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EMPLOYEES
Benefiotwsledge
kn is power.
MEDICAL COVERAGE OPTIONS
HSA PPO Traditional PPO High Deductible PPO
ANNUAL DEDUCTIBLE ANNUAL DEDUCTIBLE ANNUAL DEDUCTIBLE
$1,500/individual; $700/individual; $2,100/individual;
$3,000/family $1,400/family $4,200/family
(Medical/RX deductible combined) (Medical deductible only) (Medical/RX deductible combined)
OFFICE VISITS OFFICE VISITS OFFICE VISITS
90% paid after deductible is met $25 primary | $40 specialty 80% paid after deductible is met
COINSURANCE COINSURANCE COINSURANCE
90% paid after deductible is met 80% paid after deductible is met 80% paid after deductible is met
ANNUAL OUT-OF-POCKET MAX ANNUAL OUT-OF-POCKET MAX ANNUAL OUT-OF-POCKET MAX
$3,000/individual; $5,000/individual; $4,000/individual;
$6,000/family $10,000/family $8,000/family
Qualifies for health savings account with
Optum Bank
DENTAL VISION
PRESCRIPTION DRUG COVERAGE DEDUCTIBLE ANNUAL VISION EXAM
$50 for one member $0 copay
HSA PPO Traditional PPO High Deductible PPO $100 for family FRAMES
PPO PLAN PAYS $150 plan allowance
GENERIC GENERIC
Member pays GENERIC 100% of preventive care + 20% off remaining balance
Member pays
full cost until $12.50 copay 80% of basic care STANDARD LENSES
full cost until
deductible is PREFERRED deductible is 50% of major care $10 copay
met, then 10% 30% with $50 met, then 20% 50% of orthodontic care for
CONTACTS
min/$75 max dependent children
Conventional $150 allowance
through age 18 up to a
NONPREFERRED + 15% discount off remaining
$1,500 lifetime maximum
50% with $75 charge
per dependent
min/$100 max Disposable $150 allowance
ANNUAL MAXIMUM
$1,000 per member
OTHER BENEFITS
Rental & Car Sales
Employee Assistance Discounts
Program
Quit For Life
Travel Assistance Be tobacco free or complete the Quit For
Life tobacco cessation program to qualify
for reduced medical premiums.