•  Base Plan
     
    Click on these links to view a schedule of benefits covered
    for the Medical Base Plan: 
      
     
     
     
     

    Benefit Design

    Medical Base Plan

    Deductible (Plan Year):

    $1,000

    Individual

    Family

    $2,000

    Coinsurance:

    80%

    Total Out of Pocket Max:

    $3,000

    Individual

    Family

    $6,000

    Physician Office Visit:

    $25

    Specialist Office Visit:

    $35

    Emergency Room:

    $100, then Ded / Coins

    Urgent Care:

    $35, then Ded / Coins

    Inpatient Hospital:

    $100, then Ded / Coins

    Outpatient Surgery:

    Ded / Coins

    Prescription:

    $10/30/50  

    Specialty:  $75 or $125
       

    Employee Monthly Premiums: 

    Monthly Medical Premiums

    Base Plan

    w/o Wellness   w/Wellness

    Employee only

    $55            $25

    Employee & spouse

    $540          $510

    Employee & children

    $390          $360

    Family

    $875          $845