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The PPO plan features a $1,000 deductible and a $3,200 out-of-pocket maximum for individual coverage; for family coverage the deductible is $2,000 and the out-of-pocket maximum is $6,400. The out-of-pocket maximum includes the deductible and all copays. Once you reach the out of pocket maximum amount, your medical expenses will be capped for the remainder of the calendar year. The in-network coinsurance amount is 80%.

For primary care visits, you will pay a $30 copay; for specialist visits, you will pay $40. The emergency room copay is $250. Your medical plan also comes with a $10 vision copay. All qualifying preventive care is covered at 100% with no charges.


 Monthly Plan Rates
  Network S Network P
  PPO Premium PPO Premium
Employee $95.44 $116.48
Employee & Child(ren) $176.20 $214.96
Employee & Spouse $205.24 $250.32
Family $291.68 $355.80
If either you or your spouse use tobacco products, as defined by the policy, we will add an additional $15 per month to your rate. This applies to both Network S and Network P.