2019 Benefits

Option #1: High Deductible / HSA

Single $2,700 Family $5,400

Deductible: Coverage requires the deductible to be met before coinsurance applies

80% after deductible

Co-Insurance

Single $5,000 Family $10,000

Max Out of Pocket

Unlimited

Life Max

20% after deductible

Office Visit

100% no cost to associate

Preventative Care: Routine or periodic exams, well baby exams, well child exams, adult physical exams, pelvic examinations, routine EKG, immunizations, screening examinations

20% after deductible

Emergency Room

20% after deductible

Urgent Care

20% after deductible

Lab/Diagnostic

20% after deductible & contributes to Out of Pocket Max

RX Retail

20% after deductible & contributes to Out of Pocket Max

RX Mail Order