Medical Benefits
Administered by SelectHealth
Comprehensive and preventive healthcare coverage is important in protecting you and your family from the financial risks of unexpected illness and injury . A little prevention usually goes a long way — especially in healthcare . Routine exams and regular preventive care provide an inexpensive review of your health . Small problems can potentially develop into large expenses . By identifying the problems early , often they can be treated at little cost .
Comprehensive healthcare also provides peace of mind . In case of an illness or injury , you and your family are covered with an excellent medical plan through HRCentral .
HRCentral offers you a choice of two types of medical plans , a Traditional plan and a Consumer Directed Health plan . With the PPO , you may select where you receive your medical services . If you use in-network providers , your costs will be less .
In-Network Care MedNetwork HDHP Base MedNetwork HDHP Plus MedNetwork Traditional Deductible
$ 4,500 – Employee Only *** $ 9,000 – Family
$ 2,000 – Employee Only *** $ 4,000 – Family
$ 1,250 – Employee Only *** $ 2,500 – Family
Member Coinsurance 30 % 20 % 20 %
Out-of-Pocket Maximum
$ 6,000 – Individual $ 12,000 – Family
$ 4,000 – Individual $ 8,000 – Family
$ 4,500 – Individual $ 9,000 – Family
Preventive |
100 % |
100 % |
100 % |
PCP Office Visit Copay |
30 % after deductible |
20 % after deductible |
$ 25 |
|
Specialist Office Visit
Copay
|
30 % after deductible |
20 % after deductible |
$ 50 |
Hospitalization |
30 % after deductible |
20 % after deductible |
20 % after deductible |
Urgent Care |
30 % after deductible |
20 % after deductible |
$ 50 |
Emergency Room |
30 % after deductible |
20 % after deductible |
$ 500 ( waived if admitted ) |
Retail Rx Copays * 30-Day Supply
Generic
Medical Deductible Applies to Rx **
Medical Deductible Applies to Rx **
|
|
$ 15 after Deductible ** |
$ 15 |
Preferred Brand |
30 % after Deductible |
$ 40 after Deductible ** |
$ 40 |
Non-Preferred Brand $ 60 after Deductible ** $ 60 Out-of-Network Care
Deductible
$ 9,000 – Employee Only *** $ 18,000 – Family
$ 4,000 – Employee Only *** $ 8,000 – Family
$ 2,500 – Employee Only *** $ 5,000 – Family
Member Coinsurance 50 % 50 % 50 %
Out-of-Pocket Maximum
$ 12,000 – Individual $ 24,000 – Family
$ 8,000 – Individual $ 16,000 – Family
$ 9,000 – Individual $ 18,000 – Family
* If your doctor doesn ’ t specify “ Dispense as Written ” ( DAW ) but you request a brand drug , you pay the generic copay plus the cost difference between the brand and the generic drugs . ** Preventive generic drugs are not subject to the medical deductible under the Consumer Directed plan options . See the SelectHealth Generic Preventative Drug List , available at www . selecthealth . org *** This Deductible in the Consumer Directed plans are for the Employee Only level of coverage . If you have one or more dependents on his medical plan you must satisfy the family deductible before the plan starts paying benefits .
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