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Medical Insurance
The Health insurance is self- insured, administered by Select Benefit Administrators. Full-time and eligible part-time employees may participate in the medical plan beginning the first day of the month following hire. The plan covers either 80% or 60% of covered expenses, depending on if you use PPO providers. Three plan options are available. The Base Plan is a $750 deductible per person per year with a $20 office visit co-pay when using PPO providers. The Buy-up Plan is a $250 deductible per person per year with a $15 office visit co-pay when using PPO providers. Out-of-pocket maximums for the Base Plan are $2500 and the Buy-up Plan is $1500 when using PPO providers. The prescription drug benefit for both plans is a 3-tier formulary with monthly copays of $10 (generic), $25 (brand name formulary) and $50 (non-formulary drugs).
The third option is a PPO High Deductible Health Plan (HDHP), which has specific legal requirements. You can enroll in the HDHP only, or the HDHP and Health Savings Account (HSA) (used to set aside funds pre-tax to cover deductible and out-of pocket costs). The HSA balance accumulates from year to year and is not “use it or lose it”. The HDHP has the same type of benefits as the base and buy-up plans, but for most services, including prescriptions, you pay 100% of costs until you have met the deductible. Preventive care is paid at 100% prior to the deductible being met. The maximum amount you can deposit in your HSA annually is your deductible (single/family). Additional restrictions may affect your decision to enroll in this plan.
Dental Insurance
The Dental insurance is also a self-insured plan administered by Select Benefit Administrators. The plan features an annual $35.00 deductible per person per year. The plan pays 100% for preventive and basic restorative and 50% for major restorative and orthodontics. There is a $1000 maximum calendar year benefit on all services except orthodontics, which is limited to a lifetime maximum of $1,000. Coverage is effective the first of the month following date of hire.
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