Medical Insurance
MEDICAL INSURANCE
The City maintains a self-insured health insurance plan administered by a third-party administrator. Our third-party administrator is UMR. UMR can assist you and address your questions regarding:
- Whether or not a provider is in network
- EOB's or explanation of benefits
- ID cards
- Precertification or Preauthorization required for health care coverage
Visit UMR online at http://www.umr.com/ or call UMR at 1-800-826-9781.
The Medical and Prescription Plan Book, and Summary of Benefits and Coverage provide you with information on what the plan covers.
2026 Benefit Guide
2026 Medical Summary of Benefits and Coverage (SBC) - COMING SOON!
2026 Medical Premiums, Deductibles, and Out of Pocket Maximum
|
COVERAGE |
NON- REPRESENTED EMPLOYEE PREMIUM |
REPRESENTED EMPLOYEE PREMIUM |
DEDUCTIBLE |
MEDICAL OUT OF POCKET MAXIMUM (IN NETWORK) |
GARNER REIMBURSEMENT^ |
DEDUCTIBLE |
MEDICAL OUT OF |
| SINGLE | $40.13 | $60.20 | $5,000 | $7,000 | $3,500 | $7,000 | $10,000 |
| EMPLOYEE+1* | $74.69 | $112.04 | $10,000 | $12,000 | $7,000 | $14,000 | $15,000 |
| FAMILY* | $122.51 | $183.76 | $10,000 | $14,000 | $7,000 | $14,000 | $20,000 |
*If you have Employee+1 or Family coverage, any combination of covered family members may help meet the Employee+1 or Family coverage deductible and/or out-of-pocket maximum; however, no one person will pay more than their individual deductible or out-of-pocket amount.
^Members are eligible for reimbursement for eligible medical expenses when they see a Garner approved provider that was added to their Garner care team prior to their visit. See below for more information on Garner.
Prescriptions
- $10 co-pay for Generics
- $20 co pay for Preferred Brands
- $40 co-pay for Non-Preferred Brands
- 30% fee ($0 w/Prudent Rx) - effective 2/1/2026
- Co-pays are per each 30-day prescription
Mail Order Prescriptions
Members can receive a 90 day supply of medication for the cost of 60-days at CVS, Target or through mail order.
Mail Order Flyer
See the 2026 Medical and Prescription Plan Book for more information. - COMING SOON!
Contact Information
UMR
1-800-826-9781
http://www.umr.com/
Through UnitedHealthcare, UMR creates and publishes the Machine-Readable Files on behalf of the City of De Pere. To link to the Machine-Readable Files, please click on the URL provided: https://transparency-in-coverage.uhc.com/
CVS/Caremark
1-866-818-6911
http://www.caremark.com
Garner
Garner is a health benefit program that guides members to high-quality and cost-efficient medical providers. Garner evaluates providers using independent quality and cost data, then offers employees reimbursement to choose a provider with the best outcomes. Using Garner is as easy as 1 – 2 – 3.
- Create your Garner account
- Find and visit a top provider that was added to your account. Members must search for and add providers to their account
before the date of service to qualify for reimbursement. - Get reimbursed for your qualifying medical cost.
Use the links below to learn more about Garner.
Your Garner Guide – Get started with Garner here!
Garner Overview Video
How to Search for a Provider Video
Garner FAQ
Questions about Garner? Whether you need help understanding your Garner benefit, finding Top Providers, or have questions about claims, Garner’s Concierge is there to assist. You can message the Concierge through in-app chat, or email at concierge@getgarner.com, Mon-Fri 8:00 a.m. to 10:00 p.m. ET.
Near Site Services
The City of De Pere has partnered with Bellin Health and Prevea Health to provide our health plan participants select services for FREE at area locations.
- Prevea - Plan Participants can utilize one location in Green Bay and one location in Appleton for near site care at no cost. Eligibility is automatically verified by Prevea with your medical ID card. The locations available at no cost are below:
-
- Prevea Cormier Health Center – 737 Comier Rd, Ashwaubenon
- Prevea Appleton Health Center – 10 E. College Ave, Appleton (inside Fox Commons).
-
- Bellin – Near site service is available at most area locations and eligibility is automatically verified by Bellin.
Primary Care Services - Includes Family Medicine, Internal Medicine and Pediatrics
- Preventative and Non-Preventative (i.e. diagnostic services) care
- Includes most labs and routine vaccinations (excludes travel medicine)
- X-ray and other imaging not included
Physical and Occupational Therapy (Examples Include; OT is not available at Prevea)
Urgent Care (Prevea Urgent Care is only available at the locations listed above; calling ahead is recommended)
- Acute minor strain or injury
- Treats a variety of illnesses and injuries including colds, flu, ear infection, etc.
FastCare (Available with Bellin Only)
- Treats a variety of illnesses and injuries including colds, flu, cuts, fractures, and sprains
Behavioral Therapy Services (Available with Prevea Only)
- Marriage, parenting, and relationship issues
- Addiction
- Grief and loss
- Depression, including postpartum depression
- ADHD
- Anxiety and panic disorder
- Stress management and work/employment problems
Dietician Services (Available with Prevea Only)
- Responsible for assessing nutritional status, developing a nutritional care plan, and providing patient education relating to nutrition and diet
For more specific information on near site services, including covered services, finding a provider, and to schedule an appointment, please visit:
Prevea: www.prevea.com/city-of-depere
Bellin: bellin.org/CityofDePere
Please note: You do not have to schedule an appointment through the websites above to receive the near site services benefit, the scheduling options are available via those websites for your convenience.
Services that are processed under this benefit will be billed directly to the City of De Pere. Plan members will not receive an EOB from the insurance company, but may see visits billed at $0 when they log into their UMR account. Members will not receive a bill from either Bellin or Prevea for covered services.
Where you go for medical services can make a big difference in how much you pay and how long you wait to see a health care provider. The Choose the Right Health Care Setting flyer can help you select the right setting for your needs.
Teladoc
Teledoc is an add-on service integrated with UMR, the City’s third party administrator. Teladoc is available for medical, dermatology, and behavioral health all at $0 for any member of the City’s health insurance plan.
Medical: This low-cost alternative to in-person doctor’s visits provides anytime access to on-call doctors. It connects members to a network of physicians who can diagnose, treat and prescribe medications when needed. It offers one on one consultation where patients have the option to communicate via phone, online video or mobile app.
Dermatology: Don't wait weeks for a dermatology appointment. Start a virtual consult anytime with one of Teledoc’s U.S. board-certified dermatologists. In 24 hours or less, you'll get a diagnosis, customized treatment plan and prescriptions if needed.
Behavioral Health: Teladoc Behavioral Health is in addition to the employee assistance program and current mental health services provided under the medical plan. Teladoc offers their own virtual mental health providers so plan members age 13* and over will have increased access to therapists and psychologists. Members can choose a therapist, psychologist or psychiatrist who fits their needs and schedule visits 7 days a week from wherever they are most comfortable.
*Members must be 18 years old or older to see a psychiatrist.
Teladoc Frequently Asked Questions
Contact Information
Visit Teladoc.com
Call 1-800-TELADOC (835-2362)
Download the Teladoc app
The City of De Pere Employee Benefits Plan Notice of Privacy Practices
This notice describes the privacy practices that the City of De Pere has established for the self funded benefit plans.
