YOU’RE IN CHARGE! PILOT YOUR HEALTHCARE WITH THE MEDICAL PLAN LINEUP
The company’s medical plan is administered by UMR, and designed to help you maintain your health through preventive care services, access to an extensive network of providers, and affordable prescription medication.
Terms To Know
- Deductible—The amount you pay for covered services before the Plan will pay. Your deductible amount varies and is based on the Plan you enroll in.
- Co-insurance—Your share of the cost for covered services, calculated as a percentage of the total eligible expenses.
- Out-of-Pocket (OOP) Maximum—Protects you from major expenses with a maximum annual limit on the amount you pay for covered services. Your OOP max is calculated on your deductible and healthcare costs including co-insurance and co-payments, but not your employee contributions. Once you reach the OOP max, the Plan pays 100% of covered services for the remainder of the year.
Core Plan - HDHP
| Medical Plan – In Network | You Pay |
|---|---|
| Deductible | |
| Individual | $4,500 |
| Family | $9,000 |
| Out of Pocket Maximum (includes deductible) | |
| Individual | $7,000 |
| Family | $14,000 |
| HSA Contribution from CPM | |
| Employee Only | $500 |
| Employee + 1 Dependent | $750 |
| Employee + Family | $1,500 |
| Coinsurance / Copays (after deductible) | |
| Teladoc Consult | $49 per consult |
| Primary Care Physician | 20% after deductible |
| Specialist | 20% after deductible |
| Diagnostic Tests: X-rays, Lab, Blood Work | 20% after deductible |
| Imaging: CT/PET Scans, MRIs | 20% after deductible |
| Urgent Care | 20% after deductible |
| Emergency Room | 20% after deductible |
| Inpatient Hospital Care | 20% after deductible |
| Outpatient Surgery | 20% after deductible |
| Preventive Care | |
| Preventive Care Services | $0 |
| Out‐of‐Network: All out‐of‐network services are subject to the amount determined to be eligible by the plan and you are responsible for all charges over this allowance. | |
Premier Plan - PPO
| Medical Plan – In Network | You Pay |
|---|---|
| Deductible | |
| Individual | $700 |
| Family | $1,400 |
| Out of Pocket Maximum (includes deductible) | |
| Individual | $6,500 |
| Family | $13,000 |
| Coinsurance / Copays (after deductible) | |
| Teladoc Consultation | $0 per consult |
| Primary Care Physician | $20 |
| Specialist | $20 |
| Diagnostic Tests: X-rays, Lab, Blood Work | Included with the office visit copay |
| Imaging: CT/PET Scans, MRIs | 20% after deductible |
| Urgent Care | $20 |
| Emergency Room | $250 copay + 20% after deductible |
| Inpatient Hospital Care | 20% after deductible |
| Outpatient Surgery | 20% after deductible |
| Preventive Care | |
| Preventive Care Services | $0 |
| Out‐of‐Network: All out‐of‐network services are subject to the amount determined to be eligible by the plan and you are responsible for all charges over this allowance. | |
ID Cards
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