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Base PlanClick on these links to view a schedule of benefits covered for the Medical Base Plan:
Benefit Design
Medical Base Plan
Deductible (Plan Year):
$1,250
Individual
Family
$2,500
Coinsurance:
80%
Total Out of Pocket Max:
$5,000 (deductible, copays, coinsurance)
Individual
Family
$10,000 (deductible, copays, coinsurance)
Physician Office Visit:
$25
Specialist Office Visit:
$50
Teladoc Visit:
$15
Emergency Room:
Deductible / Coinsurance
Urgent Care:
$50
Inpatient Hospital:
$100, then Ded / Coins
Outpatient Surgery:
Deductible / Coinsurance
Prescription:
Generic: $10
Preferred brand: 20% up to $100 max
Non-preferred brand: 20% up to $200 max
Specialty: 20% up to $300 max
Employee Monthly Premiums:
Monthly Medical Premiums
Base Plan
w/o Wellness w/Wellness
Employee only
$60 $30
Employee & spouse
$590 $560
Employee & children
$420 $390
Family
$950 $920
Teladoc services now available include general medicine, dermatology and behavioral health:- call 800-TELADOC (800-835-2362) or visit Teladoc.com
- Teladoc health benefits summary
- Teladoc: How to set up your Teladoc Health account