Unified Fire Authority
Medical Benefits
Administered by SelectHealth
Comprehensive healthcare provides peace of mind . In case of an illness or injury , you and your family are covered with an excellent medical plan through Unified Fire Authority .
Unified Fire Authority offers one plan design through SelectHealth that accesses IHC facilities . The base network is SelectHealth Med and the buy-up network is the SelectHealth Care .
The health plan deductible is based on a plan year ; therefore your deductible will reset every July 1 . Pre-authorizations are required for certain services .
Lifetime Maximum Plan Payment ( Per Person ) Preexisting Conditions ( PEC )
In-Network
Benefit Accumulator Period Plan year ( July 2023 – June 2024 )
None None
Out-of-Network
|
Maximum Annual Out-of-Network Payment
( per plan year )
|
None |
None |
|
Medical Deductible and Out-of-Pocket
Annual Deductible *
( individual / family )
|
$ 1,000 / $ 2,000 |
$ 2,000 / $ 4,000 |
|
Annual Out-of-Pocket Maximum
( individual / family )
|
$ 3,000 / $ 6,000 |
$ 6,000 / $ 12,000 |
Coinsurance |
20 % |
40 % |
Inpatient Services |
|
|
Medical , Surgical and Hospice 20 % after deductible 40 % after deductible
Skilled Nursing Facility ( up to 60 days per plan year )
Inpatient Rehab Therapy : Physical , Speech , Occupational ( up to 40 days per plan year for all therapy types )
Professional Services
20 % after deductible 40 % after deductible
20 % after deductible 40 % after deductible
Office Visits ( PCP / SCP ) $ 15 / $ 20 40 % after deductible Allergy Tests See Office Visits Above Not covered Allergy Treatment and Serum 20 % Not covered Major Surgery 20 % 40 % after deductible
Preventive Care
Primary Care Provider Covered 100 % Not covered Secondary Care Provider Covered 100 % Not covered Adult and Pediatric Immunizations Covered 100 % Not covered Elective Immunizations Covered 100 % Not covered
Diagnostic Tests : Minor |
Covered 100 % |
Not covered |
Vision Services |
|
|
Preventive Eye Exams Covered 100 % Not covered All Other Eye Exams $ 20 40 % after deductible
* Annual Deductible : Individual responsible for first $ 500 of deductible . or $ 1,000 reimbursement per family . Anything above $ 500 automatically reimbursed to the employee . Visit ” Health Reimbursement Arrangement ( HRA )” on page 29 for more details on the HRA .
7