Callen Cochran Business Development Manager United Pallet Services, Inc. Large Group 2018 Medical Plans 101+
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1 Callen Cochran Business Development Manager United Pallet Services, Inc. Large Group 2018 Medical Plans 101+
2 Summit Plan Name ML32 HMO ML30 HMO ML34 HMO ML50 HMO ML31 HMO ML51 HMO Part D Creditability Creditable Creditable Creditable Creditable Creditable Creditable HSA Compatible No No No No No No Single/individual family member $750 $1,500 $1,500 $2,000 $2,500 $3,000 Family $1,500 $3,000 $3,000 $4,000 $5,000 $6,000 Single/individual family member $0 $0 $0 $0 $0 $0 Family $0 $0 $0 $0 $0 $0 Deductible for (embedded) Single/individual family member $0 $0 $0 $0 $0 $0 Family $0 $0 $0 $0 $0 $0 $10 per visit $10 per visit $30 per visit $25 per visit Specialist office visit $10 per visit $10 per visit $30 per visit $25 per visit Preventive care Outpatient rehabilitation visit $10 per visit $30 per visit $25 per visit Outpatient surgery facility fee $10 per visit $10 per visit Outpatient surgery physician/surgeon fee Diagnostic lab tests $10 per visit $10 per visit $10 per visit $25 per visit $10 per visit Imaging (CT/PET scans, MRIs) $50 per procedure $50 per procedure $50 per procedure $50 per procedure $50 per procedure $10 per procedure $10 per procedure $15 per procedure $10 per procedure $250 per day $250 per day 5 days per admission 3 days per admission 5 days per admission Hospitalization physician/surgeon fees $30 per visit $150 per visit $150 per visit $150 per visit $30 per trip $100 per trip $50 per trip $100 per trip $150 per trip $150 per trip Urgent care $15 per visit $10 per visit $25 per visit $5 per prescription $10 per prescription $10 per prescription $10 per prescription $10 per prescription $10 per prescription $20 per prescription $30 per prescription $30 per prescription $30 per prescription $30 per prescription $30 per prescription Tier 3 (non- $40 per prescription $60 per prescription $60 per prescription $60 per prescription $60 per prescription $60 per prescription $100 per prescription MH/SUD outpatient individual office visits $10 per visit $10 per visit $30 per visit $25 per visit $250 per day 5 days per admission $250 per day 3 days per admission 5 days per admission
3 Peak Plan Name ML20 HMO ML21 HMO ML22 HMO ML24 HMO ML25 HMO Part D Creditability Creditable Creditable Creditable Creditable Creditable HSA Compatible No No No No No Single/individual family member $3,000 $3,000 $4,000 $5,000 $6,000 Family $6,000 $6,000 $8,000 $10,000 $12,000 Single/individual family member $500 $1,000 $1,500 $2,500 $3,000 Family $1,000 $2,000 $3,000 $5,000 $6,000 Deductible for (embedded) Single/individual family member $0 $0 $0 $0 $0 Family $0 $0 $0 $0 $0 Specialist office visit Preventive care Outpatient rehabilitation visit Outpatient surgery facility fee Outpatient surgery physician/surgeon fee Diagnostic lab tests Imaging (CT/PET scans, MRIs) $50 per procedure $50 per procedure $50 per procedure $50 per procedure $50 per procedure Hospitalization physician/surgeon fees $10 per procedure $10 per procedure $10 per procedure $10 per procedure $10 per procedure Urgent care $10 per prescription $10 per prescription $10 per prescription $10 per prescription $10 per prescription $30 per prescription $30 per prescription $30 per prescription $30 per prescription $30 per prescription Tier 3 (non- $60 per prescription $60 per prescription $60 per prescription $60 per prescription $60 per prescription MH/SUD outpatient individual office visits after deductible
4 Ridge Plan Name ML36 HMO ML37 HMO ML35 HMO Part D Creditability Creditable Creditable Creditable HSA Compatible No No No Single/individual family member $4,000 $5,000 $5,000 Family $8,000 $10,000 $10,000 Single/individual family member $1,000 $2,500 $2,500 Family $2,000 $5,000 $5,000 Deductible for (embedded) Single/individual family member $0 $0 $0 Family $0 $0 $0 Specialist office visit Preventive care Outpatient rehabilitation visit Outpatient surgery facility fee $250 per visit $250 per visit $250 per visit Outpatient surgery physician/surgeon fee Diagnostic lab tests Imaging (CT/PET scans, MRIs) Hospitalization physician/surgeon fees $150 per visit $150 per trip Urgent care $10 per prescription $10 per prescription $10 per prescription $30 per prescription $30 per prescription $30 per prescription Tier 3 (non- $60 per prescription $60 per prescription $60 per prescription MH/SUD outpatient individual office visits
5 Vista Plan Name HD16 HDHP HMO HD11 HDHP HMO HD14 HDHP HMO HD12 HDHP HMO Part D Creditability Creditable Creditable Creditable Creditable HSA Compatible Yes Yes Yes Yes Single/individual family member $3,000 $3,000 $4,000 $4,000 Family $6,000 $6,000 $8,000 $8,000 Single/individual family member $1,500/$2,700 (integrated) $1,500/$2,700 (integrated) $2,500/$2,700 (integrated) $2,500/$2,700 (integrated) Family $3,000 (integrated) $3,000 (integrated) $5,000 (integrated) $5,000 (integrated) Deductible for (embedded) Single/individual family member N/A N/A N/A N/A Family N/A N/A N/A N/A Specialist office visit Preventive care Outpatient rehabilitation visit Outpatient surgery facility fee Outpatient surgery physician/surgeon fee Diagnostic lab tests Imaging (CT/PET scans, MRIs) $50 per procedure $50 per procedure $10 per procedure $15 per procedure $50 per admission $250 per day 5 days per 5 days per admission admission Hospitalization physician/surgeon fees $100 per trip $100 per trip Urgent care $10 per prescription $10 per prescription $10 per prescription $30 per prescription $30 per prescription $30 per prescription Tier 3 (non- $60 per prescription $60 per prescription $60 per prescription MH/SUD outpatient individual office visits $50 per admission after $250 per day 5 days per 5 days per deductible admission admission
6 2018 Large Group Endnotes 1. Family deductibles (when applicable) and out-of-pocket maximums (OOPM) are embedded. This means that an individual in a family plan is responsible for no more than the individual family member deductible and OOPM (please see exceptions below regarding highdeductible health plans (HDHPs). Once an individual family member has met their deductible, that family member will only be responsible for the specified copayment or coinsurance until that individual meets the individual family member OOPM or the family as a whole meets the family OOPM, whichever comes first. Deductibles and other cost sharing payments made by each individual in a family accrue to both the family deductible and family OOPM. Once the family deductible has been met, individual family members who have not yet met the individual family member OOPM amount will continue to be responsible for the specified copayment or coinsurance until they meet the individual family member OOPM or until the family as a whole meets the family OOPM, at which point, Sutter Health Plus pays all costs for covered services for all family members. For HDHPs, in a family plan, an individual family member s deductible must be the higher of the specified single deductible amount or the IRS minimum of $2,700 for 2018 plans. Cost sharing for optional benefits elected by a group does not accrue to the deductible or OOPM. 2. Cost sharing amounts for all essential health benefits, including those which accumulate toward an applicable deductible, accumulate toward the OOPM. 3. Non-specialist practitioner office visits include therapy visits, other office visits not provided by either primary care physicians or specialists, or office visits not specified in another benefit category. 4. For prescription drugs, cost sharing applies per prescription for a 30-day supply of prescribed and medically necessary generic or brand name drugs in accordance with formulary guidelines. A 100-day supply is available, at twice the 30-day retail copay price, through the mail order pharmacy. Specialty medications are only available for a 30-day supply through the specialty pharmacy. FDA-approved, self-administered hormonal contraceptives that are dispensed at one time for a member by a provider, pharmacist or other location licensed or authorized to dispense drugs or supplies may be covered for a 12-month supply. Cost sharing for a 12-month supply of contraceptives will be 12 times the retail cost or four times the mail order cost. Member cost sharing for oral anti-cancer drugs shall not exceed $200 per prescription for a 30-day supply. For HDHPs, this applies after the deductible has been met. Prescription drug deductibles, when applicable, and cost sharing contribute toward the annual OOPM. Please consult specific plan designs for any applicable maximum amounts for prescription cost sharing (may not apply to all plan designs). 5. Drugs prescribed for sexual dysfunction have a 50 percent share of cost. For plans with a deductible that applies to prescription drugs, the share of cost is applied after the deductible has been met. Some drugs prescribed for sexual dysfunction are limited to eight doses per 30-day supply. 6. services include, but are not limited to: inpatient psychiatric hospitalization; inpatient chemical dependency hospitalization, including detoxification; mental health psychiatric observation; mental health residential treatment; substance use disorder transitional residential recovery services in a non-medical residential recovery setting; substance use disorder treatment for withdrawal; and inpatient behavioral health treatment for pervasive developmental disorder and autism. There may be separate cost sharing for inpatient professional fees. B
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Best Buy HSA HMO FLEX Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services
Massachusetts Best Buy HSA HMO 3100 - FLEX Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2018 03/31/2018 Coverage for: Individual +
Anthem 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
Your 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
Important Questions Answers Why this Matters:
Anthem BlueCross Classic PPO 250/20/20 / $10/$30/$50/30% Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 10/01/2013-09/30/2014 Coverage For: Individual/Family Plan
Cost if you use a Non-Network Provider. Cost if you use an In-Network Provider. Covered Medical Benefits
Anthem Blue Cross California State University Risk Management Authority Your Plan: Custom Premier HMO 20/200 admit/100 OP (Custom Rx $5/$20/$60/20%) Your Network: California Care HMO This summary of benefits
Schedule of Benefits. Plan Information. Primary Care Provider: $10 Copayment per visit
Schedule of Benefits PPO IA - Premium Network Deductible: $500 / $1,000 Coinsurance: 0% Total Annual Out-of-Pocket: $6,450 / $12,900 Primary Care : $10 Copayment per visit Specialist: $30 Copayment per
Best Buy HSA HMO FLEX Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services
Massachusetts Best Buy HSA HMO 2000 - FLEX Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2018 03/31/2018 Coverage for: Individual +
Anthem Blue Cross and Blue Shield Your Plan: Lumenos Health Savings Account (HSA-Compatible) Plan $ /20 Your Network: PPO
Anthem Blue Cross and Blue Shield Your Plan: Lumenos Health Savings Account (HSA-Compatible) Plan $3500 80/20 Your Network: PPO This summary of benefits is a brief outline of coverage, designed to help
TRS-ActiveCare: ActiveCare Select Aetna Open Access Aetna Select SM Summary of Benefits and Coverage: What this Plan Covers & What it Costs
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.trsactivecareaetna.com or by calling 1-800-222-9205.
Nationwide Life Ins. Co.: Ithaca College Coverage Period: 8/10/13-8/9/14
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.chpstudent.com or by calling 1-800-633-7867. Important
Important Questions Answers Why this Matters:
Anthem BlueCross Solution PPO 1500/15/20 / $15/$30/$50/30% Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 11/01/2014-10/31/2015 Coverage For: Individual/Family
Important Questions Answers Why this Matters: For PPO Providers: $1,500 Member/$3,000 Family For Non-PPO Providers:
Anthem Blue Cross Life and Health Insurance Company ACWA / JPIA: Account Based Health Plan (EV85) Coverage Period: 01/01/2015-12/31/2015 Summary of Benefits and Coverage: What this Plan Covers & What it
Important Questions Answers Why this Matters: What is the overall deductible?
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.denverhealthmedicalplan.org or by calling 1-800-700-8140.
Important Questions Answers Why this Matters: In-network: $0/Individual; $0/Family Out-of-network: $750/Individual; $1,500/Family
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.anthem.com or by calling 1-800-421-1880. Important Questions
NC Aetna Gold PPO /50 NC Aetna Gold PPO /50 NC Aetna Gold PPO /50 NC Aetna Gold PPO /70 HSA Umb
PPOMedical NC 01/01/2016 NC Aetna Gold PPO 500 80/50 NC Aetna Gold PPO 1000 80/50 NC Aetna Gold PPO 1500 80/50 NC Aetna Gold PPO 1750 100/70 HSA Umb Plan year (Individual/Family) /$1,000 $3,000/$6,000
Anthem Blue Cross University of the Pacific Student Health Plan PPO with Student Health Center (100/80/60) Coverage Period: 08/01/ /31/2016
Anthem Blue Cross University of the Pacific Student Health Plan PPO with Student Health Center (100/80/60) Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 08/01/2015-07/31/2016
What is the overall deductible? Are there other deductibles for specific services?
Regence BlueShield: Innova Coverage Period: 08/01/2016 07/31/2017 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual and Eligible Family Plan Type: PPO This
Important 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.crystalrunhp.com or by calling 1-844-638-6506. Important
Important 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.etf.wi.gov or by calling 1-877-533-5020. Important Questions
$0 See the chart starting on page 2 for your costs for services this plan covers.
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.hap.org or by calling 1-800-422-4641. Important Questions
Anthem Blue Cross University of Southern California Modified Classic Choice HMO 30/40 Coverage Period: 01/01/ /31/2014
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.anthem.com/ca or by calling 1-800-888-8288. Important
: Lewis & Clark College
: Lewis & Clark College All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest Coverage Period: 04/01/2013-03/31/2014 Summary of Benefits and Coverage: What this Plan Covers
GEORGIA. CIGNA health savings plans. Health and Pharmacy Benefits c GA 07/ CIGNA
GEORGIA Individual & Family Plans CIGNA health savings plans Health and Pharmacy Benefits PLAN comparison 822163c GA 07/10 2010 CIGNA CIGNA HealthCare plans, offered through Connecticut General Life Insurance
Anthem Blue Cross Your Plan: Modified Premier HMO 15/100% (Essential formulary $5/$15/$25/$45/30%) Your Network: California Care HMO
Anthem Blue Cross Your Plan: Modified Premier HMO 15/100% (Essential formulary $5/$15/$25/$45/30%) Your Network: California Care HMO This summary of benefits is a brief outline of coverage, designed to
Student Health Insurance Plan Insurance Company Coverage Period: 08/01/ /31/2016
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.studentplanscenter.com or by calling 1-800-756-3702.
COPAYMENT Plans What is a copayment plan? How does it work? Features at a glance
COPAYMENT Plans What is a copayment plan? How does it work? Features at a glance MEET Ken and May Park 1 Ken and May have one child Lee, age 4. They are looking for a health care plan that features low
Nationwide Life Insurance Co.: University of Southern Maine (International) Coverage Period: 8/1/13-7/31/14
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.chpstudent.com or by calling 1-800-633-7867. Important