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 medical plan design through SelectHealth that allows employees a choice between two networks- SelectHealth Med or SelectHealth Care. The base network is SelectHealth Med and the buy-up network is SelectHealth Care. With both networks employees may access IHC Facilities.
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.
SelectHealth Care and Value Networks
Care and Med Network In-Network
Out-of-Network Out-of-Network
Annual Deductible( per person / family)
Annual Out-of-Pocket Maximum( per person / family)
Coinsurance
DOCTOR’ S OFFICE
Office Visits( PCP / SCP) Preventive Care
PRESCRIPTION DRUGS
Retail – 30 day supply Tier 1 Tier 2 Tier 3 Tier 4
Retail or Mail Order – 90 day supply Maintenance Tier 1 Maintenance Tier 2 Maintenance Tier 3
HOSPITAL SERVICES
Emergency Room Urgent Care Inpatient Services Outpatient Surgery Ambulance Service
MENTAL HEALTH SERVICES
Office Visits Inpatient Services Outpatient Services
SUBSTANCE ABUSE SERVICES
Office Visits Inpatient Services Outpatient Services
OTHER SERVICES
Maternity Services Home Health Care Outpatient Rehab Therapy: Physical, Speech, Occupational Connect Care
$ 2,000 / $ 4,000 |
$ 4,000 / $ 8,000 |
$ 4,000 / $ 8,000 |
$ 8,000 / $ 16,000 |
20 % AD |
40 % |
$ 15 / $ 20 Copay |
40 % After Deductible |
Covered 100 % |
Not Covered |
$ 10 |
$ 25 |
$ 45 |
$ 100 |
$ 10 |
$ 50 |
$ 135 |
$ 75 After Deductible |
$ 30 Copay |
40 % After Deductible |
20 % After Deductible |
40 % After Deductible |
20 % After Deductible |
40 % After Deductible |
20 % After Deductible |
Covered 100 % |
Covered 100 % After Deductible |
20 % After Deductible |
40 % After Deductible |
20 % |
40 % After Deductible |
Covered 100 % |
Covered 100 % After Deductible |
20 % After Deductible |
40 % After Deductible |
20 % |
40 % After Deductible |
20 % After Deductible |
40 % After Deductible |
20 % After Deductible |
40 % After Deductible |
$ 20 After Deductible |
40 % After Deductible |
Covered 100 % |
Not Available |
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