Medical
Medical coverage provides healthcare protection for you and your family. You can visit any provider, but in-network doctors offer the highest level of benefits and lower out-of-pocket costs by charging reduced, contracted rates. Out-of-network providers set their own fees, so you may be responsible for charges above the Reasonable and Customary (R&C) limits. Preventive care—such as physical exams, flu shots, and screenings—is covered at 100% when you use in-network providers. The main differences between plan options are how much you pay per paycheck and what you pay when you receive care.
Each plan has different:
- Annual deductible amounts – the amount you pay each year for eligible in-network and out-of-network charges before the plan begins to pay.
- Out-of-pocket maximums– the most you will pay each year for eligible network services and/or prescriptions. After you reach your out-of-pocket maximum, the plan picks up the full cost of covered medical care for the remainder of the year.
- Copays – A copay is a fixed amount you pay for a health care service. Copays do not count toward your deductible but do count toward your annual out-of-pocket maximum.
- Coinsurance – Once you’ve met your deductible, you and the plan share the cost of care, which is called coinsurance. For example, you pay 20% for services and the plan will pay 80% of the cost until you have reached your out-of-pocket maximum.
$2,500 PPO Plan
Benefit Highlights
In-Network
Deductible (Individual/Family)
$2,500/$5,000
Out-of-Pocket Max (Individual/Family)
$7,150/$14,300
Preventive Care
$0
Primary Care Visit
$15
Specialist Visit
$50/$100
Urgent Care
$25
Emergency Room
$300 + 20%* (waived if admitted)
Retail Rx (Up to 30-Day Supply)
Generic
$15
Preferred Brand
$45
Non-Preferred Brand
$80
Mail-Order Rx (Up to 90-Day Supply)
Generic
$37.50
Preferred Brand
$112.50
Non-Preferred Brand
$200
* After deductible
Weekly Plan Cost (Hourly Employees)
Employee Only: $60.00
Employee and Spouse: $219.23
Employee and Child(ren): $161.54
Employee and Family: $276.92
Bi-weekly Plan Cost (Salaried Employees)
Employee Only: $120.00
Employee and Spouse: $438.46
Employee and Child(ren): $323.08
Employee and Family: $553.85
$3,000 HDHP Plan
Benefit Highlights
In-Network
Deductible (Individual/Family)
$3,000/$6,000
Out-of-Pocket Max (Individual/Family)
$6,000/$12,000
Preventive Care
$0
Primary Care Visit
20%**
Specialist Visit
20%**
Urgent Care
20%**
Emergency Room
20%**
Retail Rx (Up to 30-Day Supply)
Generic
$10.00**
Preferred Brand
$35.00**
Non-Preferred Brand
$70.00**
Mail-Order Rx (Up to 90-Day Supply)
Generic
$25.00**
Preferred Brand
$87.50**
Non-Preferred Brand
$175.00**
* After deductible
Weekly Plan Cost (Hourly Employees)
Employee Only: $34.62
Employee and Spouse: $138.46
Employee and Child(ren): $98.08
Employee and Family: $167.31
Bi-weekly Plan Cost (Salaried Employees)
Employee Only: $69.23
Employee and Spouse: $276.92
Employee and Child(ren): $196.15
Employee and Family: $334.62
$5,000 HDHP (HSA) Plan
Benefit Highlights
In-Network
Deductible (Individual/Family)
$5,000/$10,000
Out-of-Pocket Max (Individual/Family)
$7,350/$14,700
Preventive Care
$0
Primary Care Visit
20%**
Specialist Visit
20%**
Urgent Care
20%**
Emergency Room
20%**
Retail Rx (Up to 30-Day Supply)
Generic
$10.00**
Preferred Brand
$35.00**
Non-Preferred Brand
$70.00**
Mail-Order Rx (Up to 90-Day Supply)
Generic
$25.00**
Preferred Brand
$87.50**
Non-Preferred Brand
$175.00**
* After deductible
Weekly Plan Cost (Hourly Employees)
Employee Only: $17.31
Employee and Spouse: $103.85
Employee and Child(ren): $69.23
Employee and Family: $121.15
Bi-weekly Plan Cost (Salaried Employees)
Employee Only: $34.62
Employee and Spouse: $207.69
Employee and Child(ren): $138.46
Employee and Family: $242.31