2024 Medical

Your health is our top priority.

That’s why Lennox offers two medical plan options to choose from: the Green Plan and the Blue Plan. Both plans are administered by UMR and use the UnitedHealthcare (UHC) Choice Plus network.

Eligibility

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Benefit Features

While each medical plan differs in the annual deductible, out-of-pocket maximum and per paycheck costs, both the Green Plan and Blue Plan offer the same services, copays, and coinsurance, including:
  • 100% covered in-network preventive care
  • Affordable premiums so you and your family can feel your best
  • Freedom to see any provider – you will always pay less when you use a UHC Choice Plus provider!
  • 80% cost coverage for most in-network medical services (after the deductible is met).
  • Easy in-store pick-up and home delivery options with OptumRx prescription drug coverage.
  • Specialty medications conveniently managed by VIVIO.
  • Quantum Health’s assistance in helping you discover everything you need to know about your options.
  • A range of free or low-cost programs designed to help you and your family achieve optimal health.

Which Medical Plan is Right for You?


It is important to note that both medical plans provide the same comprehensive coverage, copays, and coinsurance, but they differ in the amount you pay per paycheck, the annual deductible, and out-of-pocket maximum.
  • The Green Plan offers a lower cost per paycheck, but a higher deductible and out-of-pocket maximum.
  • The Blue Plan offers a lower deductible and out-of-pocket maximum, but a higher cost per paycheck.
Here are a few tips to help you choose a medical plan that meets your needs and your budget:
You can avoid unexpected medical bills by knowing how your plan works. Certain choices you make can affect what you’ll pay out of pocket.

Both the Green Plan and Blue Plan give you the freedom to receive care from any provider, but typically, you will always pay less when using an in-network medical provider compared to an out-of-network provider.

The Lennox medical plans work in three steps:
  1. Meet Your
    Annual DeductibleThe amount you must pay before the plan begins to pay.

    You are responsible for meeting your medical plan’s annual deductible – for most in-network and out-of-network medical care as well as prescription drug coverage – before the plan will pay for non-preventive care. Remember, in-network preventive care is always covered at 100% and is not subject to the deductible.

    Annual Deductible Green Plan Blue Plan
    In-Network Out-of-Network In-Network Out-of-Network
    Individual $1,500 $3,000 $850 $1,700
    Family $4,500 $9,000 $2,550 $5,100

  2. Share the Cost
    Once you meet the annual deductible, you and the plan share the cost of medical care, called
    coinsuranceCoinsurance is an insured individual’s share of the costs of a covered expense.
    . Both the Green Plan and Blue Plan cover 80% of the total cost for most in-network medical services. You will be responsible for the remaining 20% amount.

    Coinsurance Green Plan Blue Plan
    In-Network Out-of-Network In-Network Out-of-Network
    Medical Plan Pays 80% 60% 80% 60%
    You Pay 20% 40% 20% 40%

  3. Reach Your
    Annual Out-of-Pocket Maximum The maximum amount you will have to pay out of pocket for the plan year. If you reach this limit, the plan will pay 100% of your eligible expenses for the rest of the year.
    If you meet the annual out-of-pocket maximum before the plan year ends, your medical plan will pay 100% of your medical care and prescription drug costs for the rest of the plan year.

    Annual Out-of-Pocket Maximum Green Plan Blue Plan
    In-Network Out-of-Network In-Network Out-of-Network
    Individual $8,375 $16,750 $7,825 $15,650
    Family $16,750 $33,500 $15,650 $31,300

Need Help Choosing A Medical Plan?
Your Quantum Health Care Coordinator can help answer questions about Lennox’s medical benefits, help you choose the right plans, find in-network providers, access your health ID cards, and look for ways to save you money.

Call (877) 220-2279 for direct assistance or visit LIIQuantum.com.
Plan Features Green Plan Blue Plan
In-Network Out-of-Network In-Network Out-of-Network
Annual Deductible
(The amount you must pay before the plan will pay for non-preventive care.)
Individual $1,500 $3,000 $850 $1,700
Family $4,500 $9,000 $2,550 $5,100
Annual Out-of-Pocket Maximum 1
(The maximum amount you will have to pay out-of-pocket for the plan year.)
Individual $8,375 $16,750 $7,825 $15,650
Family $16,750 $33,500 $15,650 $31,300
What You Pay After the Annual Deductible Is Met
Preventative Care $0
(no deductible)		 Not covered $0
(no deductible)		 Not covered
Physician Office Visit 20% 40% 20% 40%
Outpatient Lab and X-ray Services 2 $0
(no deductible)		 40% $0
(no deductible)		 40%
Hospital Services 20% 40% 20% 40%
Urgent Care 20% 40% 20% 40%
Emergency Room 3 $250 + 20%
($250 waived if admitted
within 24 hours)		 $250 + 20%
($250 waived if admitted
within 24 hours)
Ambulance Services 20% 20%
Outpatient Therapy 4 20% 40% 20% 40%
Chiropractic Services 20% 40% 20% 40%
Behavioral Health / Substance Abuse 20% 40% 20% 40%

1 Your deductible, coinsurance, ER copays, and prescription drug expenses count toward your out-of-pocket maximum.
2 Most routine lab and X-ray services must be performed in an office or urgent care setting or at an independent lab facility. Excludes MRI, CT, and PET scans.
3 $250 waived if admitted to the hospital within 24 hours.
4 Includes outpatient physical, occupational, speech, and ABA therapy — subject to medical necessity review after 60 visits.

Keeping health insurance affordable is important to us. There are a few steps we ask you to take each year to maintain low monthly rates. These include:
  • Complete a Health Screening: If you enroll in the Lennox medical plan before August 1, you and your covered spouse must complete a Health Screening by September 30 and submit your results on LIIveWell. This will set your baseline and help you avoid the $75 per month Wellness surcharge the following plan year.
  • Confirm Tobacco Use: You will pay a $150 per person per month surcharge if you or your covered spouse use tobacco and enroll in a Lennox medical plan. If you are not a tobacco user, be sure to answer “No” on the Tobacco Use question.
  • Certify Working Spouse Status: You will pay an additional $100 per month surcharge if you cover a spouse who is eligible for coverage under another employer’s medical plan. If this situation does not apply to you, be sure to answer the Working Spouse Status question accordingly.
It is mandatory to fulfill these actions each year to avoid the monthly surcharges.

Lennox offers medical plan members and their covered dependents a range of programs designed to help you achieve optimal health.

Doctor on Demand by Included Health
Get 24/7 access to board-certified medical provider from your phone, tablet, or laptop. For only $30 per visit, you can speak to a licensed physician or licensed behavioral health therapist to receive urgent care for most non-emergency medical and/or mental health issues. These services can be accessed anytime, anywhere and include in-network referrals, prescriptions, care coordination, integrated behavioral health, and more.

Quantum Health’s One-on-One Support & $0 Copay Prescription Program
Lennox medical plan members and their covered eligible dependents are eligible to receive personalized nurse assistance through Quantum Health’s One-on-One Support Program, which provides free individualized support for specific chronic conditions including diabetes, coronary artery disease (CAD), congestive heart failure (CHF), asthma, or CPOD. You may even qualify for FREE chronic condition-specific medications through Quantum Health’s $0 Copay Prescription Program.

Flu Shots & Immunizations
Keeping your family healthy is your top priority, so staying current on annual flu shots and immunizations and is important. Employees and their dependents enrolled in the Lennox medical plan are covered 100% and can receive these services in a physician’s office or an in-network pharmacy. You can also call your Quantum Health Care Coordinator with any questions or concerns you may have about immunizations.

Tobacco Cessation Program
When you’re ready to quit tobacco, a Quantum Health Care Coordinator can equip you with support tools, free nicotine replacement aids, counseling sessions, and more. Complete 5 sessions by December 1 to stop paying the monthly Tobacco Use surcharge and get refunded all paid surcharges for the current year. That’s up to $3,600 in savings!

Expert Medical Opinions by Included Health
When you have a diagnosis or a recommended treatment plan, you want to know that it’s accurate and the best plan for you. With Expert Medical Opinions by Included Health, you can get a second medical opinion for free to help you make more informed decisions about your health.

SurgeryPlus
SurgeryPlus allows you to access top nationwide surgeons and the highest-quality surgical care services. Lennox will waive all employee costs for planned surgical procedures through SurgeryPlus (including deductibles and coinsurance). This means eligible non-emergent surgery will be free of charge to Lennox medical plan members!

Diabetes Management
Lennox offers no-cost diabetes support to help you take control of your health. Omada Health’s diabetes management program provides 24/7 access to customized health coaching, nutrition guidance, weight loss, and more. Through Virta Health, you can receive a free personalized treatment plan to help manage and reverse type 2 diabetes – without the risks or side effects of medications or surgery!

Hypertension Management
Omada Health offers enhanced hypertension support to help you manage your chronic high blood pressure condition. This no-cost personalized lifestyle-change program inspires healthy habits you can live with for the long term with customized health coaching.

Hinge Health Digital Physical Therapy
Hinge Health offers you access to a virtual joint pain exercise program targeting the back, knee, hip, shoulder, and other joints. Participants receive a personal coach, a physical therapist, and a wearable sensor for live feedback in the app. This benefit is available for free to Lennox medical plan members and their covered dependents.

Oshi Health Digestive Care
Oshi Health connects you with top gastroenterologists who can offer health coaching, nutrition/dietary support, and personalized care plans to help you manage common digestive conditions (e.g., IBS, GERD, SIBO). This benefit is available for free to Lennox medical plan members and their covered dependents in select states.

If you retire before age 65 and become entitled to Medicare after you’ve signed up for COBRA, your COBRA benefits cease. COBRA will cover your spouse and/or dependent children, if they are already enrolled in coverage, for up to 36 months.

If you retire after age 65 and are enrolled in Medicare (Parts A & B), you can continue COBRA coverage, as well as having Medicare. Medicare coverage will be primary. However, there are often more cost-effective insurance products for you to use with your Medicare that cost less than your COBRA, so please review your options carefully.

If you continue working for Lennox after age 65, Lennox’s medical coverage will remain primary.

If you need a Medicare form completed, please reach out to April Williams at April.Williams@lennox.com.

Keep in Mind

Need help figuring out your healthcare benefits?
Quantum Health is just a tap, click or call away!

Additional Information

2024 Plan Documents
2024 Costs
Quantum Health – Maximize Your Health Benefits
Quantum Health – Personal Nurse Care
Quantum Health – Save Money on Lab Expenses
Lennox – Chronic Condition Management Resources

Transparency In Coverage Rule
In compliance with the Transparency in Coverage Rule, through UnitedHealthcare, UMR creates and publishes the Machine-Readable Files on behalf of Lennox International Inc. The Transparency in Coverage Rule requires that group health plans post publicly available machine-readable files that include in-network negotiated payment rates and historical out-of-network charges for covered items and services. While these files are accessible to all, the file itself is large and written in JSON, which is a machine-readable language, and not easily interpreted or searchable. To link to the Machine-Readable Files, please click transparency-in-coverage.uhc.com.

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Better understand your medical benefits and save on health care expenses with a Quantum Care Coordinator.