HEALTH
Staywell
Health Insurance Plan
- Eligibility - All permanent
full-time and/or permanent part-time employees who work at least
25 hours per week and their eligible dependents. Date of
eligibility is 45 days for permanent full-time employees and 180
days for permanent part-time employees.
- PPO utilized is HealthSmart
Preferred Care, Inc.
- Co-Pay - $25.00 for office
visits. $25.00 for surgery performed in physician's office.
- Deductible- $700 per plan
year with a maximum of three per family ($2,100). Separate
$200 deductible for inpatient hospital admission (waived if PPO
hospital used). 80% covered
after deductible if in-network PPO provider is used.
Out-of-network benefits are covered at 60% after plan year
deductible for all covered expenses.
- Out-of-pocket maximum -
$1,800 for covered expenses (this does not include the $1,000 deductible).
- Prescription benefit-
Generic - $2.00
Name Brand (cost-effective) - $15.00 or 20%, whichever is greater
Name Brand (high cost) - $30.00 or 20%, whichever is greater
Name Brand (multisource) - member pays the cost difference between
brand drug and generic
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