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Buy-Up Plan
Click on these links to view a schedule of benefits covered for the Medical Buy-Up Plan:
Buy-Up Plan - UMR Benefit Summary
Buy-Up Plan Summary of Benefits & Coverage - Health Care Reform Document
Benefit Design
Medical Buy Up Plan
Deductible (Plan Year):
$500
Individual
Family
$1,000
Coinsurance:
90%
Total Out of Pocket Max:
$1,500
Individual
Family
$3,000
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
Buy Up Plan
w/o Wellness w/Wellness
Employee only
$100 $70
Employee & spouse
$630 $600
Employee & children
$460 $430
Family
$990 $960