Medical

Medical coverage provides healthcare protection for you and your family. You can visit any provider, but in-network doctors offer the highest level of benefits and lower out-of-pocket costs by charging reduced, contracted rates. Out-of-network providers set their own fees, so you may be responsible for charges above the Reasonable and Customary (R&C) limits. Preventive care—such as physical exams, flu shots, and screenings—is covered at 100% when you use in-network providers. The main differences between plan options are how much you pay per paycheck and what you pay when you receive care.

Each plan has different:

  • Annual deductible amounts – the amount you pay each year for eligible in-network and out-of-network charges before the plan begins to pay.
  • Out-of-pocket maximums– the most you will pay each year for eligible network services and/or prescriptions. After you reach your out-of-pocket maximum, the plan picks up the full cost of covered medical care for the remainder of the year.
  • Copays – A copay is a fixed amount you pay for a health care service. Copays do not count toward your deductible but do count toward your annual out-of-pocket maximum.
  • Coinsurance – Once you’ve met your deductible, you and the plan share the cost of care, which is called coinsurance. For example, you pay 20% for services and the plan will pay 80% of the cost until you have reached your out-of-pocket maximum.

Contact Information

Kaiser HMO

Benefit Highlights
In-Network

Deductible (Individual/Family)
$1,000/$2,000

Out-of-Pocket Max (Individual/Family)
$4,000/$8,000

Preventive Care
$0

Primary Care Visit
$20 copay

Specialist Visit
$20 copay

Urgent Care
$20 copay

Emergency Room
20% after deductible

Retail Rx (Up 30-day Supply)

Generic
$10

Brand Name
$30

Specialty
20% up to $250 per prescription

Mail Order Rx (Up 90-day Supply)

Generic
$20

Brand Name
$60

Specialty
20% up to $250 per prescription

Shows what you pay for in-network services only. You always pay the deductible and copay ($). You pay coinsurance (%) after you meet the deductible.

Plan Cost - Bi-weekly

Employee Only: $40.97

Employee and Spouse: $126.21

Employee and Child(ren): $99.97

Employee and Family: $191.21

Anthem PPO 1000

Benefit Highlights

In-Network

Deductible (Individual/Family)
$1,000/$3,000

Out-of-Pocket Max (Individual/Family)
$3,500/$7,500

Preventive Care
$0

Primary Care Visit
$20 copay

Specialist Visit
$40 copay

Urgent Care
$50 copay

Emergency Room
$250 per visit (waived if admitted)

Retail Rx (Up 30-day Supply)

Generic
$15

Brand Name
$30

Specialty
Varies based on tier

Mail Order Rx (Up 90-day Supply)

Generic
$30

Brand Name
$60

Specialty
2x retail (Varies based on tier)

Shows what you pay for in-network services only. You always pay the deductible and copay ($). You pay coinsurance (%) after you meet the deductible.

Plan Cost - Bi-weekly

Employee Only: $56.36

Employee and Spouse: $188.37

Employee and Child(ren): $131.35

Employee and Family: $239.30

Anthem HSA 1650

Benefit Highlights

In-Network

Deductible (Individual/Individual within a Family/Family)
$1,650/$3,300/$3,500

Out-of-Pocket Max (Individual/Individual within a Family/Family)
$4,000/$4,000/$5,000

Preventive Care
$0

Primary Care Visit
20% after deductible

Specialist Visit
20% after deductible

Urgent Care
20% after deductible

Emergency Room
20% after deductible

Retail Rx (Up 30-day Supply)

Generic
$15 after deductible

Brand Name
$30 after deductible

Specialty
Cost varies depending on drug tier

Mail Order Rx (Up 90-day Supply)

Generic
$30 after deductible

Brand Name
$60 after deductible

Specialty
Cost varies depending on drug tier

Shows what you pay for in-network services only. You always pay the deductible and copay ($). You pay coinsurance (%) after you meet the deductible.

Plan Cost - Bi-weekly

Employee Only: $41.74

Employee and Spouse: $104.93

Employee and Child(ren): $84.49

Employee and Family: $193.02

Anthem HRA 3500

Benefit Highlights

In-Network

Deductible (Individual/Family)
$3,500/$7,000

Out-of-Pocket Max (Individual/Family)
$4,500/$9,000

Preventive Care
$0

Primary Care Visit
20% after deductible

Specialist Visit
20% after deductible

Urgent Care
20% after deductible

Emergency Room
20% after deductible

Retail Rx (Up 30-day Supply)

Generic
$15 after deductible

Brand Name
$30 after deductible

Specialty
Cost varies depending on drug tier

Mail Order Rx (Up 90-day Supply)

Generic
$30 after deductible

Brand Name
$60 after deductible

Specialty
Cost varies depending on drug tier

Shows what you pay for in-network services only. You always pay the deductible and copay ($). You pay coinsurance (%) after you meet the deductible.

Plan Cost - Bi-weekly

Employee Only: $18.46

Employee and Spouse: $57.10

Employee and Child(ren): $44.20

Employee and Family: $106.68

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