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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):
$1,000
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