Overview
The City of Plano’s medical plan is administered by WebTPA. This plan is an EPO Plan, which means it provides in-network only benefits. It is very important to make sure you are seeing in-network providers, so check your provider’s status at webtpa.com.
If you enroll in the Healthcare Highways network plan, your providers and facilities must all be in-network with Healthcare Highways. If you enroll in the Aetna network plan, your providers and facilities must all be in-network with Aetna.
The City of Plano prides itself in providing an excellent benefit plan to its employees. Maintaining good health and receiving quality care in times of illness is of utmost importance. Below is a summary of the health benefits available to you through two network plan options: Healthcare Highways (HCH) and Aetna.
Plan Details
| Description | WebTPA/Healthcare Highways Network (HCH) | WebTPA/Aetna Network |
|---|---|---|
| Annual Deductible | $1,000 Individual | $2,500 Individual |
| Coinsurance Level | Plan pays 80% / You pay 20% | Plan pays 70% / You pay 30% |
| Out-of-Pocket Maximum (includes medical deductible, medical coinsurance, medical copays, Rx deductible, and Rx copays) | $8,000 Individual | $10,150 Individual |
| Lifetime Maximum | Unlimited | Unlimited |
| Preventive Care | Plan pays 100% | Plan pays 100% |
| Physician Services | Primary Care - $25 copay | Primary Care - $25 copay |
| Physician Services | Specialist - $40 copay | Specialist - $40 copay |
| Physician Services | Catalyst Health Network/Village Health Partners - $5 copay | Catalyst Health Network/Village Health Partners - $5 copay |
| Telehealth - Teladoc | $5 copay | $5 copay |
| CVS MinuteClinic | N/A | $5 copay |
| Urgent Care Services | $40 copay | $50 copay |
| Emergency Room (copay waived if admitted) | Deductible + $200 copay per event | Deductible + $200 copay per event |
| Chiropractic Care (24 visits per calendar year) | $25 copay | $25 copay |
| Airrosti (Injuries / pain) | $15 copay | $15 copay |
| Inpatient Hospital Services | Deductible + 20% | Deductible + 30% |
| Outpatient Services | Deductible + 20% | Deductible + 30% |
| Mental Health / Substance Abuse | Outpatient individual therapy - $25 copay | Outpatient individual therapy - $25 copay |
| Mental Health / Substance Abuse | Outpatient group therapy - $20 copay | Outpatient group therapy - $20 copay |
| Mental Health / Substance Abuse | Inpatient hospitalization - Deductible +20% | Inpatient hospitalization - Deductible +30% |
| Home Health Care (60 days per calendar year) | Deductible + 20% | Deductible + 30% |
| Skilled Nursing (60 days per calendar year) | Deductible + 20% | Deductible + 30% |
| Hospice (Limited to 360 days per lifetime) | Deductible + 20% | Deductible + 30% |
Find an In-Network Provider
Healthcare Highways (HCH)
HCH is a specialized (high performance) healthcare network with a lower annual deductible, coverage at a higher percent (coinsurance), and an overall lower out-of-pocket costs plan.
How to Find an In-Network Provider
Healthcare Highways Provider
- Step 1: Go to webtpa.com and log in to your account.
- Step 2: Click on the Find a Provider tab.
You can also visit providersearch.healthcarehighways.com and choose HCH Sync-TX network. Out-of-state plan participants (PHCS) should visit providersearch.multiplan.com and select PHCS Out of Area.
Aetna
The Aetna plan offers access to a larger network of doctors and hospitals with higher out-of-pocket costs.
- Step 1: Go to webtpa.com and log in to your account.
- Step 2: Click on the Find a Provider tab.
If you do not have a WebTPA login, you can go to aetna.com/asa to search for an in-network provider.
Direct Your Provider to the Right Place
DO NOT CALL AETNA OR HEALTHCARE HIGHWAYS.
Please advise your provider to contact WebTPA at 844-380-4552 to validate member eligibility and benefit coverage and to ensure they are in the Aetna Signature Administrators’ network, Healthcare Highways or Aetna Signature Administrators, you elected for your 2026 benefits. Providers should not call Healthcare Highways or Aetna for this information as Healthcare Highways or Aetna is not your insurance company.
Providers can access the Interactive Voice Response (IVR) system 24/7 for eligibility and benefit information. They may also visit webtpa.com to create a free provider portal account — a faster way to verify eligibility.
Connect4Health (C4H) Medical Premium Incentive Program
Connect4Health (C4H) is your wellness incentive program designed to help you save on your monthly benefit costs. Employee and spouse/domestic partner incentives must be achieved and rewarded separately. If either the employee or spouse/domestic partner does not meet the C4H requirements, an additional $50 per month per person will be deducted from the employee’s paycheck.
If you are enrolled in coverage as of January 1, complete the following two items no later than August 31 for next year’s premiums:
- Preventive exam: Choose one — annual exam, mammogram, colonoscopy (including Cologuard if recommended by your physician), or well-woman exam.
- Biometric screening/annual bloodwork: Complete at your doctor’s office.
How to File a Claim
Please send claims and related correspondence to:
WebTPA
PO Box 99906
Grapevine, TX 76099-9706
Payor ID #75261
Questions about Claims or Billing:
Since your providers file your claims with WebTPA, you should contact WebTPA Customer Service at 844-380-4552 or email service.team@webtpa.com.
Find a Cost Estimate
- Step 1: Log in to your member portal account at webtpa.com and select “Find a Provider” to find a medical service, or select a category to “Find Pricing for Medical Services.”
- Step 2: Filter results to the desired location or demographics.
- Step 3: Click on a provider to learn more!
Contact Information
DO NOT CALL AETNA OR HEALTHCARE HIGHWAYS.
WebTPA | 2021COP
844-380-4552webtpa.com
Questions? Email the WebTPA service team at service.team@webtpa.com.
WebTPA Member Portal
Members can access information about their plan benefits and claim information at webtpa.com.
This secure site keeps member information safe and ensures strict HIPAA-compliant confidentiality. The member portal provides self-service tools designed to save time by giving you the ability to view eligibility information, print a temporary ID card, order a new ID card, view claim status and history, download important forms and documents, and communicate with customer service.
Download the App
Download the app from the Apple App Store or Google Play.
Please note — Members must create an online account at webtpa.com before logging in to the mobile app.