Story Transcript
2023 BENEFITS GUIDE LACLEDE COUNTY R-I
CONTACT INFORMATION Phone: 1 ( 417) 893. 8437 Em ai l : i nf o@hpm g- l l c. com
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TABLE OF
CONTENTS OVERVIEW WHAT YOU NEED TO KNOW............................................ 4 GLOSSARY OF INSURANCE TERMS................................ 6-7 BENEFITS HEALTH INSURANCE....................................................... HEALTH INSURANCE RATES........................................... DENTAL INSURANCE....................................................... VISION INSURANCE........................................................ GROUP TERM LIFE INSURANCE...................................... VOLUNTARY GROUP TERM LIFE INSURANCE............... ACCIDENT INSURANCE.................................................... CRITICAL ILLNESS............................................................ HOSPITAL INDEMNITY INSURANCE................................ NOTES.................................................................................
8-15 16-18 19-21 22 23 24 25-28 29 30 31
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WHAT YOU NEED TO KNOW Em ploye es under co nt ra c t wh o wo r k a m in im u m o f 3 0 h o u r s pe r w e e k a r e el ig ible to e nroll th em selves a n d t h eir q u a lified d e pe n d e n ts i n a ppl i c a bl e Lacle de Count y S ch o o l Dist r ic t em p lo y ee b en efit s . E mpl oye e s mu s t be ac tive ly at wor k to en ro ll in b en efit s. Ch eck l ist of what to br in g fo r o p en en ro llm ent fo r ea c h d e pe n d e nt th at yo u a re en rol l ing in eligible be n efit s: 1. 2. 3.
S o cia l S e cur it y Num b er Ad dress Date of Bir t h
Hav in g the se items will exp ed it e t h e co m p let io n o f a ll e n r o l l me n t f o r ms , b en ef icia ry ca rds, e t c.
I f you are a cur re nt e m p loyee ( n o t a n ew h ire) , p lea se k e e p th e fo l l ow i n g in for m at io n in mind: •
You ca nnot ma k e an y c h a n ges u n t il t h e a n n u a l “ o pe n e n r o l l me n t pe r i o d ”, w hich a llows e mpl o y ees wh o m a y h a ve p revio u sly d e c l i n e d to e n r o l l th e opport unity t o e nro ll in n ew c o vera ge. (C ert a in re s tr i c ti o n s a n d l i mi tati o n s m ay a pply t o e mpl o y ees wh o in it ia lly d eclin ed c o v e r a g e w h e n th e y f i r s t b eca me e lig ible to en ro ll.) ○
Howe ve r, t he re are c ert a in q u a lify in g even t s t h at a l l o w c u r r e n t e mpl o y e e s to ma k e be ne fit c h a n ges. T h ese in c lu d e, b u t a re n o t l i mi te d to : »
ma rria g e , divorc e, a d o p t io n o r b irt h o f c h ild , d e a th o f a s po u s e o r o th e r e lig ible depen d en t .
You mig ht see the se b oxes o n cer t a in p a ges. Here’s w h at th e y me a n :
EC
E m p l oyer Co ntr ibutio n - yo ur em pl oyer co ntr ibutes a percentage to your prod uc t prem iu m s
ER
E m p l oyer Pa id - yo ur em pl oyer cover s 100% o f th e cost of your prod uc t
NH
N ew H ire E l igibl e - if yo u a re a n ew h ire fo r th e dis tr i c t, you are eli gi ble for this benef it
DISCLAIMER: This benefit summary is provided for illustrative purposes only and is simply an overview of your benefits. For a detailed explanation for each policy you should review a copy of the actual policy on file with the Human Resources Department or you may specifically request a copy of each policy from Educational Benefits.
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WELCOME TO OPEN ENROLLMENT
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GLOSSARY
OF INSURANCE TERMS An n ua l M a x imum - th e to t a l d o lla r a m o u nt t h at a p lan w i l l pay fo r c a re in cur re d by a n indivi d u a l en ro llee o r fa m ily ( u n d er a f a mi l y pl a n ) i n a s pe c i f i e d b en efit pe r iod. B en efit Yea r - a per iod in wh ic h covered exp en ses a re a cc r u e d a n d a re co u nte d toward the a nnua l ma xim u m s, d ed u c t ib les, a n d / o r ou t- o f - po c k e t l i mi ts. B en efit s - items or ser vices covered u n d er a n in su ra nce pl a n . B en eficia r y - a person o r ent it y ent it led to receive t he c l a i m a mo u nt a n d o th e r b en efits upo n t he deat h o f t h e b en efa c to r o r o n t h e matu r i t y o f th e po l i c y. B roker - a n individual a gent o r a gen c y wh o rep resents th e bu ye r, rath e r th a n th e insura nce co mpany, a n d t r ies to fin d t h e b u yer t h e be s t po l i c y. Th e bro k e r can ma k e specific reco m m en d at io n s a b o u t wh ich p la n s be s t s u i t yo u a n d yo u r f am ily ’s needs. COB R A - a fe de ra l law t h at m ay a llow t h e in su red to te mpo ra r i l y k e e p in surance covera g es a f ter em p loy m ent en d s. Cl aim - a request fo r p ay m ent u n d er a n in su ra n ce p l a n . A c l a i m w i l l l i s t th e s er vices re ndere d, t h e d ate o f ser vice, a n d a n item iz ati o n o f co s t. Coin sura nce - insura n ce in wh ic h t h e in su red is req u i re d to pay a f i xe d p erce nt a g e of the co st o f exp en ses a f ter t h e d ed u c t i bl e h a s be e n pa i d. Cop ayment (Copay) - a fixed a m o u nt t h at t h e in su red i s re qu i re d to pay be fo re receiving t he ser vice. D edu c t ible - a n out- of- p o c ket a m o u nt t h at a n in su re d mu s t pay pr i o r to a n in surance pla n paying a c la im . D ependent - a child or o t h er in d ivid u a l fo r wh o m a pa re nt, re l ati ve, o r o th e r p er s o n may cla im a p erso n a l exem p t io n t a x d ed u c t ion . El im inatio n Per iod - a p er io d o f co nt in u o u s d isa b ilit y w h i c h mu s t be s ati s f i e d b efore you a re e ligible to receive b en efit s.
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Ev iden ce of I nsura bilit y ( EO I) - p a r t o f t h e a p p licat io n p ro ce s s fo r a n i nsuran ce po lic y dur ing w h ich a n a p p lica nt p rovid es h ea l th i n fo r mati o n . Coverage does not be com e effec t ive u nt il a p p rova l o f t h e E O I . Flexibl e Spe nding Account ( F S A) - a t y p e o f a cco u nt t h at prov i d e s th e a cco u nt h ol der w it h spe cific ta x a d va nt a ges o n q u a lified m ed ic a l a n d /o r d e pe n d e nt c are exp enses (ex. M e dica l R eim b u rsem ent, D ep en d ent Ca re, a n d /o r L i mi te d Pur p ose FSA). G uarantee d Issue - a pred eter m in ed b en efit a m o u nt a llowe d by a n i n s u ra n ce p l an w itho ut requir ing Evid en ce o f I n su ra b ilit y ( EO I) . GI a l l ows yo u to e n ro l l re gardl ess of hea lth statu s, a ge, gen d er, o r o t h er fa c to rs th at mi g ht pre d i c t th e us e of h e a lth se r vices. This d o es n o t, h owever, p rec lu d e th e a ppl i c ati o n o f th e p re - existing co ndit io n exc lu sio n s. L im ited Pur po se FSA - a t y p e o f a cco u nt to b e u sed wit h a n H S A . I t i s re s e r ve d fo r th e payment of dent a l a n d visio n exp en ses o n ly. Lo n g-Ter m Ca re - a ra ng e o f ser vices a n d su p p o r t s yo u m ay n e e d to me e t yo u r p er s on al ca re needs in th e event o f a ch ro n ic illn ess o r d i s a bi l i t y. M edical l y N ece ssa r y - a covered h ea lt h ser vice o r t reat me nt th at i s ma n d ato r y to protec t a nd enha nce th e h ea lt h st at u s o f a p at ient, a n d co u l d a d ve r s e l y af fec t th e pat ient ’s condit io n if o m it ted, in a cco rd a n ce w i th a cce pte d s tan dards of medica l prac t ice. Net wor k - t he fa cilities, provid ers, a n d su p p liers yo u r in s u ra n ce pl a n h a s co ntrac ted wit h to provide h ea lt h c a re ser vices ( i.e. “in - n e t wo r k ” ) . Non -Prefer red Provider - a p rovid er wh o d o es n o t h ave a co ntra c t w i th yo u r i nsuran ce ca r r ie r or pla n to p rovid e ser vices to yo u. Yo u’ l l pay mo re to s e e a n on -prefer red provider (i .e. “o u t- o f- n et wo r k ” ) . O ut- of -Pock et M a x imum - t h e m a xim u m a m o u nt o f m o n e y yo u may pay fo r s er vices in a bene fit ye a r. Pre -Existing Condit io n - a m ed ic a l co n d it io n t h at is exc lu d e d f ro m cove ra g e by an in s urance co mpa ny be c a u se t h e co n d it io n wa s b elieve d to ex i s t pr i o r to th e i ndiv idua l obt a ining a polic y fro m t h e in su ra n ce co m p a ny. Prem ium /R ate - the a mo u nt yo u p ay fo r yo u r in su ra n ce pre mi u ms e a c h mo nth . Q ual if ying L ife Event (QLE) - a ch a n ge in yo u r sit u at io n t h at c a n ma k e yo u e l igib l e for a specia l e nro llm ent p er io d, a llowin g yo u to e n ro l l i n a n i n s u ra n ce p l an outside of the ye a r ly o p en en ro llm ent p er io d ( ex. lo s s o f cove ra g e, g e tti n g m ar r ied or divorced, havin g a b a by / a d o p t in g a ch ild, o r a d e ath i n th e f a mi l y) .
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HEALTH INSURANCE H e alt h i n su ra nce cover s yo u a n d yo ur fa m il y fo r yo ur ba s ic h ealth need s af ter you’ve met your cove rag e d ed u c tibl e ( so m e ben efits in c l ude co pay a f ter deduc t i ble). Coverage i nclud es vi si ts w i t h a p r i m a r y c a re p hysic i a n , s pec ia l t y phys ic ia n s, in patient/outpati ent hospi tal care.
PPO PLAN Valenz Mercy Individual Deductible
$1,500
Family Deductible
$3,000
Individual Out-of-Pocket Maximum
$4,500
Family Out-of-Pocket Maximum
$9,000
Coinsurance
70%
Lifetime Maximum
Unlimited
COVERED SERVICES OV Primary
$10 Copay
OV Specialist
$40 Copay
Preventive Care
$0 Copay
Outpatient Lab Services
$0 Copay
Outpatient RAD*
30% AD*
Urgent Care***
$50 Copay
Emergency Room (waived if AD*)
$200 Copay + 30%
Inpatient Hospital Care
30% AD*
Chiropractic
$40 Copay
Physical Therapy Hospital/Outpatient Setting
$40 Copay
Inpatient Injectables
30% AD*
Outpatient Injectables
$0 through SMBC Program
PRESCRIPTIONS
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Generic
$5 Copay
Preferred Brand
$35 Copay
Non-Preferred Brand
$75 Copay
Specialty Drugs
$0 through SMBC Program
HEALTH INSURANCE H e al t h i n su ra nce cover s yo u a n d yo ur fa m il y fo r yo ur ba s ic h ea lth need s af ter you’ve met your cove rag e d ed u c tibl e ( so m e ben efits in c l ude co pay a f ter deduc t i ble). Coverage i nclud es vi si ts wi t h a p r i m a r y c a re p hysic ian , s pec ia l t y phys ic ia n s, in patient/outpati ent hospi tal care.
PPO PLAN Valenz Mercy
Valenz Mercy
Individual Deductible
$2,500
$3,500
Family Deductible
$5,000
$7,000
Individual Out-of-Pocket Maximum
$4,500
$7,000
Family Out-of-Pocket Maximum
$9,000
$14,000
Coinsurance
80%
70%
Lifetime Maximum
Unlimited
Unlimited
OV Primary
$10 Copay
$10 Copay
OV Specialist
$35 Copay
$40 Copay
Preventive Care
$0 Copay
$0 Copay
Outpatient Lab Services
$0 Copay
$0 Copay
Outpatient RAD*
20% AD*
30% AD*
Urgent Care***
$50 Copay
$50 Copay
Emergency Room (waived if AD*)
$100 Copay
$100 Copay
Inpatient Hospital Care
20% AD*
30% AD*
Chiropractic
$35 Copay
$40 Copay
Physical Therapy Hospital/Outpatient Setting
$35 Copay
$50 Copay
Inpatient Injectables
20% AD*
30% AD*
Outpatient Injectables
$0 through SMBC Program
$0 through SMBC Program
Generic
$5 Copay
$5 Copay
Preferred Brand
$35 Copay
$35 Copay
Non-Preferred Brand
$60 Copay
$70 Copay
Specialty Drugs
$0 through SMBC Program
$0 through SMBC Program
COVERED SERVICES
PRESCRIPTIONS
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HEALTH INSURANCE H e alt h i n su ra nce cover s yo u a n d yo ur fa m il y fo r yo ur ba s ic h ealth need s af ter you’ve met your cove rag e d ed u c tibl e ( so m e ben efits in c l ude co pay a f ter deduc ti ble). Coverage i nclud es vi si ts w i t h a p r i m a r y c a re physic i a n , s pec ia l t y phys ic ia n s, in patient/outpati ent hospi tal care.
HSA PLAN Valenz Mercy HSA
Valenz Mercy HSA
Individual Deductible
$3,500
$5,000
Family Deductible
$7,000
$10,000
Individual Out-of-Pocket Maximum
$3,500
$6,350
Family Out-of-Pocket Maximum
$7,000
$12,700
Coinsurance
0%
0%
Lifetime Maximum
Unlimited
Unlimited
OV Primary
$0 AD*
$20 AD*
OV Specialist
$0 AD*
$40 AD*
Preventive Care
$0 Copay
$0 Copay
Outpatient Lab Services
$0 AD*
$0 AD*
Outpatient RAD*
$0 AD*
$0 AD*
Urgent Care***
$0 AD*
$50 AD*
Emergency Room (waived if AD*)
$0 AD*
$150 AD*
Inpatient Hospital Care
$0 AD*
$0 AD*
Chiropractic
$0 AD*
$0 AD*
Physical Therapy Hospital/Outpatient Setting
$0 AD*
$0 AD*
Inpatient Injectables
$0 AD*
$0 AD*
Outpatient Injectables
$0 through SMBC Program
$0 through SMBC Program
Generic
$0 AD*
$10 AD*
Preferred Brand
$0 AD*
$30 AD*
Non-Preferred Brand
$0 AD*
$60 AD*
Specialty Drugs
$0 through SMBC Program
$0 through SMBC Program
COVERED SERVICES
PRESCRIPTIONS
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HEALTH INSURANCE H e al t h i n su ra nce cover s yo u a n d yo ur fa m il y fo r yo ur ba s ic h ealth need s af ter you’ve met your cove rag e dedu c t ib l e ( so m e ben efits in c l ude co pay a f ter deduc t i ble). Coverage i nclud es vi si ts wi t h a p r i m a r y c a re p hysic i a n , s pec ia l t y phys ic ia n s, in patient/outpati ent hospi tal care.
PPO PLAN Cox Directed
Cox Directed
Individual Deductible
$1,500
$2,500
Family Deductible
$3,000
$5,000
Individual Out-of-Pocket Maximum
$4,500
$4,500
Family Out-of-Pocket Maximum
$9,000
$9,000
Coinsurance
70%
80%
Lifetime Maximum
Unlimited
Unlimited
OV Primary
$25 Copay
$25 Copay
OV Specialist
$50 Copay
$35 Copay
Preventive Care
$0 Copay
$0 Copay
Outpatient Lab Services
$0 Copay
$0 Copay
Outpatient RAD*
30% AD*
20% AD*
Urgent Care***
$50 Copay
$50 Copay
Emergency Room (waived if AD*)
$200 Copay + 30%
$100 Copay
Inpatient Hospital Care
30% AD*
20% AD*
Chiropractic
$50 Copay
$35 Copay
Physical Therapy Hospital/Outpatient Setting
$50 Copay
$35 Copay
Inpatient Injectables
30% AD*
20% AD*
Outpatient Injectables
$0 through SMBC Program
$0 through SMBC Program
Generic
$15 Copay
$15 Copay
Preferred Brand
$35 Copay
$35 Copay
Non-Preferred Brand
$75 Copay
$60 Copay
Specialty Drugs
$0 through SMBC Program
$0 through SMBC Program
COVERED SERVICES
PRESCRIPTIONS
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HEALTH INSURANCE H e al t h i n su ra nce cover s yo u a n d yo ur fa m il y fo r yo ur ba s ic h ea lth need s af ter you’ve met your cove rag e d ed u c tibl e ( so m e ben efits in c l ude co pay a f ter deduc ti ble). Coverage i nclud es vi si ts wi t h a p r i m a r y c a re p hysic ian , s pec ia l t y phys ic ia n s, in patient/o utpati ent hospi tal care.
PPO PLAN / HSA PLAN Cox Directed PPO
Cox Directed HSA
Individual Deductible
$3,500
$3,500
Family Deductible
$7,000
$7,000
Individual Out-of-Pocket Maximum
$7,000
$3,500
Family Out-of-Pocket Maximum
$14,000
$7,000
Coinsurance
70%
0%
Lifetime Maximum
Unlimited
Unlimited
OV Primary
$25 Copay
$0 AD*
OV Specialist
$50 Copay
$0 AD*
Preventive Care
$0 Copay
$0 Copay
Outpatient Lab Services
$0 Copay
$0 AD*
Outpatient RAD*
30% AD*
$0 AD*
Urgent Care***
$50 Copay
$0 AD*
Emergency Room (waived if AD*)
$100 Copay
$0 AD*
Inpatient Hospital Care
30% AD*
$0 AD*
Chiropractic
$50 Copay
$0 AD*
Physical Therapy Hospital/Outpatient Setting
$50 Copay
$0 AD*
Inpatient Injectables
30% AD*
$0 AD*
Outpatient Injectables
$0 through SMBC Program
$0 through SMBC Program
Generic
$15 Copay
$0 AD*
Preferred Brand
$35 Copay
$0 AD*
Non-Preferred Brand
$70 Copay
$0 AD*
Specialty Drugs
$0 through SMBC Program
$0 through SMBC Program
COVERED SERVICES
PRESCRIPTIONS
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HEALTH INSURANCE He al t h i n su ra nce cover s yo u a n d yo ur fa m il y fo r yo ur ba s ic h ea lth need s af ter you’ve met your cove rage dedu c t ib l e ( so m e ben efits in c l ude co pay a f ter deduc ti ble). Coverage i nclud es vi si ts w i t h a p r im a r y c a re physic ian , s pec ia l t y phys ic ia n s, in patient/outpati ent hospi tal care.
HSA PLAN Cox Directed Individual Deductible
$5,000
Family Deductible
$10,000
Individual Out-of-Pocket Maximum
$6,350
Family Out-of-Pocket Maximum
$12,700
Coinsurance
0%
Lifetime Maximum
Unlimited
COVERED SERVICES OV Primary
$20 AD*
OV Specialist
$40 AD*
Preventive Care
$0 Copay
Outpatient Lab Services
$0 AD*
Outpatient RAD*
$0 AD*
Urgent Care***
$50 AD*
Emergency Room (waived if AD*)
$150 AD*
Inpatient Hospital Care
$0 AD*
Chiropractic
$0 AD*
Physical Therapy Hospital/Outpatient Setting
$0 AD*
Inpatient Injectables
$0 AD*
Outpatient Injectables
$0 through SMBC Program
PRESCRIPTIONS Generic
$10 AD*
Preferred Brand
$30 AD*
Non-Preferred Brand
$60 AD*
Specialty Drugs
$0 through SMBC Program
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HEALTH INSURANCE H e alt h i n su ra nce cover s yo u a n d yo ur fa m il y fo r yo ur ba s ic h ea lth need s af ter you’ve met your cove rag e d ed u c tibl e ( so m e ben efits in c l ude co pay a f ter deduc t i ble). Coverage i nclud es vi si ts w i t h a p r i m a r y c a re p hysic ian , s pec ia l t y phys ic ia n s, in patient/outpati ent hospi tal care.
PPO PLAN Dual Network Plan
Dual Network Plan
Individual Deductible
$1,200
$2,400
Family Deductible
$2,400
$4,800
Individual Out-of-Pocket Maximum
$3,600
$5,000
Family Out-of-Pocket Maximum
$7,200
$10,000
Coinsurance
80%
70%
Lifetime Maximum
Unlimited
Unlimited
OV Primary
$25 Copay
$25 Copay
OV Specialist
$50 Copay
$50 Copay
Preventive Care
$0 Copay
$0 Copay
Outpatient Lab Services
$0 Copay
$0 Copay
Outpatient RAD*
30% AD*
30% AD*
Urgent Care***
$50 Copay
$50 Copay
Emergency Room (waived if AD*)
$200 Copay
$200 Copay
Inpatient Hospital Care
20% AD*
30% AD*
Chiropractic
$50 Copay
$50 Copay
Physical Therapy Hospital/Outpatient Setting
$50 Copay
$50 Copay
Inpatient Injectables
20% AD*
30% AD*
Outpatient Injectables
$0 through SMBC Program
$0 through SMBC Program
Generic
$15 Copay
$15 Copay
Preferred Brand
$35 Copay
$35 Copay
Non-Preferred Brand
$75 Copay
$75 Copay
Specialty Drugs
$0 through SMBC Program
$0 through SMBC Program
COVERED SERVICES
PRESCRIPTIONS
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HEALTH INSURANCE H e al t h i n su ra nce cover s yo u a n d yo ur fa m il y fo r yo ur ba s ic h ea lth need s af ter you’ve met your cove rag e dedu c t ib l e ( so m e ben efits in c l ude co pay a f ter deduc t i ble). Coverage i nclud es vi si ts wi t h a p r i m a r y c a re physic ian , s pec ia l t y phys ic ia n s, in patient/outpati ent hospi tal care.
HSA PLAN Dual Network Plan HSA
Dual Network Plan HSA
Individual Deductible
$4,000
$5,500
Family Deductible
$8,000
$11,000
Individual Out-of-Pocket Maximum
$4,000
$6,500
Family Out-of-Pocket Maximum
$8,000
$13,000
Coinsurance
100%
100%
Lifetime Maximum
Unlimited
Unlimited
OV Primary
$0 AD*
$20 AD*
OV Specialist
$0 AD*
$40 AD*
Preventive Care
$0 Copay
$0 Copay
Outpatient Lab Services
$0 AD*
$0 AD*
Outpatient RAD*
$0 AD*
$0 AD*
Urgent Care***
$0 AD*
$50 AD*
Emergency Room (waived if AD*)
$0 AD*
$150 AD*
Inpatient Hospital Care
$0 AD*
$0 AD*
Chiropractic
$0 AD*
$0 AD*
Physical Therapy Hospital/Outpatient Setting
$0 AD*
$0 AD*
Inpatient Injectables
$0 AD*
$0 AD*
Outpatient Injectables
$0 through SMBC Program
$0 through SMBC Program
Generic
$0 AD*
$10 AD*
Preferred Brand
$0 AD*
$30 AD*
Non-Preferred Brand
$0 AD*
$60 AD*
Specialty Drugs
$0 through SMBC Program
$0 through SMBC Program
COVERED SERVICES
PRESCRIPTIONS
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HEALTH INSURANCE RATES $1,500 VALENZ MERCY PPO PLAN COVERAGE TIER
MONTHLY RATES EE Cost
ER Cost
Total Cost
Employee
$14.00
$540.00
$554.00
Employee + Spouse
$554.00
$540.00
$1,094.00
$436.00
$540.00
$976.00
$1,006.00
$540.00
$1,546.00
Employee + Child(ren) Family
$2,500 VALENZ MERCY PPO PLAN COVERAGE TIER Employee
MONTHLY RATES EE Cost
ER Cost
Total Cost
$4.00
$540.00
$544.00
Employee + Spouse
$534.00
$540.00
$1,074.00
Employee + Child(ren)
$417.00
$540.00
$957.00
Family
$977.00 $540.00 $3,500 VALENZ MERCY PPO PLAN
COVERAGE TIER
$1,517.00
MONTHLY RATES EE Cost
ER Cost
Total Cost
$0.00
$540.00
$536.00
Employee + Spouse
$519.00
$540.00
$1,059.00
Employee + Child(ren)
$404.00
$540.00
$944.00
Family
$956.00
$540.00
$1,496.00
Employee
$3,500 VALENZ MERCY HSA PLAN COVERAGE TIER
EE Cost
ER Cost
Total Cost
$0.00
$540.00
$536.00
Employee + Spouse
$519.00
$540.00
$1,059.00
Employee + Child(ren)
$404.00
$540.00
$944.00
Employee
Family
$956.00 $540.00 $5,000 VALENZ MERCY HSA PLAN
COVERAGE TIER
$1,496.00
MONTHLY RATES EE Cost
ER Cost
Total Cost
$0.00
$540.00
$454.00
Employee + Spouse
$357.00
$540.00
$897.00
Employee + Child(ren)
$260.00
$540.00
$800.00
Family
$727.00
$540.00
$1,267.00
Employee
16
MONTHLY RATES
HEALTH INSURANCE RATES $1,500 COX DIRECTED PPO PLAN COVERAGE TIER
MONTHLY RATES EE Cost
ER Cost
Total Cost
Employee
$25.00
$540.00
$565.00
Employee + Spouse
$576.00
$540.00
$1,116.00
Employee + Child(ren)
$456.00
$540.00
$996.00
$1,037.00
$540.00
$1,577.00
Family
$2,500 COX DIRECTED PPO PLAN COVERAGE TIER
MONTHLY RATES EE Cost
ER Cost
Total Cost
Employee
$15.00
$540.00
$555.00
Employee + Spouse
$555.00
$540.00
$1,095.00
Employee + Child(ren)
$436.00
$540.00
$976.00
Family
$1,007.00 $540.00 $3,500 COX DIRECTED PPO PLAN
COVERAGE TIER Employee
$1,547.00
MONTHLY RATES EE Cost
ER Cost
Total Cost
$7.00
$540.00
$547.00
Employee + Spouse
$540.00
$540.00
$1,080.00
Employee + Child(ren)
$423.00
$540.00
$963.00
Family
$986.00
$540.00
$1,526.00
$3,500 COX DIRECTED HSA PLAN COVERAGE TIER
MONTHLY RATES EE Cost
ER Cost
Total Cost
$7.00
$540.00
$547.00
Employee + Spouse
$540.00
$540.00
$1,080.00
Employee + Child(ren)
$423.00
$540.00
Employee
Family
$986.00 $540.00 $5,000 COX DIRECTED HSA PLAN
COVERAGE TIER Employee
$963.00 $1,526.00
MONTHLY RATES EE Cost
ER Cost
Total Cost
$0.00
$540.00
$463.00
Employee + Spouse
$385.00
$540.00
$925.00
Employee + Child(ren)
$276.00
$540.00
$816.00
Family
$752.00
$540.00
$1,292.00
17
HEALTH INSURANCE RATES $1,200 DUAL NETWORK PPO PLAN COVERAGE TIER
MONTHLY RATES EE Cost
ER Cost
Total Cost
Employee
$120.00
$540.00
$660.00
Employee + Spouse
$764.00
$540.00
$1,304.00
$622.00
$540.00
$1,162.00
$1,302.00
$540.00
$1,842.00
Employee + Child(ren) Family
$2,400 DUAL NETWORK PPO PLAN COVERAGE TIER
MONTHLY RATES EE Cost
ER Cost
Total Cost
Employee
$45.00
$540.00
$585.00
Employee + Spouse
$616.00
$540.00
$1,156.00
Employee + Child(ren)
$490.00
$540.00
$1,030.00
$1,093.00
$540.00
$1,633.00
Family
$4,000 DUAL NETWORK HSA PLAN COVERAGE TIER
MONTHLY RATES EE Cost
ER Cost
Total Cost
Employee
$23.00
$540.00
$563.00
Employee + Spouse
$572.00
$540.00
$1,112.00
$451.00
$540.00
$991.00
$1,031.00
$540.00
$1,571.00
Employee + Child(ren) Family
$5,500 DUAL NETWORK HSA PLAN COVERAGE TIER
EE Cost
ER Cost
Total Cost
$0.00
$540.00
$477.00
Employee + Spouse
$402.00
$540.00
$942.00
Employee + Child(ren)
$300.00
$540.00
$840.00
Family
$790.00
$540.00
$1,330.00
Employee
18
MONTHLY RATES
DENTAL INSURANCE H av i n g d enta l insu ra nce co ntr ibutes to yo ur over a l l wel l -bein g. D ental i nsurance provi d es cove rage fo r p reventative, b a s ic, a n d m a j o r s er v ices.
D E N TA L S E R V I C E S P R E V E N TAT I V E S E R V I C E S (N o D educ tible )
10 0%
BASIC SERVICES (DEDUCTIBLE APPLIES)
10 0%
MAJOR SERVICES (DEDUCTIBLE APPLIES)
80 %
CHILD ORTHODONTIA RIDER (DEDUCTIBLE APPLIES)
• • • • •
R o u t in e Per io d ic Exa ms X- rays Flu o r id e Treat m ent C lea n in g S ea la nt s
• • • • •
Fillin gs R o o t Pla n in g & S c a lin g S im p le Ex t ra c t io n s No n - su rgic a l Per io d o nti c s O ra l S u rger y
• • • • • • • •
I n lays O n lays Crown s Br id ges D ent u res S u rgic a l Per io d o nt ics I m p la nt s R o o t Ca n a l
$1,500 Lifet im e M a xim u m
50 % A N N UA L M A X I M U M
I n Net wo r k : $1,250 p er p e r s o n O u t- o f- Net wo r k : $1,250 p e r pe r s o n
DEDUCTIBLE
I n Net wo r k : $50 p er p erso n / $ 1 5 0 pe r f a mi l y O u t- o f- Net wo r k : $50 p er pe r s o n / $ 1 5 0 pe r f a mi l y
COVERAGE TIER
MONTHLY RATES
Employee
$33.99
Employee + Spouse
$67.24
Employee + Child(ren)
$84.58
Family
$126.73 19
DENTAL INSURANCE H av i n g d enta l insu ra nce co ntr ibutes to yo ur over a l l wel l -bein g. D ental i nsurance provi d es cove rage fo r p reventative, b a s ic, a n d m a j o r s er v ices.
D E N TA L S E R V I C E S P R E V E N TAT I V E S E R V I C E S (N o D educ tible )
100%
BASIC SERVICES (DEDUCTIBLE APPLIES)
80%
MAJOR SERVICES (DEDUCTIBLE APPLIES)
0%
• • • • •
R o u t in e Per io d ic Exa ms X- rays Flu o r id e Treat m ent C lea n in g S ea la nt s
• • • • •
Fillin gs R o o t Pla n in g & S ca lin g S im p le Ex t ra c t io n s No n - su rgica l Per io d o nti c s O ra l S u rger y
• • • • • • • •
I n lays O n lays Crown s Br id ges D ent u res S u rgica l Per io d o nt ics I m p la nt s R o o t Ca n a l
A N N UA L M A X I M U M
I n Net wo r k : $1,250 p er p e r s o n O u t- o f- Net wo r k : $1,250 p e r pe r s o n
DEDUCTIBLE
I n Net wo r k : $50 p er p erson / $ 1 5 0 pe r f a mi l y O u t- o f- Net wo r k : $50 p er p e r s o n / $ 1 5 0 pe r f a mi l y
COVERAGE TIER
20
MONTHLY RATES
Employee
$24.49
Employee + Spouse
$48.21
Employee + Child(ren)
$62.71
Family
$94.58
DENTAL INSURANCE H av i n g d enta l insu ra nce co ntr ibutes to yo ur over a l l wel l -bein g. D ental i nsurance provi d es cove rag e fo r preventative, b a s ic, a n d m a j o r s er v ices.
D E N TA L S E R V I C E S P R E V E N TAT I V E S E R V I C E S ( N o D educ tible )
1 00%
BASIC SERVICES (DEDUCTIBLE APPLIES)
8 0%
MAJOR SERVICES (DEDUCTIBLE APPLIES)
5 0%
CHILD ORTHODONTIA RIDER (DEDUCTIBLE APPLIES)
• • • • •
R o u t in e Per io d ic Exa ms X- rays Flu o r id e Treat m ent C lea n in g S ea la nt s
• • • • •
Fillin gs R o o t Pla n in g & S ca lin g S im p le Ex t ra c t io n s No n - su rgica l Per io d o nti c s O ra l S u rger y
• • • • • • • •
I n lays O n lays Crown s Br id ges D ent u res S u rgica l Per io d o nt ics I m p la nt s R o o t Ca n a l
$1,500 Lifet im e M a xim u m
5 0% A N N UA L M A X I M U M
I n Net wo r k : $1,750 p er p e r s o n O u t- o f- Net wo r k : $1,750 p e r pe r s o n
DEDUCTIBLE
I n Net wo r k : $50 p er p erson / $ 1 5 0 pe r f a mi l y O u t- o f- Net wo r k : $50 p er pe r s o n / $ 1 5 0 pe r f a mi l y
COVERAGE TIER
MONTHLY RATES
Employee
$35.97
Employee + Spouse
$71.16
Employee + Child(ren)
$86.15
Family
$131.79 21
VISION INSURANCE Vi s i o n i n s u ra nce is o f fered to h el p peo pl e s ee by prov idin g a fford able access to hi gh- q uali t y eye care an d e yewea r. An indiv idua l o r fa m il y v is io n in s ura n ce pl a n saves you money on f rames, l e n s e s, co nta c t s, eye ex a m s a n d m o re.
VISION SERVICES Exam Copay
$10
M ater ials Cop ay
$10
CONTAC TS El ec tive Al l owa nce
$ 1 5 0 a l l owa n ce
Co ntac t Le ns Eva l uat i on , Fi tti n g, & Follow-U p Ca re Cop ay
$60 maximum
LENSES Sin gle Vis i on Al l owa nce
Cove re d i n fu l l af ter $10 Co p ay
B ifocal All owa nce
Cove re d i n fu l l af ter $10 Co p ay
Tr ifocal Al l owa nce
Cove re d i n fu l l af ter $10 Co p ay
Lentic ular
Cove re d i n fu l l af ter $10 Co p ay
SERVICES
FREQUENCY
COVERAGE TIER
E x am
12 m o nt h s
Employee
$5.77
Fra mes
24 m o nt h s
Employee + Spouse
$11.53
S p ec tacl e Lenses
12 m o nt h s
Employee + Child(ren)
$12.87
Co ntac t Lens Eval uation , Fit t ing & Fo ll ow-Up Ca re
12 m o nt h s
Family
$19.56
22
MONTHLY RATES
EMPLOYER PAID
GROUP TERM LIFE INSURANCE Yo u r n e e d s va r y greatl y u po n a ge, n um ber o f depen dents, depend ents’ ages and your f i nanci al s i t u at i on . Ter m L ife is designed to prov ide ben efits to yo ur des ignated benef i ci ar y for loss of li fe. A D & D i n s u ra nce cover s yo u a n d yo ur ben efic ia r ies in th e event o f an acci d ental loss of li fe. L acled e Co u nt y p ays $ 1 5 , 0 0 0 towa rds a l l el igibl e em pl oyee‘s gro up ter m li fe i nsurance.
EMPLOYEE BENEFIT
Amount
$15,000
AD&D Benefit
$15,000
23
VOLUNTARY GROUP TERM LIFE INSURANCE
You r n e e d s va r y greatl y u po n a ge, n um ber o f depen dents, depe nd ents’ ages and your f i nanci al si t u at i on . Ter m L ife is design ed to prov ide ben efits to yo ur des i gnated benef i ci ar y for loss of li fe. AD & D i n su ra nce cover s yo u a n d yo ur ben efic ia r ies in th e event of an acci d ental loss of li fe.
EMPLOYEE
SPOUSE
DEPENDENT
Minimum Amount
$10,000
$5,000
$2,000
Maximum Amount
$500,000
$250,000
$10,000
$500,000 in increments of $10,000, not to exceed 5x annual earnings
$250,000 in increments of $5,000, not to exceed 100% of employee amount
Child(ren): Birth through 26: $10,000 in increments of $2,000
$200,000
$50,000: Through Age 69 $0.00: Age 70+
Amount
Guaranteed Issue Group Term Life Benefit Reduction Benefit Features
24
-
Benefits reduce to 65% upon the person‘s attainment of age 65-69, and 50% at age 70+ (Spouse Reduction is based on Employee Age)
-
Portability Conversion Privilege Waiver of Premium
-
-
ACCIDENT INSURANCE Acci d e nt insu ra nce hel p s p ay fo r un expec ted h ea l th c a re expen ses d ue to i njur i es that occur ever y d ay – f ro m the so ccer f iel d to th e s k i s l o pe a n d th e h ighway in -bet ween. Acci d ent i nsurance p rov i d e s benef it s du e to covered a cc idents fo r in itia l c a re, in j ur i es, and follow-up care.
BENEFITS
PLAN A
PLAN B
PLAN C
Ambulance Transportation
$300 Ground $1,500 Air
$350 Ground $1,750 Air
$400 Ground $2,000 Air
Blood/Plasma/Platelets
$200
$300
$400
Chiropractic Services (Limit 12 per calendar year per family)
$35 per session, 6 sessions maximum
$50 per session, 6 sessions maximum
$50 per session, 6 sessions maximum
Coma
$10,000
$15,000
$20,000
Concussion
$300
$300
$400
Dental Injury
$450 for Crown; $150 for Extraction
$600 for Crown; $200 for Extraction
$600 for Crown; $200 for Extraction
Diagnostic Examination
$200 per CT/MRI scan
$250 per CT/MRI scan
$300 per CT/MRI scan
$200 $400 $800 $1,600
$250 $500 $1,000 $2,000
$300 $600 $1,200 $2,400
$1,600 $3,200 $6,400 $12,800
$2,000 $4,000 $8,000 $16,000
$2,400 $4,800 $9,600 $19,200
Skin Graft
50%
25%
25%
Dislocations (Surgical / Non-Surgical) Ankle Collarbone Elbow Finger Foot Hand Hip Knee Lower Jaw Shoulder Toe Wrist
$3,600 / $1,800 $3,600 / $1,800 $1,800 / $900 $600 / $300 $3,600 / $1,800 $1,800 / $900 $9,600 / $4,800 $6,000 / $3,000 $1,800 / $900 $1,800 / $900 $600 / $300 $1,800 / $900
$4,800 / $2,400 $4,800 / $2,400 $2,400 / $1,200 $800 / $400 $4,800 / $2,400 $2,400 / $1,200 $12,800 / $6,400 $8,000 / $4,000 $2,400 / $1,200 $2,400 / $1,200 $800 / $400 $2,400 / $1,200
$6,000 / $3,000 $6,000 / $3,000 $3,000 / $1,500 $1,000 / $500 $6,000 / $3,000 $3,000 / $1,500 $16,000 / $8,000 $10,000 / $5,000 $3,000 / $1,500 $3,000 / $1,500 $1,000 / $500 $3,000 / $1,500
Burns Second Degree Burns Less than 10% At least 10%, but less than 25% At least 25%, but less than 35% 35% or more Third Degree Burns Less than 10% At least 10%, but less than 25% At least 25%, but less than 35% 35% or more
25
ACCIDENT INSURANCE CONT. BENEFITS Partial Dislocation (Amount of benefit for non-surgical dislocation)
PLAN A
PLAN B
PLAN C
25%
25%
25%
Multiple Dislocations (Percent of highest benefit for any one dislocation among all dislocations sustained)
100%
100%
100%
Emergency Treatment
$201
$250.50
$300
Epidural Anesthesia Injections
$200 per injection, 2 maximum
$300 per injection, 2 maximum
$400 per injection, 2 maximum
$200 for removal of foreign object, $400 for surgical repair
$250 for removal of foreign object, $500 for surgical repair
$300 for removal of foreign object, $600 for surgical repair
$2,400 / $1,200 $2,400 / $1,200 $1,200 / $600 $1,200 / $600 $2,400 / $1,200 $2,400 / $1,200 $400 / $200 $2,400 / $1,200 $2,400 / $1,200 $12,800 / $6,400 $2,400 / $1,200 $6,400 / $3,200 $2,400 / $1,200 $1,200 / $600 $6,400 / $3,200 $1,200 / $600 $2,400 / $1,200 $20,000 / $10,000
$3,000 / $1,500 $3,000 / $1,500 $1,500 / $750 $1,500 / $750 $3,000 / $1,500 $3,000 / $1,500 $500 / $250 $3,000 / $1,500 $3,000 / $1,500 $16,000 / $8,000 $3,000 / $1,500 $8,000 / $4,000 $3,000 / $1,500 $1,500 / $750 $8,000 / $4,000 $1,500 / $750 $3,000 / $1,500 $25,000 / $12,500
$3,600 / $1,800 $3,600 / $1,800 $1,800 / $900 $1,800 / $900 $3,600 / $1,800 $3,600 / $1,800 $600 / $300 $3,600 / $1,800 $3,600 / $1,800 $19,200 / $9,600 $3,600 / $1,800 $9,600 / $4,800 $3,600 / $1,800 $1,800 / $900 $9,600 / $4,800 $1,800 / $900 $3,600 / $1,800 $30,000 / $15,000
$6,000 / $3,000 $2,400 / $1,200 $400 / $200 $2,400 / $1,200 $6,400 / $3,200 $2,400 / $1,200
$7,500 / $3,750 $3,000 / $1,500 $500 / $250 $3,000 / $1,500 $8,000 / $4,000 $3,000 / $1,500
$9,000 / $4,500 $3,600 / $1,800 $600 / $300 $3,600 / $1,800 $9,600 / $4,800 $3,600 / $1,800
25%
25%
25%
Eye Injury
Fractures (Surgical / Non-Surgical) Ankle Arm Bones of Face Coccyx Collarbone Elbow Finger Foot Hand Hip Kneecap Leg Jaw Nose Pelvis Rib Shoulder Blade Skull (Except bones of face or nose -Depressed) Skull (Simple) Sternum Toe Vertebrae Vertebral Column Wrist Chip Fractures (Amount of benefit for non- surgical fracture)
26
ACCIDENT INSURANCE CONT. BENEFITS
PLAN A
PLAN B
PLAN C
Multiple Fracture (Amount of the highest benefit for any one fracture among all fractures sustained)
100%
100%
100%
Initial Hospital Admission
$1,000
$1,500
$2,000
Initial ICU Hospital Admission
$2,000
$3,000
$4,000
Hospital Confinement
$200 per day, 365 days maximum
$300 per day, 365 days maximum
$400 per day, 365 days maximum
ICU Confinement
$400 per day, 30 days maximum
$600 per day, 30 days maximum
$800 per day, 30 days maximum
Lacerations No Sutures Required
$50
$62.50
$75
Sutures Required (Total length of all sutured Lacerations) Less than 2” long 2” but less than 6” long 6” long or greater
$100 $400 $800
$125 $500 $1,000
$150 $600 $1,200
Lodging
$200 per day up to 30 days if more than 100 miles from residence
$300 per day up to 30 days if more than 100 miles from residence
$400 per day up to 30 days if more than 100 miles from residence
Medical Appliances
$200
$300
$400
Organized Youth Sports Benefit (% of benefit amount, excluding the AD&D benefit, if applicable)
25%
25%
25%
Paralysis Benefits
$20,000 quadriplegia; $10,000 paraplegia / hemiplegia
$25,000 quadriplegia; $12,500 paraplegia / hemiplegia
$30,000 quadriplegia; $15,000 paraplegia / hemiplegia
Physical Therapy
$100 per session; 10 sessions maximum
$125 per session; 10 sessions maximum
$150 per session; 10 sessions maximum
Physician Office Visit
$100 Initial, $100 Follow-up
$125 Initial, $125 Follow-up
$150 Initial, $150 Follow-up
Prosthesis
$500 for one, $1,000 for two or more
$750 for one, $1,500 for two or more
$1,000 for one, $2,000 for two or more
27
ACCIDENT INSURANCE CONT. BENEFITS
PLAN A
PLAN B
PLAN C
?
$125 per day, 30 days maximum
$150 per day, 30 days maximum
$2,000 $200 $600 $1,000 $600 $1,200
$2,500 $250 $750 $1,500 $750 $1,500
$3,000 $300 $900 $1,800 $900 $1,800
$600
$750
$900
$1,200
$1,500
$1,800
Transportation
$300, if more than 100 miles from residence
$450, if more than 100 miles from residence
$600, if more than 100 miles from residence
X-rays (per covered accident)
$50
$75
$100
Accidental Death Benefit
Employee: $25,000 Spouse: $12,500 Child(ren): $5,000
Employee: $30,000 Spouse: $15,000 Child(ren): $7,500
Employee: $50,000 Spouse: $25,000 Child(ren): $12,500
Accidental Death on Common Carrier
100% of benefit
100% of benefit
100% of benefit
Accidental Dismemberment Single Loss Thumb/Finger/Toe Catastrophic Loss Speech 2+ Thumb/Finger/Toe Two or more losses except the loss of fingers, thumbs or toes
50% of benefit 1% of benefit 100% of benefit 100% of benefit 3% of benefit 100% of benefit
50% of benefit 1% of benefit 100% of benefit 100% of benefit 3% of benefit 100% of benefit
50% of benefit 1% of benefit 100% of benefit 100% of benefit 3% of benefit 100% of benefit
Wellness
$50
$75
$100
Rehabilitation Facility Confinement Surgery Benefits Abdominal or Thoracic Exploratory Surgery (no repair) Knee Cartilage (surgically repaired) Ruptured Disc (surgically repaired) Rotator Cuff (one surgically repaired) Rotator Cuff (two or more surgically repaired) Tendon or Ligament (one surgically repaired) Tendon or Ligament (two or more surgically repaired)
$100 per day, 30 days maximum
COVERAGE TIER
28
MONTHLY RATES PLAN A
PLAN B
PLAN C
Employee
$19.75
$25.87
$32.90
Employee & Spouse
$27.96
$34.80
$41.55
Employee & Child(ren)
$31.25
$40.58
$50.97
Family
$39.65
$49.56
$59.71
CRITICAL ILLNESS Cr i t i cal I l l ness insu ra nce pa y s a l um p s um ben efit dir ec tl y to y ou and your covered d epend ents u p on d i ag no sis o f a covered c r itic a l il l n es s.
BENEFIT DESCRIPTION
BENEFIT
Heart Category Heart Attack Stroke Aneurysm
Percent of Principal Sum 100% 100% 100%
Organ Category Major Organ Failure
Percept of Principal Sum 100%
Quality of Life Category ALS/Lou Gehrig’s Disease Advanced Alzheimer’s Disease Advanced MS Advanced Parkinson’s Disease Loss of Sight Loss of Hearing Loss of Speech
Percent of Principal Sum 50% 50% 50% 50% 100% 100% 100%
Lifetime Category Maximum (Category Recurrence)
100% of Insurance Amount
Diagnosis Child Cerebral Palsy Cleft Lip or Palate Cystic Fibrosis Downs’ Syndrome Muscular Dystrophy Spina Bifida Type 1 Diabetes
100%
Subsequent Occurrence Benefit
100% of benefit if diagnosed 6 months or later
Benefit Waiting Period
None
Pre-existing Period
None
Benefit Reduction
None
Guarantee Issue Employee Spouse Child
$30,000 $30,000 $15,000
Maximum Principal Sum Employee Spouse Child Spouse and Child Principal Sum cannot exceed Employee Principal Sum
$30,000 $30,000 $15,000
Employee Coverage
Choose from a benefit of $5,000 to a maximum of $30,000 in $5,000 increments
Spouse Coverage
Choose from a benefit of $5,000 to a maximum of $30,000 in $5,000 increments, not to exceed 100% of approved employee amount
Dependent Coverage
50% of approved employee amount up to a maximum of $15,000
Cancer Benefit
100%
29
HOSPITAL INDEMNITY INSURANCE Th e h os p i t a l ind em nit y po l ic y h el ps o ffer yo u fin a n c ia l pro tec tion i n the event that you or your d e p e n d e nts a re a d m itted to th e h o s pita l. B en efits prov ide yo u wi th assi stance i n payi ng your d e d u c t i b l e a nd co - pay m ents a s s o c iated w ith in patient expen s es.
BENEFITS
STANDARD
HIGH
Hospital Room & Board Benefits (180 Daily Benefits per Coverage Year)
$100
$200
Hospital Critical Care Unit Benefits Critical Care Unit Benefits per Day (30 Daily Benefits per Coverage Year)
$200
$400
Hospital Admission Benefit (Three Daily Benefit per Coverage Year)
$1,000
$1,500
Hospital Critical Care Admission Benefit (One Daily Benefit per Coverage Year)
$1,000
$1,500
Nursery Admission Benefit (One Daily Benefit per Coverage Year)
$200
$500
Nursery Confinement Benefit (Ten Daily Benefit per Coverage Year)
$50
$100
Included
Included
Non-Insurance Services On-Call Travel Assistance
STANDARD MONTHLY PREMIUM
HIGH MONTHLY PREMIUM
Employee
$18.88
$38.38
Employee + Spouse
$33.82
$68.54
Employee + Child(ren)
$26.33
$53.42
Family
$40.75
$82.45
COVERAGE TIER
NOTE: THIS IS NOT MAJOR MEDICAL INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL INSURANCE. IT DOES NOT QUALIFY AS MINIMUM ESSENTIAL HEALTH COVERAGE UNDER THE FEDERAL AFFORDABLE CARE ACT.
30
NOTES
31
CONTACT INFORMATION Ph o n e : 1 (4 1 7 ) 8 9 3 .8 4 3 7 Em a il: in fo @ h p m g -llc .c om
32