A significant change in this year’s Benefits Open Enrollment process is the availability of two medical plans, each with differing coverage levels and differing contributions. A breakdown of each plan is in the table that follows.
Remember: If you do not make a choice between the two options, you will be automatically enrolled in Option A, the standard plan. A full summary and comparison of both plans will be included in the Benefits Open Enrollment packet.
| Option A: The Standard Plan |
Option B: The Alternate Plan |
|||
| Plan Details: | In-Network | Out of Network | In-Network | Out of Network |
| Deductible | $250 Individual / $500 Family |
$750 Individual / $1,500 Family |
$250 Individual / $500 Family |
$750 Individual / $1,500 Family |
| Out-of-pocket | $2,000 Individual / $4,000 Family | $5,000 Individual / $10,000 Family | ||
| Coinsurance | 90% | 70% | 80% | 60% |
| Physician office, home or hospital visit co-pay | $15 | $25 | ||
| Generic drug co-pay | $10 | $10 | ||
| Brand-name co-pay drug with no generic option, or when physician prescribes as ‘Dispense as Written’ | $35 | $35 | ||
| Member requests brand drug when generic available co-pay | $35 plus cost difference | $35 plus cost difference | ||
| Employee Premium: | Option A: | Option B: | ||
| Employee only | $60 | $30 | ||
| Employee + child(ren) | $75 | $40 | ||
| Employee + spouse | $120 | $60 | ||
| Family | $130 | $70 | ||