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Employee Benefits Overview
Plan A Health InsurancePlan B Health InsuranceWellness BenefitsTDA Retirement PlanLong Term Disability & Life InsuranceVacation/ Sick Leave & Holiday ScheduleDownload Benefits Brochure

Medical Insurance - Plan A

 Medical Deductible:

PPO - $600 per person per calendar year
PPO - $1200 per family per calendar year
NON-PPO - $1200 per person per calendar year
NON-PPO - $2400 per family per calendar year

Prescription Drug Deductible

Per person, per calendar year - $100
Per family, per calendar year - $300

Co-Insurance:
80% PPO after deductible
50% NON PPO after deductible
Out-Of-Pocket:
(per calendar year and excludes deductible)
$1,200 PPO
Unlimited NON PPO
Doctor Co-Pay:
PPO: $30 then 100% up to $150 max.
NON PPO: 50%
Prescription Drug Benefit:
*Co-Payments per prescription

Tier 1: Generic -Greater of $10 copay or 20%    Tier 2: Brand Name within formulary -Greater of $25 copay or 20%, deductible applies
Tier 3: Brand Name outside formulary- Greater of $55 copay or 30%, deductible applies
Tier 4: Lifestyle 50%, deductible applies          
Tier 5: Brand name when Generic Available - 100%
Dental Insurance:
Maximum Annual Benefit: $2,000
(other than orthodontic)
Orthodontic Lifetime Maximum: $2,000
Individual Calendar Year Deductible: $100

 
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