2018 Medical Plan Comparison Chart
|
|
- Corey Wilkinson
- 5 years ago
- Views:
Transcription
1 2018 Medical Plan Comparison Chart USC TROJAN CARE EPO USC Custom Is a referral required to see a specialist? No No Yes Yes Medical Deductibles Individual $100 $100 $250 $600 $0 $300 $0 Family (3+ members) $300 $300 $750 $1,800 $0 $900 $0 Tier 1 2 s cross accumulate (count toward one another) Medical Out-of-Pocket Maximum Employee Only $1,000 $1,500 $2,500 $12,500 $1,500 $2,500 $3,000 Employee Plus Adult $2,000 $3,000 Employee Plus Child $5,000 $25,000 $3,000 $5,000 $6,000 Employee Plus Children $3,000 $4,500 $37,500 $4,500 $9,000 Employee Plus Family $3,000 $4,500 $37,500 $4,500 $9,000 Prescription Out-of-Pocket Maximum Employee Only $2,000 $4,850 No out-of-pocket max Combined with medical Combined with medical Employee Plus Adult/ Child(ren)/Family $4,000 $7,200 (two or more people) No out-of-pocket max 1 This is a summary only and does not include all the details, exclusions, or limitations about covered services. For more details about coverage or costs, contact the HR Service Center at uschr@usc.edu or (213)
2 USC TROJAN CARE EPO USC Custom Medical s PCP office visit (including maternity) SCP office visit member pays $20 copay ($10 copay with designated PCP) member pays $20 $20 $20 $30 $30 UCR* after / $20 $20 $40 $40 $30 $40 Preventive care UCR* after / Urgent care centers Member pays $35 Not Available Member pays $35 UCR* after / Member pays $30 Member pays $50 Member pays $30 Emergency care (waived if admitted) Member pays $150 copay Member pays $200 copay (only at USC Verdugo Hills Hospital) Member pays $200 copay Member pays $200 copay and any charges above 100% of UCR*; plan pays 100% of UCR Member pays $150 copay Member pays $150 copay Member pays $100 copay plus 10% of cost Prescription Cost Sharing Generic $5 copay $10 copay If filled at a nonnetwork pharmacy, Brand (no generic available) Brand (generic available) $25 copay 20% of cost, with a minimum $30 copay; $125 max copay $70 copay 50% of cost, with a minimum $50 copay; no max copay Specialty drug $125 copay Generic: $10 copay Brand: 20% of cost, with a minimum $30 copay; $125 max copay the plan will reimburse you 50% of the plan s network contracted rate (not of cost); reimbursement request must be received within 60 days of fill $10 copay $10 copay after $25 Brand/formulary: 20% of cost, with a minimum $30 copay; $125 max copay Brand/non-formulary: 45% of cost (min $50, max $250) Same as above, except self-administered injectable drugs $200 (does not apply to insulin) $25 copay after $25 $40 copay after $25 20% of cost (maximum $100) after $25 2 This is a summary only and does not include all the details, exclusions, or limitations about covered services. For more details about coverage or costs, contact the HR Service Center at uschr@usc.edu or (213)
3 USC TROJAN CARE EPO USC Custom Ambulance Emergency ground transportation (nonemergency transport requires prior authorization) Not available after pays 20% after of Inpatient Hospital Services (all hospital s are subject to prior authorization) Facility member pays $100 (not subject to ) Maternity delivery only at USC Verdugo Hills Hospital $300 Maternity delivery: $100 only at Good Samaritan Hospital when delivery is done by a USC Care Medical Group Obstetrician UCR* after $600. Member pays $600 plus balance $250 Surgery/doctor visits ; member after > 50% of UCR Ambulatory Surgery Facility member $200 $200 UCR* not to exceed $2700 after $600 plus remainder of charges Physician ; member after and balance 3 This is a summary only and does not include all the details, exclusions, or limitations about covered services. For more details about coverage or costs, contact the HR Service Center at uschr@usc.edu or (213)
4 USC TROJAN CARE EPO USC Custom Behavioral Health and Substance Use Disorder Services Authorization Inpatient, partial hospitalization, residential treatment center, and intensive outpatient visits require prior authorization Inpatient, partial hospitalization, residential treatment center, and intensive outpatient visits require prior authorization Inpatient, partial hospitalization, and residential treatment center authorized by the Medical Group Inpatient, partial hospitalization, and residential treatment center require prior authorization Inpatient - facility member pays $100 $300 UCR;* $600 plus balance Inpatient - physician ; member after and balance Partial hospitalization ; member after and balance Residential treatment member pays $100 $300 UCR.* Member pays $600 plus balance Outpatient - facility member pays $200 $200 UCR* not to exceed $2700 after $600 plus remainder of all charges Outpatient - professional member pays $20 copay ($10 copay with designated PCP) $20 $30 and balance $20 $40 $30 Other Health Services Coverage in foreign countries Emergency only No Yes Yes Emergency only Emergency only Emergency Only 4 This is a summary only and does not include all the details, exclusions, or limitations about covered services. For more details about coverage or costs, contact the HR Service Center at uschr@usc.edu or (213)
5 Financial Incentives/Surcharges to Medical Plans Employee Contribution Impact Surcharge/Incentive Description Affected Plan Monthly Annual Health Assessment Credit All plans except Anthem MyChoice HMO Subtract $40 Subtract $480 Tobacco-Free Credit All plans except Anthem MyChoice HMO Subtract $25 Subtract $300 PCP Selection Discount USC Trojan Care EPO only $10 off PCP copays Not applicable Working Spouse Surcharge All plans except Anthem MyChoice HMO Add $50 Add $600 Vision Well vision exam (one exam/year) Frames In- USC Roski Provider 2018 VSP CHOICE PLAN In- VSP Provider $0 copay $15 copay $15 copay Up to $45 Up to $200 (every other calendar year) Up to $170 (every other calendar year) Out-of- Provider Up to $55 (every other calendar year) Lenses Single vision, lined bifocal, lined trifocal, lenticular Progressive $55 $175 copay Contacts (in lieu of glasses) Up to $175 Up to $150 *Only one copay applies when lenses and frames are purchased. Up to $45-$125 $25 copay Up to $85 Up to $150 5 This is a summary only and does not include all the details, exclusions, or limitations about covered services. For more details about coverage or costs, contact the HR Service Center at uschr@usc.edu or (213)
6 Dental Out-of-Pocket Maximum (combined) Services at the USC School of Dentistry $1,500/person Delta Dental PPO Plan United Concordia DHMO Plan In- Out-of- Primary Dental Office (PDO) Not applicable Deductible Individual $50 $75 $0 Per Family $150 $225 $0 Preventive & Diagnostic Cleaning, Exams, X-ray 100%, no 90%, no 80%, after $0 copay Basic Services Routine Extractions, Fillings, Root Canal Therapy, Osseous Surgery, Oral Surgery 100%, after 80%, after 70%, after $0 $140 copay Major Services Crowns, Bridges, Dentures 100%, after 60%, after 50%, after Crowns: $25 $75 copay* Bridges: $70 $90 copay* Dentures: $100 $120 copay Orthodontia Comprehensive Orthodontic Treatment 50% $1,500 $2,000 copay Lifetime Maximum $1,500 Not applicable. Orthodontic benefits are available once per lifetime per member. Eligibility for Orthodontia Covers both children and adults Covers both children and adults Implants Implant Rider 50% Not covered Implants Lifetime Max $1,500 Not applicable * Charges for the use of precious (high noble) or semiprecious (noble) metal are not included in the copayment for crowns, bridges, pontics, inlays and onlays. The decision to use these materials is a cooperative effort between the provider and the patient, based on the professional advice of the provider. Providers are expected to charge no more than an additional $125 for these materials. 6 This is a summary only and does not include all the details, exclusions, or limitations about covered services. For more details about coverage or costs, contact the HR Service Center at uschr@usc.edu or (213)
2018 Medical Plan Comparison Chart
2018 Medical Plan Comparison Chart Benefit Is a referral required to see a specialist? No No Yes Yes Medical Deductibles Individual $100 $100 $250 $600 $0 $300 $0 Family (3+ members) $300 $300 $750 $1,800
More information2018 Medical Plan Comparison Chart
2018 Medical Plan Comparison Chart USC TROJAN CARE EPO USC Custom TIER 1: Keck Medicine TIER 2: Anthem TIER 3: Out-of-network TIER 1: USC Custom TIER 2: Anthem Is a referral required to see a specialist?
More information2018 Medical Plan Comparison Chart
2018 Medical Plan Comparison Chart Benefit Is a referral required to see a specialist? No No Yes Yes Medical Deductibles Individual $100 $100 $250 $600 $0 $300 $0 Family (3+ members) $300 $300 $750 $1,800
More informationBasic Life and Accidental Death & Dismemberment (AD&D) Insurance
Basic Life and Accidental Death & Dismemberment (AD&D) Insurance USC recognizes the importance of life insurance for employees at all ages and stages in life, by automatically providing Basic Life and
More informationPLUMBERS LOCAL 75 HEALTH FUND BENEFIT HIGHLIGHTS SUMMARY
PLUMBERS LOCAL 75 HEALTH FUND BENEFIT HIGHLIGHTS SUMMARY Prepared by: Lee Jost and Associates October, 2005 PLUMBERS LOCAL 75 HEALTH FUND Benefit Highlights Benefit Description Class A Employees and Dependents
More informationWashington Counties Insurance Fund 2017 Benefit Plan Comparison for Retirees
Washington Counties Insurance Fund 2017 Benefit Plan Comparison for Retirees Retiree Medical Plans for Under Age 65 (former WCIF medical enrollees only) Retiree Medical Plans for Over Age 65 (all eligible
More informationMedical Plan 2019 Coverage Options
Medical Plan 2019 Coverage Options These documents provide a convenient overview of your health care insurance rates and coverage (medical, including pharmacy; dental; vision) and your contribution limits
More information2017 Denver Employees Retirement Plan Non-Medicare Medical Plan Summary
HDHP* 2017 Denver Employees Retirement Plan Non-Medicare Summary Colorado HDHP HDHP** DHMO* Colorado DHMO Navigate (Colorado only) Annual Deductible Single $1,350 $1,350 $1,350 $500 $500 $500 Family $2,700
More informationGUIDE TO MEDICAL AND DENTAL PLANS
GUIDE TO MEDICAL AND DENTAL PLANS B e n e f i t s e f f e c t i v e J u l y 1, 2 0 1 4 t h r o u g h J u n e 3 0, 2 0 1 5 Choosing your benefits is an important decision. This guide provides you with the
More informationEmployee Benefits Guide
Employee Benefits Guide Plans effective January 1, 2017 Regular Part-Time Administrators Welcome to Montgomery County Community College! Montgomery County Community College (the College) strives to offer
More informationthe options the options
Invested in Invested in all weighing weighing all the options the options 207 Health Coverage Comparison Chart Making the right choice is important. Here s some information you ll need, to help you make
More information2018 Health Coverage Comparison Chart
Invested in weighing the possibilities 08 Health Coverage Comparison Chart Making the right choice is important. Here s some information you ll need to help make more informed decisions. What s Inside
More informationNortel FLEX 2012 Enrollment. Summary of Health Benefits
Nortel FLEX 2012 Enrollment Summary of Health Benefits 1 Summary of Health Benefits Medical Network Area The chart below outlines the main features of the Medical Plan options available to you if you live
More informationPlan Year 2019 Health Plan Comparison
Plan Year 2019 Health Plan Comparison Note: The information in the tables below contain general plan benefits and may not include additional provisions or exclusions. For more in-depth plan benefits, please
More information2016 Medical, Dental and Vision Plan Comparisons
Y URBENEFITS EXPLORE YOUR COUNTY OF RIVERSIDE OPTIONS 2016 Medical, Dental and Vision Plan Comparisons 2016 COR Benefits Guide 1 COUNTY MEDICAL PLANS COMPARISON CHART These benefit summaries only highlight
More informationClergy Benefit Comparison Effective January 1, 2018
Clergy Benefit Comparison Effective January 1, 2018 HMO-POS Plan Personal Care Account (Provided by VUMPI) There is no Personal Care Account There is no Personal Care Account $750 Individual, $2,250 Family
More information2018/2019 Open Enrollment Bulletin
2018/2019 Open Enrollment Bulletin Open Enrollment for Your LAPRA Benefits is Here Open Enrollment is your once-a-year opportunity to evaluate your health care needs and make any changes to your medical
More informationPlan Year 2020 Medical Plan Comparison
Plan Year 2020 Medical Plan Comparison MEDICAL Service Areas Global Global Statewide Urgent and Emergent Statewide Urgent and Emergent Annual (medical and prescription combined) $1,500 Individual $3,000
More informationGarfield Heights Board of Education SuperMed Plus Effective 1/1/
Garfield Heights Board of Education SuperMed Plus Effective 1/1/2011 687072 461 Benefits Network Non-Network January 1 st through December 31 st Dependent Age Older Aged Child 26 26 Removal upon Birth
More information2018 Benefits Summary
Choose your benefits. Save the galaxy. 2018 Benefits Summary A comprehensive comparison of all plans (excluding Hawaii and Puerto Rico) KNOW YOUR OPTIONS BEFORE YOU CHOOSE Review these summary charts to
More informationYour Plan: Anthem Bronze PPO 6000/0%/6000 w/hsa Your Network: Prudent Buyer PPO
Your Plan: Anthem Bronze PPO 6000/0%/6000 w/hsa Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does
More informationSomething for everyone. Let s find yours Benefits Open Enrollment October 30 November 21, 2017
Something for everyone. Let s find yours. 2018 Benefits Open Enrollment October 30 November 21, 2017 Make the right choice for you and your family For 2018, we re introducing new medical plan options and
More informationOPERATING ENGINEERS HEALTH & WELFARE FUND BENEFIT PLANS SUMMARY COMPARISON FOR ACTIVES and EARLY RETIREES
PPO Plan For Non-PPO Providers Employee Premium None None None None None Explanation of Plans and Options Available to You Deductible Annual Out-of-Pocket Maximum Medical and ¹Pediatric Dental & Vision
More informationOEBB Summary of Vision Benefits Plan Year
OEBB Summary of Vision Benefits 2017 18 Plan Year You will not receive an ID card from VSP. No ID card needed at your appointment, simply tell them you have VSP. To find out more, go to vsp.com or call
More information2018 Health Coverage Comparison Chart
Invested in weighing the possibilities 08 Health Coverage Comparison Chart Making the right choice is important. Here s some information you ll need to help make more informed decisions. What s Inside
More informationLMUSD CERTIFICATED PLANS
LMUSD CERTIFICATED PLANS 2017-2018 Plan A 100-A $20 Plan B 100-D $20 Plan C 90-G $20 Plan D 80-G $20 Plan E 80-M $40 2-Tier ANCH BRONZE MEDICAL - CALENDAR YEAR Deductibles & Maximums Member Pays Member
More informationYour Plan: Anthem Gold Select HMO 35/25%/6600 Your Network: Select HMO
Your Plan: Anthem Gold Select HMO 35/25%/6600 Your Network: Select HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does not reflect
More informationTeva 2013 Open Enrollment Your Choices and Options
2013 COBRA Guide Open Enrollment Your Choices and Options 2 HEALTHCARE 2 Medical (includes vision) 5 Prescription Drug 6 Dental Enroll November 5 16 More information will be provided by our vendor, Conexis.
More informationOPERATING ENGINEERS HEALTH & WELFARE FUND BENEFIT PLANS SUMMARY COMPARISON FOR ACTIVE and RETIRED PARTICIPANTS
PPO Plan For Non-PPO Providers Employee Premium None None None None None Explanation of Plans and Options Available to You Deductible Annual Out-of-Pocket If you choose a doctor who is not contracted with
More informationYour Plan: Anthem Bronze Select PPO 6350/0%/6350 w/hsa Your Network: Select PPO
Your Plan: Anthem Bronze Select PPO 6350/0%/6350 w/hsa Your Network: Select PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does
More informationBENEFIT PPO 1B PPO 3B PPO 5B PPO 7B. Individual: $100 Family: $300
CVT PPO Health Plans with Anthem Blue Cross and CVS/caremark Oak Park Unified SD - CERTIFICATED, CLASSIFIED, MANAGEMENT, TRUSTEES October 1, 2018 - September 30, 2019 BENEFIT PPO 1B PPO 3B PPO 5B PPO 7B
More informationYour Plan: Anthem Silver PPO 2000/35%/6850 Your Network: Prudent Buyer PPO
Your Plan: Anthem Silver PPO 2000/35%/6850 Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does not
More informationEmployee Benefits Guide
Employee Benefits Guide Plans effective January 1, 2017 Full-Time Faculty Welcome to Montgomery County Community College! Montgomery County Community College (the College) strives to offer you and your
More informationBenefit Summaries Small Business Private Exchange
Benefit Summaries Small Business Private Exchange For Groups of 1-100 Employees Gold/Silver CONTENTS Gold HMO...2 Gold HSP... 4 Gold PPO...16 Silver HMO...20 Silver HSP... 22 Silver PPO... 34 Silver EPO...
More informationRegence BlueShield: Regence Gold 1000 Preferred
Regence BlueShield: Regence Gold 1000 Preferred Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2016 12/31/2016 Coverage for: Individual & Eligible Family
More informationYour Benefit Summary Balance 6800 Bronze
Your Benefit Summary Balance 6800 Bronze Providence Signature Network In-Network Out-of-Network Individual Calendar Year Deductible (family amount is 2 times individual) $6,800 $13,600 Individual Out-of-Pocket
More informationDental TERMS YOU SHOULD KNOW GENERAL TERMS-DENTAL. Preventive Services. Basic Services. Prosthodontic Services
Dental GENERAL TERMS-DENTAL TERMS YOU SHOULD KNOW Basic Services Procedures necessary to restore teeth (other than crowns or cast restorations), oral surgery, endodontics (root canal therapy), and periodontics.
More informationYour Plan: Anthem Silver PPO 3400/0%/3400 w/hsa Your Network: Anthem PPO
Your Plan: Anthem Silver PPO 3400/0%/3400 w/hsa Your Network: Anthem PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does not
More informationYour Plan: Anthem Platinum Priority Select HMO 10/10%/2500 Plus Your Network: Priority Select HMO
Your Plan: Anthem Platinum Priority Select HMO 10/10%/2500 Plus Your Network: Priority Select HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process.
More informationBenefit Summaries Small Business Private Exchange
Benefit Summaries Small Business Private Exchange For Groups of 1-100 Employees Silver/Bronze CONTENTS Silver HMO...2 Silver HSP... 4 Silver PPO...16 Silver EPO...18 Bronze HSP...20 Bronze HMO... 22 Bronze
More informationLAT BRO 7/09. Latitude. For Groups with 2-50 Employees
LAT BRO 7/09 Latitude For Groups with 2-50 Employees The world isn t flat your healthcare plan shouldn t be either. Latitude Latitude : The Smart, Flexible Solution Chart Your Own Course with Latitude
More informationGray Television 2017 BENEFITS AT A GLANCE
Medical Plan Overview BENEFIT GREEN PLAN WITH HSA YELLOW PLAN RED PLAN HSA Employer Contribution IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK Employee Only $1,000 N/A N/A
More informationYour Plan: Anthem Gold PPO 1000/20%/4000 Your Network: Prudent Buyer PPO
Your Plan: Anthem Gold PPO 1000/20%/4000 Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does not
More informationYour Plan: Anthem Silver Blue Access PPO 2000/50%/6350 Your Network: Blue Access
Your Plan: Anthem Silver Blue Access PPO 2000/50%/6350 Your Network: Blue Access This summary of benefits is a brief outline of coverage, designed to help y ou with the selection process. This summary
More information2018 Open Enrollment Guide
2018 Open Enrollment Guide Important Change to Spousal Coverage Explained Inside: See page 3 What s Inside Welcome to Open Enrollment 1 What is Open Enrollment? 2 What s New for 2018 3 How to Enroll &
More informationMedical Benefit Summary - Non-Union
Medical Summary - Non-Union Service HAP HMO Plan PREVENTIVE SERVICES - *UNLIMITED PER MEMBER PER CALENDAR YEAR Health Maintenance Exam includes chest X-ray, EKG and select lab procedures Annual Gynecological
More informationDignity Health Benefits
FACILITY SPECIFIC BENEFIT INFORMATION FOR St. Rose Hospitals - Non-Union This document contains important information about your Medical, Dental, Vision, Life, Accidental Death & Dismemberment and Longterm
More informationBenefit Summaries Small Business Private Exchange
Benefit Summaries Small Business Private Exchange For Groups of 1-100 Employees (Revised 11/20/18) CONTENTS About this Guide...2 Platinum HMO...3 Platinum EPO...15 Gold HMO...17 Gold PPO...31 Gold EPO...
More informationCarroll County Public Schools. Flexible Benefits. Open Enrollment Guide
Flexible Benefits Open Enrollment Guide 2019 125 North Court Street Westminster, MD 21157 Together - It's Possible! 2019 FLEXIBLE BENEFITS OPEN ENROLLMENT The Flexible Benefits Program (medical, dental,
More informationOpen Enrollment. November 5 to November 23, pg. 1
Open Enrollment November 5 to November 23, 2018 pg. 1 Table of Contents General Information. 3 Open Enrollment Checklist.. 4 What s New for 2019?... 5 NEW Optional Life Insurance. 6 2019 Employee Premiums
More informationYour Plan: Anthem Bronze PPO 6000/35%/6600 Your Network: Prudent Buyer PPO
Your Plan: Anthem Bronze PPO 6000/35%/6600 Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does not
More informationAnthem Blue Cross of California Your Plan: Anthem Gold Select HMO 500/20%/6500 Your Network: Select HMO
Anthem Blue Cross of California Your Plan: Anthem Gold Select HMO 500/20%/6500 Your Network: Select HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection
More informationYour Plan: Anthem Bronze Select PPO 5000/30%/6250 Plus Your Network: Select PPO
Your Plan: Anthem Bronze Select PPO 5000/30%/6250 Plus Your Network: Select PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does
More information2019 Benefits Summary
2019 Benefits Summary A comprehensive comparison of all plans (excluding Hawaii and Puerto Rico) KNOW YOUR OPTIONS BEFORE YOU CHOOSE Review these summary charts to better understand the Disney benefits
More informationYour Plan: Anthem Gold Blue Choice PPO 1500/20%/4000 Your Network: Blue Choice PPO
Your Plan: Anthem Gold Blue Choice PPO 1500/20%/4000 Your Network: Blue Choice PPO This summary of benefits is a brief outline of coverage, designed to help y ou with the selection process. This summary
More informationYour Plan: Anthem Bronze PPO 3250/50%/6550 Plus w/hsa Your Network: Anthem PPO
Your Plan: Anthem Bronze PPO 3250/50%/6550 Plus w/hsa Your Network: Anthem PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does
More informationYour Plan: Anthem Gold Select PPO 1000/20%/4000 Plus Your Network: Select PPO
Your Plan: Anthem Gold Select PPO 1000/20%/4000 Plus Your Network: Select PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does
More informationIU Health Plans Silver Enhanced Plus Dental & Vision CSR 94. Schedule of Benefits
IU Health Plans Silver Enhanced Plus Dental & Vision CSR 94 Schedule of s Schedule of s / 1 The Schedule of s is a summary of your s and Cost Sharing. The definitions stated in your Contract apply to this
More informationHEALTH PLAN BENEFITS AND COVERAGE MATRIX
HEALTH PLAN BENEFITS AND COVERAGE MATRIX THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. THE EVIDENCE OF COVERAGE AND PLAN CONTRACT SHOULD BE CONSULTED FOR
More informationBenefit Summaries Small Business Private Exchange
Benefit Summaries Small Business Private Exchange For Groups of 1-100 Employees CONTENTS About this Guide...2 Platinum HMO...3 Gold HMO...13 Gold HSP...15 Gold PPO... 27 Silver HMO...31 Silver HSP... 33
More information(30- to 34-day supply) 100% after $40 copay; significant or new therapeutic class drugs: 50%
C O U N T Y S I N T R A N E T S I T E : H T T P : / / I N T R A N E T. C O. R I V E R S I D E. C A. U S 25 Exclusive Care Select Medicare Coordination Plan Tier 1: Exclusive Care Network Tier 2: Any Provider
More informationYour Plan: Anthem Bronze PPO 6350/30%/6850 Plus Your Network: Anthem PPO
Your Plan: Anthem Bronze PPO 6350/30%/6850 Plus Your Network: Anthem PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does not
More informationmedical solutions traveler employee medical benefits
medical solutions traveler employee medical benefits OPEN ENROLLMENT FOR PLAN YEAR 1.1.18-12.31.18 GOLD ($500 DEDUCTIBLE) SILVER ($2,000 DEDUCTIBLE) BRONZE ($3,500 DEDUCTIBLE) Deductible Single/Family
More informationBENEFITS SUMMARY. Stay Healthy. Medical Insurance Dental Insurance Vision Insurance Gold s Gym Fitness Plan. Feeling Secure
Welcome to TekSynap where employees are our best asset. Benefits at TekSynap are available the first day of the calendar month following date of hire. We are committed to a comprehensive employee benefit
More information2019 Open Enrollment. Presented by Araceli Cosio, Filice Insurance
2019 Open Enrollment Presented by Araceli Cosio, Filice Insurance Introduction Open Enrollment is your annual opportunity to make benefit election changes without a qualifying event. During open enrollment
More informationMedicare Part D Notice: The benefits in this summary are effective:
Medicare Part D Notice: If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage.
More informationINDIVIDUAL & FAMILY HEALTH BENEFIT PLANS FOR NORTHEAST OHIO
INDIVIDUAL & FAMILY HEALTH BENEFIT PLANS FOR NORTHEAST OHIO Understanding what Offers: New Plans offer: Guaranteed Coverage / no pre-existing conditions Prescription Drug benefits $0 cost preventative
More informationSchedule of Benefits
Complete HMO 1500 30% Schedule of Benefits For Individuals and Small Group Employers health plan meets Minimum Creditable Coverage standards and will satisfy the individual mandate that you have health
More information2019 RETIREE BENEFIT HIGHLIGHTS
2019 RETIREE BENEFIT HIGHLIGHTS Contact Information City of Palm Bay Online Enrollment Medical Insurance Prescription Drug Coverage Mail-Order Program Human Resources BenTek Cigna Telehealth Cigna Home
More informationImportant Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.soundhealthwellness.com or by calling 1-800-225-7620.
More information2018 Health, Dental and Vision Monthly Contributions
2018 Health, Dental and Vision Monthly Contributions Benefit Plan Monthly Contributions for Active Regular Full-Time and Part-Time Employees Employee Only Spouse Child(ren) Family Dental: Cigna PPO $ 13
More informationSchedule of Benefits
Schedule of Benefits Complete HMO $0 This health plan meets Minimum Creditable Coverage standards and will satisfy theindividual mandate that you have health insurance. Please see the last page for additional
More informationYour Plan: Anthem Silver Blue Access Choice 5000/20%/6600 Your Network: Blue Access Choice
Your Plan: Anthem Silver Blue Access Choice 5000/20%/6600 Your Network: Blue Access Choice This summary of benefits is a brief outline of coverage, designed to help y ou with the selection process. This
More informationAppendix A. Out-of-Network - In-Network for emergencies only Annual Deductible $250
Medical / Hearing ( PPO for employees whose residence is outside of the HMO Zip Code service area) Out-of-Network - In-Network for emergencies only $250 Appendix A Employee Choice of either BCN HMO or
More informationSchedule of Benefits
Schedule of Benefits Choice Easy Tier HMO 2000 15%/35% For Individuals and Small Group Employers IMPORTANT NOTICE: This plan includes a Tiered Provider Network called Easy Tier Hospital Network. In this
More informationSHL Solutions EPO Silver 30/2000/100%
SHL Solutions EPO Silver 30/2000/100% HIOS ID: 83198NV0060013 Calendar Year Deductible (CYD): $2,000 of EME per Insured and $4,000 of EME per family. An Insured may not contribute any more than the Individual
More information$0 $0 $2,000 $4, % after deductible 80% after deductible Medical Care (including inpatient visits and consultations)/surgical Expenses
Summary of Premier Balance PPO $0 Platinum A Benefits On the chart below, you'll see what your plan pays for specific services. You may be responsible for a facility fee, clinic charge or similar fee or
More informationAnthem Blue Cross and Blue Shield Your Plan: Anthem Bronze Pathway PPO 5000/30%/7150 Your Network: Pathway PPO
Anthem Blue Cross and Blue Shield Your Plan: Anthem Bronze Pathway PPO 5000/30%/7150 Your Network: Pathway PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection
More informationFIRST QUARTER 2018 SMALL GROUP PRODUCT PORTFOLIO
FIRST QUARTER 2018 SMALL GROUP PRODUCT PORTFOLIO Benefits of Blue Innovative plan designs Full-network tiered benefit plans at every metal level align and focus plans are designed to help keep your costs
More informationHealth Plan Benefits and Coverage Matrix
Health Plan Benefits and Coverage Matrix THIS MATRI IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. THE EVIDENCE OF COVERAGE AND PLAN CONTRACT SHOULD BE CONSULTED FOR
More informationAnthem Blue Cross of California Your Plan: Anthem Gold HMO 40/20%/6500 Your Network: California Care HMO
Anthem Blue Cross of California Your Plan: Anthem Gold HMO 40/20%/6500 Your Network: California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection
More informationColorado Health Plan Description Form Anthem Blue Cross and Blue Shield BluePreferred for Individuals
Colorado Health Plan Description Form Anthem Blue Cross and Blue Shield BluePreferred for Individuals PART A: TYPE OF COVERAGE 1. TYPE OF PLAN Preferred provider plan 2. OUT-OF-NETWORK CARE COVERED? 1
More informationUniversity of Cincinnati Medical Plan Summary and Comparison Non AAUP - Effective January 1- December 31, 2018
Annual Deductible Annual Health Savings Account Funding (UC) $1500 individual $3,000 family Varies by Annual Base Pay as of 1/1/18 $3,000 per person $6,000 family Varies by Annual Base Pay as of 1/1/18
More informationFOURTH QUARTER 2017 SMALL GROUP PRODUCT PORTFOLIO
FOURTH QUARTER 2017 SMALL GROUP PRODUCT PORTFOLIO THE CARD THAT OPENS DOORS IN 50 STATES. Benefits of Blue Plan options NEW tiered benefit plans Tiered benefit plans offered at every metal level (align
More informationWhen You Can Change Plans. Care is provided through physicians or medical staff at a Kaiser Permanente facility located in the member's service area.
LABORERS HEALTH AND WELFARE TRUST FUND FOR ACTIVE PLAN AND SPECIAL PLAN PARTICIPANTS COMPARISON AND SUMMARY OF THE MEDICAL-HOSPITAL AND PRESCRIPTION DRUG PLANS EFFECTIVE MARCH 1, 2017 P L A N F E A T U
More informationRetirees with Medicare (RETIREMENT DATE ON or AFTER March 1, 2015) Benefits Comparison Benefits effective January 1, December 31, 2019
Pelican HRA1000 Magnolia Local Plus Network Blue Cross and Blue Shield of Louisiana Preferred Care Providers & Blue Cross National Providers Blue Cross and Blue Shield of Louisiana Preferred Care Providers
More informationRetirees with Medicare (RETIREMENT DATE BEFORE March 1, 2015) Benefits Comparison Benefits effective January 1, December 31, 2019
Network Eligible OGB Members Pelican HRA1000 Blue Cross and Blue Shield of Louisiana Preferred Care Providers & Blue Cross National Providers Magnolia Local Plus Blue Cross and Blue Shield of Louisiana
More informationMEDICAL PLAN SUMMARY 2017
MEDICAL PLAN SUMMARY 2017 General Plan Information RED PLAN WHITE PLAN BLUE PLAN Blue Choice PPO SM BlueOptions SM Blue Choice PPO SM In Out of Blue Preferred SM Blue Choice PPO SM Blue SM Traditional
More informationDiocese of Monterey. July 2018-June 2019 Benefits Summary. Diocese of Monterey. 425 Church Street, Monterey, California 93940
Diocese of Monterey July 2018-June 2019 Benefits Summary Diocese of Monterey 425 Church Street, Monterey, California 93940 831.373.4345 www.dioceseofmonterey.org Benefits Overview The Diocese of Monterey
More informationCHOOSE YOUR BENEFITS 2016 BENEFITS SUMMARY. A comprehensive comparison of all plans offered in Hawaii PURSUE GOOD HEALTH
CHOOSE YOUR PURSUE GOOD HEALTH 2016 SUMMARY A comprehensive comparison of all plans offered in Hawaii ER FSA HMO HRA PCP PPO Rx Emergency Room KNOW YOUR OPTIONS BEFORE YOU CHOOSE Review these summary charts
More informationUniversity of Cincinnati Medical Plan Summary and Comparison Effective January 1- December 31, 2018-AAUP only
Annual Deductible Annual Health Savings Account Funding (UC) $1500 individual $3,000 family Varies by Annual Base Pay as of 1/1/2018 $3,000 per person $6,000 family Varies by Annual Base Pay as of 1/1/2018
More informationAnthem Blue Cross of California Your Plan: Anthem Gold HMO 25/20%/6600 Your Network: California Care HMO
Anthem Blue Cross of California Your Plan: Anthem Gold HMO 25/20%/6600 Your Network: California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection
More informationBENEFITS ENROLLMENT
2018 2019 BENEFITS ENROLLMENT Open Enrollment begins February 12, 2018. This is your annual opportunity to choose the benefits coverage that s right for you and your family. You will have until March 2,
More informationWHAT S INSIDE. BENEFITS FOR A FULL LIFE At work or at play, we ve got your back. Tax-advantaged accounts. Benefits eligibility. Medical plan overview
08 BENEFITS GUIDE BENEFITS FOR A FULL LIFE At work or at play, we ve got your back. Hiking fanatic. Fearless rock climber. Stylish glamper. Whatever your passion, you need to be prepared for the unexpected.
More informationBenefits. Human Resources
Benefits What We Will Review Today Health Insurance Medical Prescriptions Dental Coverage Options Cost Eligibility Effective Date Benefit Enrollment Forms Due Dates Time Frames Life Insurance Retiree Health
More informationCOMPREHENSIVE MEDICAL BENEFITS
CEMENT MASONS HEALTH AND WELFARE TRUST FUND ACTIVE CEMENT MASONS AND THEIR ELIGIBLE DEPENDENTS EFFECTIVE JANUARY 1, 2010 DIRECT PAYMENT When You Can Change Plans Type of Plan Geographical Area Covered
More informationSchedule of Benefits
Schedule of Benefits NHP Prime HMO 2000/4000 30/50 35% FlexRx SM 6 Tier II A Prime HMO health plan meets Minimum Creditable Coverage standards and will satisfy the individual mandate that you have health
More informationYour Plan: Bronze Pathway X HMO Plus w/hsa Your Network: Pathway X HMO
Your Plan: Bronze Pathway X HMO Plus w/hsa Your Network: Pathway X HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does not reflect
More informationSchedule of Benefits
Schedule of Benefits NHP Prime HMO 2000/4000 30/50 FlexRx SM 6 Tier II A Prime HMO Plan health plan meets Minimum Creditable Coverage standards and will satisfy the individual mandate that you have health
More informationAnthem Blue Cross and Blue Shield Your Plan: Anthem Bronze PPO 6000/30%/7150 Your Network: PPO
Anthem Blue Cross and Blue Shield Your Plan: Anthem Bronze PPO 6000/30%/7150 Your Network: PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process.
More information