Medical Plans
Plan A - Standard Plan
Co-Pay - $20.00 co-pay per office visit to providers in the MMO network including unlimited visits for treatment of illness or injury
Annual Deductible - In-network - $400 deductible per person/$800 maximum per family per calendar year in-network Out of Network - $500 deductible per person/$1,000 maximum per family per calendar year out-of-network
Plan Pays - After deductible is met; 90% of charges in-network/60% for out-of-network
Emergency Room Visits - $100 co-pay for ER visits - after deductible is met
Annual out-of-pocket maximums - In-network - Single: $1,750/Family: $3,500, - Out-of-network - Single: $3,500/Family: $7,000
Wellness Benefit - $1,000 per person, per year deductible is waived, benefit is 100%
Includes: well child care office visits, immunizations/vaccinations, pap test, mammogram, PSA, and routine physicals, Diabetes Management, $500 combined lifetime maximum for certified smoking cessation and/or weight loss program when approved and monitored by a physician
Prescription drug benefits - included
Vision benefits - included
Flexible Spending Account - eligible $5,000 annual maximum
Plan B - High-Deductible Plan
Annual Deductibles - In-network deductibles per calendar year $1,150 deductible - single coverage /$2,300 deductible - family coverage
Out-of-network deductibles per calendar year - $1,500 deductible - single coverage / $3,000 deductible - family coverage
Plan Pays - 90% of charges for in-network and 60% for out-of-network after deductible is met
Out-of-pocket maximums: - Single: $3,000 in-network / $5,800 out-of-network, Family: $6,000 in-network / $11,600 out-of-network
Wellness benefit - $1,000 Wellness Benefit per person, per year - deductible is waived, benefit is 100%. $500 combined lifetime maximum for certified smoking cessation and/or weight loss program
Prescription - No prescription card, but prescription drugs are covered as part of the major medical plan and go towards the deductible. Once deductible is met prescriptions are reimbursed at 75%.
Vision - benefits included
Flexible Spending Account available - $5,000 maximum contribution per calendar year
Health Savings Account available - Single: $3,000 maximum annual contribution / Family: $5,950 maximum annual contribution
