savings Account (HSA) medical plan and pays a majority portion of the total premium.   An HSA Medical Plan is an alternative to traditional health insurance; it includes a health savings bank account (HSA Bank Account) that enables participants to pay for current health expenses and/or save for future qualified medical and retiree health expenses on a tax-free basis.  See the HSA Bank Account page for additional information, including the Outcome-Based Wellness incentive which can be used for eligible health expenses (like out-of-pocket deductible, co-insurance and prescription expenses).

2020 UMR Medical Summary Plan Description (SPD) – Updated 7-20

Summary of Benefits and Coverage – 2020

Medical Plan Access (UMR)

Access claims, EOBs, update other insurance or accident details, or estimate health cost expenses (Health Cost Estimator):

Contact the UMR Plan Advisors for medical questions, claim issues, pre-certifications, referrals, disease management: 877-852-2545

Want to talk to a nurse for health and wellness questions?  Call the 24/7 UMR Nurse Line at 877-950-5083, PIN 197 or live chat with a nurse at  (Or see the Foth On-site Nurse – Additional Information)

Request/Print additional Medical/Prescription ID Card

To set up your Teladoc® account and start using the benefit today, visit, call 1-800-teladoc (1-800-835-2362) or download the app.

General Medicine

All medical plan participants have the option to access a national network of U.S. board-certified physicians through Teladoc®.  Doctors and pediatricians can treat flu, allergies, sinus infections, rash, strep throat, and more.  This service is available 24/7.  If needed, a physician can send a prescription to a nearby pharmacy.  There is no premium for this benefit, just a per-visit charge. If you are ever displaced by a natural disaster, Teladoc provides free telehealth appointments, visit

General Medicine: $45


Dermatologists can treat issues such as psoriasis, eczema, acne, and more. Appointments must be scheduled and typically at least two visits are needed.

Dermatology: $75

Mental Health

Taking care of your mental health is an important part of your overall well-being. With Teladoc’s mental health benefit, adults 18 and older can get care for anxiety, depression, grief, family issues, and more. Choose to see a psychiatrist, psychologist, social worker, or therapist and establish an ongoing relationship. Please note that Teladoc doesn’t offer a crisis hotline and appointments must be scheduled in advance.  (When you or your family member want a more immediate consultation, consider using our employee assistance program, LifeWorks, for 24/7 care support.)

Scheduling a phone or video visit with a Teladoc therapist is easy and convenient. You can make an appointment using either the Teladoc app or the Teladoc website (use medical ID number to register new accounts). Appointments are confirmed within 72 hours. The costs for appointments are listed below.  The appointment cost applies to your medical plan and you can pay for your appointment using your health savings account if you prefer.

Initial evaluation: $200
Psychiatrist: $95 per session
Psychologist, licensed clinical social worker, counselor, or therapist: $85 per session

Medical Premiums (Per Paycheck)

    Full-time Members  Part-Time Members
  Single  $49.52  $54.47
  Family  $141.42  $156.40
  Family w/ Working Spouse*  $191.42  $206.40

*Working Spouse is defined as a spouse/domestic partner who is offered insurance through his/her employer, but chooses to be primary on Foth’s plan. Refer to the Medical Coverage Eligibility Form for additional information.

Premium Rates assume Health Assessment participation. Failure to complete the Health Assessment will result in an additional per paycheck premium of $10 for single plans and $20 for family plans. New hires are waived until the next upcoming testing period and will receive the Health Assessment premium rate and wellness incentive for the first calendar year.

Find In-Network Medical Providers

UnitedHealthcare Choice Plus Network
Search for in-network medical and behavioral health providers

UnitedHealthCare Options PPO Network (Participants residing in Dane and Rock, WI counties)
Search for in-network medical and behavioral health providers

Premium Designations: There are several possible Premium designations for a doctor.  Consider a physician who meets the UnitedHealth Premium program for quality and cost-efficient care criteria, noted as: .  Also, by clicking on the physician’s name, you can view estimated costs for services under the “Services & Costs” tab.

Understand the costs:  Different providers may charge different amounts for the services they offer. Your search results will give you a range of the average costs for preventive care or medical procedures in your area. And the individual provider listings show whose costs are below, above, or meet the local average.  If a procedure typically includes multiple steps of treatment, you can review the total cost and your estimated out-of-pocket cost for each step. So you’ll know what to expect, from start to finish.  Your estimated out-of-pocket costs are personalized to you, based on your own benefit plan’s deductible, annual out-of-pocket max, co-pay, co-insurance and how much you’ve paid toward your deductible.

Notice on payment of out-of-network providers

Other Medical Insurance/Accident Details

Other Medical Insurance – Whether or not you have other insurance, all Foth medical plan participants must update your “Other Medical Insurance” information with UMR every 12 months to help avoid denial notices on your Explanation of Benefits (EOB).  You can do this by simply calling UMR at 866-586-0613 (toll-free) and following the prompts, or visit

Accident Details – If you receive an EOB that states the claim was denied and requires updated accident details, call UMR at 888-291-3774 or visit


Medical Reimbursement Claim Form – For submitting claims not processed through insurance (e.g., flu shot)

Post-Service Appeal Request Form

Affidavit of Domestic Partnership – To qualify a domestic partner for coverage under Foth’s health insurance

Additional Medical Information

Preventive Care List Overview
UMR Granting Access for Family Members Accounts

Brown Bag – UMR Plan Advisor Overview

Medicare Information:  Medicare Options Booklet & Medicare Made Clear
Medicare Overview Video from Francis Investment Counsel (4 minutes)

UMR Flyers

 Real Appeal®

All Foth medical plan participants (member, spouse, and dependents over age 18) have the opportunity to enroll in an online weight loss program called Real Appeal® at no additional premium cost or deductible. Real Appeal can help you lose excess weight, no matter how much you want to lose, and reduce your risk of developing chronic conditions like diabetes and cardiovascular disease.  It’s a step-by-step online program designed to help you get on the fast track to lasting weight loss without turning your life upside down.  This­ program focuses on making small changes to help you live a healthier life. On­ average, most participants lose 10 pounds after attending just 4 online classes.

Depending on your needs, a personal weight-loss coach will customize a plan specific to your health goals, fitness level and lifestyle. Plus, this support will be provided for an entire year.  When you enroll in Real Appeal you receive:

  • Up to a year of support from a Transformation Coach
  • 24/7 access to convenient digital tools and dashboards that help you track your food, activity, and weight
  • A Success Kit full of weight management tools including fitness guides, a recipe book, weight scale, food scale, and more
  • Support from weekly online group classes

UMR Maternity Management

If you are thinking about having a baby or are already expecting, we invite you to sign up for UMR’s maternity management service.  Enrolling in this program can help you learn how healthy lifestyle choices and proper medical care before and during your pregnancy can boost your odds of having a healthy, full-term baby.  As part of this free program, you can earn a $25 reward card for signing up in the first or second trimester.  Maternity Management Self-Enrollment: Maternity Management or call UMR at 877-852-2545. Maternity Management Flyer

UMR Treatment Decision Support

Your medical benefits include access to specially trained registered nurses who can help you review your options when the choice isn’t clear. Their job is to give you the information you need to feel comfortable working with your doctor to pick a plan that fits your personal treatment needs.  Treatment Decision Support


Benefits/Human Resources
Enrollment, plan changes, general benefits