VEHI Health Plans EFFECTIVE 1/1/2018
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1 VEHI Health Plans EFFECTIVE 1/1/2018
2 Overview New VEHI Health Plans All four plans: Cover the same benefit services Use the same national BCBS network Are supported by the VEHI wellness program (PATH) Have lower premiums than the current array of VEHI plans
3 Medical & Rx Services Categories of Essential Benefits Hospitalization: In-Patient/Out-Patient Care/Surgical Covered Physician Services Maternity Care Diagnostic & Therapy Services Physician Visits: Primary & Preventive Care, Physical Exams & Immunizations Specialty Care Diagnostic Care Physical/Speech/Occupational Therapies OB-GYN Care: Gynecological Care Prenatal & Post-Natal Care Current VEHI Plans Emergency Room & Urgent Care Facility Yes Yes Infertility Treatments Yes No Ambulance Service: To nearest facility in emergency Non-emergency transfers Home Care: Skilled Nursing Visits Private Duty Nursing Short-term Therapy in Home Chiropractic Care Yes Yes Medical Supplies & Equipment Yes Yes Mental Health & Substance Abuse Care: Inpatient / Outpatient Prescription Drugs: FDA-Approved Drugs and Antigens prescribed by doctor Diabetic Supplies, including test strips, insulin and syringes Vision Exams Yes Yes Yes Yes Yes Yes Yes (Sexual dysfunction drugs covered) Only in VHP Future VEHI Plans Yes Yes Yes Yes Yes Yes Yes (Sexual dysfunction drugs not covered) Yes now on all plans (adult and children)
4 National/International Network Same network for all plans in 2018 The Exclusive Provider Organization (EPO) Network provides you with the same great network in Vermont, as well as Access to any National and International BlueCard network provider Must use a BCBS provider, unless You are in an urgent or emergent situation You receive prior approval to see a non-network provider 96% of VEHI subscribers stayed within this network over the past year. Find a provider at: All members must designate a Primary Care Provider (PCP)
5 Final Approved Rates January 1, 2018 June 30, 2018 Monthly Rates FY 18 Single Parent/ Child(ren) Two-Person Family VEHI Platinum $ $1, $1, $1, VEHI Gold $ $1, $1, $1, VEHI Gold CDHP $ $ $ $1, VEHI Silver CDHP $ $ $ $1, Current Rates FY 17 Single Parent/ Child(ren) Two-Person Family VHP $ n/a $1, $1,982.66
6 New tier level Parent/Child(ren) All of VEHI s new plans will now offer a Parent & Child(ren) coverage tier for employees with 1 or more children on the policy, who are not covering another adult on the policy Less expensive than a two-person or family tier VEHI/BCBSVT will automatically transition eligible employees and their children to these plans during the implementation; however, please let VEHI/BCBSVT know if anyone has been missed.
7 How is Out-of-Pocket Calculated? All copayments, deductible and co-insurance are counted toward the annual out-ofpocket maximum. If the maximum is reached, all out-of-pocket costs stop for the rest of the calendar year. Deductible Copayments Co-insurance Out-of-pocket Maximum
8 Out-of-pocket Maximum Ranges (per calendar year) Single Family Federal Allowance 2017 $7,150 $14,300 VEHI OOPM Range 2018 $2,500 - $4,000 $5,000 - $8,000 VHC OOPM Range 2017 $2,500 - $7,150 $5,000 - $14,300
9 Health Plans Member Cost Share Member Cost Share Member Cost Share Cost Share HRA or HSA Compatible HRA HRA HRA/HSA HRA/HSA Medical Deductible $500/$1,000 $1,200/$2,400 $1,800/$3,600 (aggregate) $3,000/$6,000 Medical Out of Pocket Maximum $1,500/$3,000 $1,800/$3,600 $2,500/$5,000 (aggregate) $4,000/$8,000 Prescription Deductible $0 $0 Included in medical deductible Included in medical deductible Prescription Out of Pocket Maximum $1,300/$2,600 $1,300/$2,600 $1,300/$2,600 (aggregate) (included in Medical OOPM) $1,300/$2,600 (aggregate) (included in Medical OOPM) Total Out of Pocket Exposure (Medical and Rx) $2,800/$5,600 $3,100/$6,200 $2,500/$5,000 (aggregate) $4,000/$8,000 Preventive PCP Visit $0 $0 $0 $0 Primary Care Physician / Mental Health or Substance Abuse Visit $25 $25 Deductible, then 20% coinsurance Deductible, then 20% coinsurance Specialist Visit $35 $35 Deductible, then 20% coinsurance Deductible, then 20% coinsurance Urgent Care Facility $75 Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance Emergency Room $250 Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance Inpatient, Outpatient, Radiology, DME, Ambulance, etc. Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance Generic tier 1 / tier 2 / Brand / NP Brand $4 / $10 /$20 / 50% $4 / $10 /$20 / 50% Deductible, then 20% coinsurance Deductible, then 20% coinsurance Wellness Prescriptions $4 / $10 /$20 / 50% $4 / $10 /$20 / 50% No member cost No member cost
10 VEHI Platinum & Gold All copayments, deductible and co-insurance are counted toward the annual out-of-pocket maximum. In these plans, medical costs and pharmacy costs are tracked separately. If the maximum is reached for medical care, all medical out-of-pocket costs stop for the rest of the calendar year. If the maximum is reached for pharmacy, all pharmacy out-of-pocket costs stops for the rest of the calendar year. Deductible Rx Copayments Rx Co-insurance Copayments Co-insurance Medical Out-of-pocket Maximum Prescription Out-of-pocket Maximum
11 VEHI Platinum Member Cost Share Medical Deductible $500 / $1,000 Medical Out of Pocket Maximum $1,500 / $3,000 Prescription Deductible $0 Prescription Out of Pocket Maximum $1,300 / $2,600 Total Out of Pocket Exposure (Medical and Rx) $2,800 / $5,600 Preventive PCP Visit $0 Primary Care Physician / Mental Health or Substance Abuse Visit $25 Specialist Visit $35 Urgent Care $75 Emergency Room $250 Inpatient, Outpatient, Radiology, DME, Ambulance, etc. Deductible, then 20% coinsurance Generic tier 1 / Generic tier 2 (new) $4 / $10 Preferred / Non-Preferred Brand $20 / 50% Monthly Rates Single Two Person (Two Adults) Parent & Child(ren) (new) Family VEHI Platinum (FY 18) $ $1, $1, $1, VEHI VHP (FY 17 ) $ $1, n/a $1,982.66
12 VEHI Gold Member Cost Share Medical Deductible $1,200 / $2,400 Medical Out of Pocket Maximum $1,800 / $3,600 Prescription Deductible $0 Prescription Out of Pocket Maximum $1,300 / $2,600 Total Out of Pocket Exposure (Medical and Rx) $3,100 / $6,200 Preventive PCP Visit $0 Primary Care Physician / Mental Health or Substance Abuse Visit $25 Specialist Visit $35 Urgent Care Emergency Room Inpatient, Outpatient, Radiology, DME, Ambulance, etc. Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance Generic tier 1 / Generic tier 2 (new) $4 / $10 Preferred / Non-Preferred Brand $20 / 50% Monthly Rates Single Two Person (Two Adults) Parent & Child(ren) (new) Family VEHI Gold ( FY 18) $ $1, $1, $1, VEHI VHP (FY 17) $ $1, n/a $1, VEHI $1,200 (FY 17) $ $1, n/a $1,586.30
13 VEHI Gold & Silver CDHP All copayments, deductible and co-insurance are counted toward the annual out-ofpocket maximum. Medical and pharmacy costs are tracked together, although the pharmacy has a lower, embedded cap. If the maximum is reached, all out-of-pocket costs stop for the rest of the calendar year. Medical & Rx Deductible Medical & Rx Co-insurance $20 Vision Copay Out-of-pocket Rx Out-of-Pocket Maximum Maximum
14 VEHI Gold CDHP (default plan) Member Cost Share Medical Deductible (Aggregate) $1,800 / $3,600 Medical Out of Pocket Maximum $2,500 / $5,000 Prescription Deductible Prescription Out of Pocket Maximum Included in medical deductible $1,300 / $2,600 (included in Medical OOPM) Total Out of Pocket Exposure (Medical and Rx) $2,500 / $5,000 Preventive PCP Visit $0 Primary Care Physician / Mental Health or Substance Abuse Visit Specialist Visit Urgent Care, Emergency Room Inpatient, Outpatient, Radiology, DME, Ambulance, etc. Generic or Brand drugs Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance Wellness drugs (new) Monthly Rates Single Two Person (Two Adults) No member cost Parent & Child(ren) (new) Family VEHI Gold CDHP (FY 18) $ $ $ $1, VEHI VHP (FY 17) $ $1, n/a $1, VEHI $1,800 (FY 17) $ $1, n/a $1,586.30
15 VEHI Silver CDHP Member Cost Share Medical Deductible $3,000 / $6,000 Medical Out of Pocket Maximum $4,000 / $8,000 Prescription Deductible Prescription Out of Pocket Maximum Included in medical deductible $1,300 / $2,600 (included in Medical OOPM) Total Out of Pocket Exposure (Medical and Rx) $4,000 / $8,000 Preventive PCP Visit $0 Primary Care Physician / Mental Health or Substance Abuse Visit Specialist Visit Urgent Care, Emergency Room Inpatient, Outpatient, Radiology, DME, Ambulance, etc. Generic or Brand drugs Wellness drugs (new) Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance Deductible, then 20% coinsurance No member cost Monthly Rates Single Two Person (Two Adults) Parent & Child(ren) (new) Family VEHI Silver CDHP (FY 18) $ $ $ $1, VEHI VHP (FY 17) $ $1, n/a $1, VEHI $1,800 (FY 17) $ $1, n/a $1,586.30
16 Out-of-pocket Costs Out-of-pocket Costs (OOP) (eg: copayments, deductibles and coinsurance) are present in all four plans- but in differing amounts and for different benefit services. Higher premium plans have lower medical out-of-pocket maximums. OOP costs apply only when health care benefit services are used. OOP costs are capped on a calendar year basis - there is a maximum OOP cost in medical and pharmacy for each plan. The family pharmacy OOP maximum is the same across plans, while the medical OOP maximum differs. (Pharmacy OOP is aggregate on the CDHPs) There is no out-of-pocket cost sharing for preventive services in any of the plans. There is no out-of-pocket cost sharing for wellness prescriptions in the Gold CDHP or Silver CDHP. There is no out-of-pocket cost sharing for diabetic medications or supplies in any of the plans.
17 Payment for services Services that require copayments are expected to be paid at the time of service. Pharmacy copayments or deductible/coinsurance are also expected at the time of sale. Deductibles and coinsurance are normally collected after the claim has been processed and adjudicated by BCBSVT. A remittance advice is sent to the provider An Explanation of Benefits is sent to the member The provider then bills the member for the service based on the allowed amount, and the amount of the member s cost-share The provider may ask for some payment up front if they confirm that the member has a large deductible to meet. If an HRA or HSA with automatic payment to the provider is in place, the member should work with the provider to wait for the claim to process.
18 Stacked vs Aggregate Deductibles Family Gold Policy Deductible Examples $4,000 $3,500 Annual Family Ded $3,600 No per-member cap $3,000 $2,500 $2,000 $1,500 $3,600 Annual Family Ded $2,400 Capped at $1,200 per member $600 $600 $1,000 $500 $1,200 $0 Gold CDHP (Aggregate) Gold (Stacked)
19
20 Claim Example: VEHI Gold CDHP (Aggregate) VEHI Silver CDHP (Stacked) In this example our Member is on twoperson plan and incurs a $10,000 claim. The Dependent of the Member later has a $1,500 claim. $1,800/$3,600 deductible $2,500/$5,000 out-of-pocket max Member has $10,000 claim Member meets the $3,600 aggregate deductible Member is responsible for 20% of the remaining $6,400 (up to $1,400) = $1,280 Member has paid $4,880 toward the outof-pocket maximum Dependent of Member later has a $1,500 claim The Member had met the entire deductible, and most of the out-of-pocket maximum. Dependent of Member only has to pay 20% on their claim up to $120 to meet the family aggregate out-of-pocket maximum. All further claims for either member or dependent would be covered at 100% for the remainder of the calendar year. Total out-of-pocket cost $5,000 $3,000/$6,000 deductible $4,000/$8,000 out-of-pocket max Member has $10,000 claim Member meets the $3,000 stacked deductible Member is responsible for 20% of the remaining $7,000 (up to $1,000) = $1,400 Member has paid $4,000 toward their outof-pocket maximum All further claims for the Member would be covered at 100% for the remainder of the year. Dependent of Member later has a $1,500 claim The Dependent has not met their deductible, so the entire $1,500 claim goes toward their $3,000 deductible. The Dependent would still be responsible for their claims until their deductible was met, and then would be responsible for 20% up to the out-of-pocket maximum. With an additional exposure of $2,500. Total out-of-pocket cost $5,500
21 Prescription out-of-pocket maximums On the VEHI Platinum and Gold copayment-style plans: your out-of-pocket maximum for prescriptions is stacked (no one member has to pay more than $1,300 in a calendar year) On the VEHI Gold CDHP and Silver CDHP plans: the prescription benefits are always aggregate even on the Silver plan this does not apply to the single plan, only the two-person, parent/child(ren) and family plans two-person, parent/child(ren) and family plans must meet the entire $2,600 before the out-of-pocket maximum is met, and the entire family will receive 100% prescription coverage for the remainder of the calendar year the prescription benefits are aggregate to meet IRS requirements of HSA eligibility
22 Wellness Prescriptions Applicable to the Gold CDHP & Silver CDHP plans only Prescription drugs on the Wellness Rx list are not subject to deductible, and are covered at 100% coverage Categories on the Wellness Rx list include: Asthma/COPD Diabetes Hyperlipidemia Hypertension Osteoporosis Prenatal Please note that not all prescriptions under the categories are covered at 100% A full list of 100% covered Wellness medications can be found at Please note: Platinum/Gold non-cdhp plans are subject to copay/coinsurance except for diabetic medications
23 Pre-2018 Coverage for Diabetes VHP JY Plan Comprehensive CDHP $1,800 Diabetic Medications obtained through the prescription drug benefit Diabetic supplies ( e.g. Test strips, Insulin and Syringes) obtained through the prescription drug benefit Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Diabetic Durable Medical Equipment (DME) (e.g. Pump, Continuous Glucose Monitor) Covered at 100% Covered at 100% Subject to ded/coins Subject to ded/coins
24 Post-2018 Coverage for Diabetes Diabetic Medication on the Wellness Rx list Diabetic Medication NOT the on Wellness Rx list Diabetic supplies ( e.g. Test Strips, Insulin and Syringes) obtained through the prescription drug benefit Diabetic Durable Medical Equipment (e.g. Pump, Continuous Glucose Monitor) VEHI Platinum VEHI Gold VEHI Gold CDHP VEHI Silver CDHP Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Covered at 100% Subject to ded/coins Subject to ded/coins
25 Preventive Care Coverage The Affordable Care Act (ACA) expanded the coverage of preventive care below are examples of benefits that are covered at 100% on all VEHI health plans. For example: Annual exam for all family members Well-baby and well child office visits Immunizations Colorectal screening Services for women also include: Annual OBGYN exam and pap test Screening mammogram Generic oral birth control, as well as implantable and injectable contraceptives Standard breast pump from a durable medical equipment network provider Lactation support from a network lactation consultant For a full list of covered services, please see scroll down to step 3 and you ll find the link to the ACA preventive care list
26 Primary Care Provider vs Specialist Primary Care Provider A provider who was selected by a member of a managed care team to manage all aspects of his or her health care. The following types of providers are eligible to be a PCP: general practice, internal medicine, family practice, pediatrician, geriatrics, naturopath, or nurse practitioner. Specialist A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. A non-physician specialist is a provider who has more training in a specific area of health care. Important note: if your PCP is unavailable, there should be a cross-covering provider made available to you. Seeing another PCP (who is not designated to cross-cover) will process as a Specialist Visit.
27 Important Reminders Employees may enroll in any of the four VEHI health plans and can switch plans once per year during the employer s open enrollment period. Enrollment information for 1/1/18 is needed from the school district by 11/15/17 If enrollment information is not received by 11/15/17, employees will be moved to the VEHI Gold CDHP Plan Employees can also switch health plans mid-year if they have a life event (marriage, birth, adoption) New Parent & Child(ren) tier comes into effect for 1/1/18 *If negotiated
28 Cost Exposures
29 Combined Cost Exposure for a Single Plan Single Plans $12,000 $10,000 $8,000 $2,800 $3,100 $2,500 $4,000 $6,000 $4,000 $2,000 $7,891 $7,475 $6,279 $5,476 $0 VEHI Platinum VEHI Gold VEHI Gold CDHP VEHI Silver CDHP Premium Out of Pocket Exposure
30 Combined Cost Exposure for a Two-Person Plan $25,000 Two-Person Plans $20,000 $5,600 $6,200 $15,000 $5,000 $8,000 $10,000 $5,000 $15,781 $14,951 $11,793 $10,952 $0 VEHI Platinum VEHI Gold VEHI Gold CDHP VEHI Silver CDHP Premium Out of Pocket Exposure
31 Combined Cost Exposure for a Parent/Child(ren) Plan $20,000 $18,000 $16,000 $14,000 $12,000 $10,000 $8,000 $6,000 $4,000 $2,000 $0 Parent/Child(ren) Plans $5,600 $6,200 $8,000 $5,000 $13,194 $12,510 $9,708 $9,231 VEHI Platinum VEHI Gold VEHI Gold CDHP VEHI Silver CDHP Premium Out of Pocket Exposure
32 Combined Cost Exposure for a Family Plan $30,000 Family Plans $25,000 $5,600 $6,200 $20,000 $5,000 $8,000 $15,000 $10,000 $22,322 $21,161 $17,394 $15,583 $5,000 $0 VEHI Platinum VEHI Gold VEHI Gold CDHP VEHI Silver CDHP Premium Out of Pocket Exposure
33 VEHI Member Claims Data NO CLAIMS 8% $ % $2500-$ % $1800-$2499 8% $1500-$1799 4% $0.01-$ % Information is based on all VEHI membership (subscribers and their dependents). Claims incurred in calendar year 2015, paid through February Call customer service for your personalized claims history at Or visit our Member Resource Center at
34 Healthcare Spending Accounts
35 Tax-Favored Funding Arrangements Available Health Savings Account (HSA) Health Reimbursement Arrangement (HRA) Flexible Spending Account (FSA) VEHI does not in any way endorse specific health care plan options or cost-sharing arrangements. Decisions about health care plans, funding arrangements, costsharing mechanisms, and related salary considerations are made through collective bargaining between school districts and local unions. VEHI shares information about the use of HRAs, HSAs and FSAs in order to ensure parties have access to information about the options available and to secure cost-effective pricing for administering these plans through a third-party vendor.
36 Health Savings Account (HSA) Must be paired with a Consumer-Directed Health Plan (or CDHP) per IRS regulations Can be funded by the employee and/or employer, if negotiated. Money deposited pre-tax, grows pre-tax and withdrawn pre-tax for qualified expenses HSA dollars can be used to pay for member s share of cost Accounts and funds belong to the employee (No use it or lose it ) Accounts stay with employee even after employment ends
37 Health Reimbursement Arrangement (HRA) Eligible to be paired with any health plan Employer owned account Promise to pay funded by the employer pre-tax Can cover deductibles, copayments or coinsurance as determined in collective bargaining
38 Flexible Spending Account (FSA) Generally funded by the employee Election done before the beginning of the plan year plan accordingly Typically has use it or lose it provisions Medical FSAs can be used in conjunction with an HRA Limited-purpose FSAs can be used in conjunction with an HSA (covers dental, eye-glasses or contacts)
39 More Information on VEHI Website Including Health Care Spending Accounts Webinars
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More information$300 Individual; $ 800 Family. Applies to out-of-network services only. What is the overall deductible?
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.indecscorp.com or by
More informationAnthem BlueCross BlueShield MMEBG HSA 2 Lumenos Health Savings Accounts (Blue Preferred Select) Coverage Period: 07/01/ /30/2017
Anthem BlueCross BlueShield MMEBG HSA 2 Lumenos Health Savings Accounts (Blue Preferred Select) Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 07/01/2016-06/30/2017
More informationPLAN DESIGN AND BENEFITS - NYC Community Plan SM 6-11 PARTICIPATING PROVIDER REFERRED*
Aetna Health Inc. for Referred Benefits Plan Effective Date: 10/1/2011 PLAN FEATURES Deductible (per calendar ) $5,000 Individual $15,000 Family Unless otherwise indicated, the Deductible must be met prior
More informationCentral State University Student Health Plan Coverage Period: 8/11/13-8/10/14
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
More informationImportant Questions Answers Why this Matters:
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family Plan Type: PPO This is only a summary. If you want more detail about your coverage and costs, you
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.crystalrunhp.com or by calling 1-844-638-6506. Important
More informationWhat 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
More informationImportant Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
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.avmed.org/go/state or by calling 1-888-762-8633 Important
More informationCustom Extrusion, Inc.: Non-Grandfathered Coverage Period: 7/1/15 6/30/16
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.chpbenefits.com or by calling 1-800-633-7867. Important
More informationRegence BlueShield : HSA 2.0
Regence BlueShield : HSA 2.0 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 10/01/2016-09/30/2017 Coverage for: Individual and Eligible Family Plan Type: PPO This
More informationImportant Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
Exclusive Care: Plan Coverage Period: 01/01/2019 12/31/2019 This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the Summary Plan Document at
More informationARUP Laboratories, Inc. EPO Medical 750 Plan Coverage Period: 01/01/ /31/2017
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.uhealthplan.utah.edu/aruplabs/ or by calling 1-888-271-5870.
More informationCalifornia Natural Products: EPO Option Coverage Period: 01/01/ /31/2017
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.deltahealthsystems.com or by calling 1-209-858-2525 Ext
More informationEmployee Benefit Plan: Missoula County Public Schools Coverage Period: 01/01/ /31/2014 Summary of Benefits and Coverage:
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Plan Type: HDHP This is only a summary. If you want more detail about your coverage and costs, you can get
More informationIU Health Plans: Southern Indiana Physicians HSA Medical Saver Plan Coverage Period: 01/01/ /31/2018 Summary of Benefits and Coverage:
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.myiuhealthplans.com or by calling 1.866.895.5975. Important
More informationCovered 100% 20% 1 exam per 12 months for members age 18 and older.
PLAN FEATURES NON- Deductible (per calendar year) $1,200 Individual $2,000 Individual $3,600 Family $6,000 Family All covered expenses, excluding prescription drugs, accumulate toward both the preferred
More informationNationwide Life Insurance Co.: Oral Roberts University 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
More informationNot applicable Optional. CHE PREFERRED CARE (Home Host) Covered 100%
PLAN FEATURES Catholic Health East PROVIDED BY LIFE INSURANCE COMPANY Deductible (per calendar year) Unless otherwise indicated, the Deductible must be met prior to benefits being payable. Once Family
More informationSchedule of Benefits. Plan Information Participating Provider Non-Participating Provider
Schedule of Benefits Panther Basic HSA PPO - Premium Network Deductible: $1,500 / $3,000 Coinsurance: 30% Total Annual Out-of-Pocket: $5,000 / $10,000 Primary Care Provider: 30% after Deductible Specialist:
More informationEven though you pay these expenses, they don t count toward the outof-pocket limit.
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.summit-inc.net or www.yctrust.net or by calling Summit
More informationImportant 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
More informationHealthTrust: Access Blue 20-RX10/20/45 Coverage Period: 07/01/ /30/2017
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 1-800-870-3122. Important Questions
More informationAvMed In-Network Tier A Providers: $1,500 individual / $3,000 family AvMed In-Network Tier B Providers: 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.avmed.org or by calling 1-800-477-8768. Important Questions
More informationPLAN DESIGN AND BENEFITS - PA POS HSA COMPATIBLE NO-REFERRAL 2.4 ($2,500 Ded) PARTICIPATING PROVIDERS
PLAN FEATURES Deductible (per plan year) $2,500 Individual NON- $5,000 Individual $5,000 Family $10,000 Family Unless otherwise indicated, the Deductible must be met prior to benefits being payable. All
More informationImportant 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.
More informationSummary of Coverage. $6,350 / $12,700 (Includes Deductibles, Copays and Coinsurance Amounts) Preventive Care Covered at 100%
Benefits for 2017-2018 Medical Summary of Coverage Plan Features Blue Care Network HMO HRA IN NETWORK Purchased Deductible * Employee Deductible * $4,000 individual / $8,000 family * $500 individual /
More informationUFCW: Self-Funded Comprehensive Medical Plan Two Coverage Period: 03/01/ /31/2017 Summary of Benefits and Coverage:
This is only a summary. If you want more detail about your medical coverage and costs, you can get the complete terms in the policy or plan document at www.hma-hi.com or by calling 1-866-331-5913. If you
More informationNationwide Life Ins. Co.: Cape Cod Academy Coverage Period: 9/1/13-8/31/14
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
More informationThis 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
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.networkhealth.com/benefits/sbc/individualpolicy.pdf or
More informationImportant Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
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.empireblue.com or by calling 1-800-342-9816. Important
More informationNationwide Life Insurance Co.: University of Southern Maine (Domestic) Coverage Period: 8/15/13 8/14/14
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
More informationImportant Questions Answers Why this Matters:
Amtrust Financial Services: Lumenos Health Savings Accounts Enhanced Plan - Non- Embedded Coverage Period: 03/01/2016-12/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs
More informationAnthem Blue Cross Blue Shield: Anthem Silver DirectAccess - cbka 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 or by calling 1-888-231-5046. Important Questions
More informationLourdes Health System Proposed Effective Date: Aetna Helathfund Aetna Choice POS ll - ASC Salary Band: Less than $21,000 to $41,999
PROVIDED BY LIFE INSURANCE COMPANY FUND FEATURES HealthFund Amount $750 Employee $1,500 Employee + Spouse $1,500 Employee + Child(ren) $1,500 Family Amount contributed to the Fund by the employer Fund
More informationIndividual Plan: Silver HDP 1 Coverage Period: 01/01/ /31/2014
Depending on your income, you may qualify for one of the following Cost Share Reduction plans: Cost Sharing Reduction Plan 100-150% Federal Poverty Level Cost Sharing Reduction Plan 151-200% Federal Poverty
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.careconnect.com or by calling 1-855-706-7545. Important
More informationWhat is the overall deductible? Are there other deductibles for specific services? Is there an out-of-pocket limit on my expenses?
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.nhp.org or by calling Customer Service at 1-866-414-5533
More informationBMC HealthNet Plan: Bronze Saver/Bronze Low Coverage Period: 08/01/ /31/2013 Summary of Benefits and Coverage:
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.bmchp.org or by calling 1-877-492-6967. Important Questions
More informationThis 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
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.summacare.com or by calling 1-800-996-8701. Important
More informationCoverage for: Individual Plan Type: POS. Important Questions Answers Why this Matters: In network: $0 Out-of -network: $300 Individual; $600 Family
Doctors Community Hospital BlueChoice Opt-Out Plus OA Coverage Period: 01/01/2016 12/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Plan Type:
More informationCalifornia Small Group MC Aetna Life Insurance Company
PLAN FEATURES Deductible (per calendar year) $5,000 Individual $10,000 Family Unless otherwise indicated, the Deductible must be met prior to benefits being payable. All covered expenses accumulate toward
More informationEmergency Department: $175 Copayment per visit Coinsurance: 0%
Schedule of Benefits UPMC Small Business Advantage Primary Care Provider: $25 Copayment per visit Gold PPO $1,000 $25/$50 - Premium Network Specialist: $50 Copayment per visit Deductible: $1,000 / $2,000
More informationStudent 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.
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 https://eoc.anthem.com/eocdps/fi or by calling 1-800-542-9402.
More informationVersion: 15/02/2017 [ TPID: ] Page 1
PLAN FEATURES NETWORK CARE OUT-OF-NETWORK CARE Primary Care Physician Selection Not required Not required Deductible (per calendar year) $1,500 Individual $3,000 Family $3,000 Individual $9,000 Family
More informationSome of the services this plan doesn t cover are listed on page 6. See your policy or plan Yes. plan doesn t cover?
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.nslijcareconnect.com or by calling 1-855-706-7545. Important
More informationRoger Williams University-Facilities BlueChip Health Reimbursement Arrangement Coverage Period: 07/01/ /30/2019
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.bcbsri.com or by calling 1-800-639-2227 or (401) 459-5000.
More informationRegence BlueShield: Engage 70 Coverage Period: 11/01/ /31/2017
Regence BlueShield: Engage 70 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 11/01/2016 10/31/2017 Coverage for: Individual and Eligible Family Plan Type: PPO
More informationAvMed Network: $1,500 individual / $3,000 family Doesn t apply to preventive care. 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.avmed.org or by calling 1-800-376-6651. Important Questions
More informationImportant Questions Answers Why this Matters:
Anthem BlueCross BlueShield Lumenos Health Savings Account (with copays) Option 1 Rx 9 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 10/01/2014-09/30/2015 Coverage
More informationNationwide Life Ins. Co.: SUNY Maritime College Coverage Period: 8/11/13 8/10/14
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
More informationQuote Effective: 04/01/ /30/2019 Version Updated: 01/07/2019
Quote Effective: 04/01/2019-06/30/2019 Version Updated: 01/07/2019 Print Package: HIOS ID (Enrollment Code) 78124NY1000265-00 (SON5) Plan Name: Rating Region: Rate Rochester For the Benefits described
More informationEnhancedBlue SM Gold 1000 PPO
EnhancedBlue SM Gold 1000 PPO Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2016 12/31/2016 Coverage for: Single & Family Plan Type: PPO This is only a
More informationWhat is the overall deductible? Are there other deductibles for specific services?
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.avmed.org or by calling 1-800-376-6651. Important Questions
More informationPLAN DESIGNS AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY INC
Aetna Pharmacy Management Custom RX PLAN FEATURES Deductible (per calendar year) $250 Deductible Unless otherwise indicated, the Deductible must be met prior to benefits being payable. Member Coinsurance
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.landoflincolnhealth.org or by calling 1-888-858-9130.
More informationAnthem Blue Cross: Anthem Silver DirectAccess, a Multi-State Plan 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 1-855-333-5730. Important
More informationImportant Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
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.myscrippshealthplan.com or by calling 1-877-552-7247.
More informationBoard of Huron County Commissioners : HSA
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 MedMutual.com/SBC or by calling 800.540.2583. Important Questions
More informationSalve Regina University: Companion Life Coverage Period: 8/15/13 8/15/14
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
More informationCalifornia Small Group MC Aetna Life Insurance Company NETWORK CARE
PLAN FEATURES Deductible (per calendar year) Unless otherwise indicated, the Deductible must be met prior to benefits being payable. All covered expenses accumulate toward the preferred and non-preferred
More informationImportant Questions Answers Why this Matters:
Anthem BlueCross BlueShield Lumenos Health Savings Account Option 51 Rx 9 What this Plan Covers & What it Costs Coverage Period: 01/01/2013-12/31/2013 Individual/Family CDHP This is only a summary. If
More informationAnthem BlueCross BlueShield MMEBG HSA 2 Lumenos Health Savings Accounts (Blue Preferred Select) Coverage Period: 07/01/ /30/2016
Anthem BlueCross BlueShield MMEBG HSA 2 Lumenos Health Savings Accounts (Blue Preferred Select) Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 07/01/2015-06/30/2016
More informationAnthem Blue Cross University of Southern California Modified Premier HMO 20 Coverage Period: 01/01/ /31/2014 Summary of Benefits and Coverage:
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
More information