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

UPMC Health Plan

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

2025



IMPORTANT:
  • Rates
  • Changes for 2025
  • 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 2 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 20 for requirements.

Postal Employees and Annuitants are no longer eligible for this plan. (unless currently under Temporary Continuation of Coverage)

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

                                    

                                        

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