Our Health Insurance Plans

Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Plan 6
Plan Name MEC 2 MEC 5 MVP Bronze MVP Gold MVP Plus MVP Ultra
Network PHCS / Multiplan PHCS / Multiplan PHCS / Multiplan PHCS / Multiplan PHCS / Multiplan PHCS / Multiplan
ACA Preventative Benefits Included Included Included Included Included Included
Virtual Medicine Included Included Included Included Included Included
Deductible None None None None None None
Maximum Out of Pocket $7,350 $7,350 $7,350 $5,000 $2,000 $2,000
Inpatient Hospital Services No Benefit $350 Copay per admission(3 day limit) $350 Copay per admission(5 day limit) $350 Copay per admission(10 day limit) $400 Copay $400 Copay
Outpatient Hospital Services / Surgical No Benefit $350 Copay per admission(1 visit limit) $350 Copay per admission(5 visit limit) $350 Copay per admission(10 visit limit) $400 Copay $400 Copay
Maternity Inpatient No Benefit No Benefit No Benefit Included as in-patient hospital stay $400 Copay $400 Copay
Office Visits - PCP $25 Copay - 2 visits per year $25 Copay - 6 visits per year $25 Copay - 8 visits per year $15 Copay - 12 visits per year $20 Copay $20 Copay
Office Visits - Specialist $50 Copay - 2 visits per year $50 Copay - 6 visits per year $50 Copay - 8 visits per year $25 Copay - 12 visits per year $20 Copay $20 Copay
Lab / X-Ray $50 Copay - 1 visit per year $50 Copay - 3 visit per year $50 Copay - 3 visit per year $50 Copay - 4 visit per year $50 Copay $50 Copay
CT/MRI/MRA/PET Scan No Benefit $350 Copay - 1 visit per year $350 Copay - 1 visit per year $350 Copay - 3 visits per year $400 Copay $400 Copay
Urgent Care $50 Copay - 2 visits per year $50 Copay - 2 visits per year $50 Copay - 2 visits per year $35 Copay - 3 visits per year $50 Copay $50 Copay
Emergency Room No Benefit $350 Copay - 1 visit per year $350 Copay - 1 visit per year $350 Copay - 2 visits per year $400 Copay $400 Copay
Chemotherapy/Radiation No Benefit No Benefit No Benefit No Benefit No Benefit $400 Copay
Dialysis No Benefit No Benefit No Benefit No Benefit No Benefit $400 Copay
Colonoscopy No Benefit No Benefit No Benefit No Benefit No Benefit $400 Copay
Prescriptions Generic Drugs - $10 Copay Generic Drugs - $10 Copay Generic Drugs - $10 Copay Generic & Limited Brand 20% Copays
Generic: $10
Brand: $40
Copays
Generic: $10
Brand: $40
Non Pref: $80
This is general benefit information and should not be constituted as a guarantee of coverage or a level of benefit. Participants must follow plan rules to get the most from the plan. See policy or SBC for detailed coverage.
Monthly Rates
Single $127.68 $277.81 $315.06 $374.01 $488.02 $561.99
EE + Spouse $189.70 $487.59 $545.52 $675.23 $809.24 $867.11
EE + Child(ren) $169.02 $417.66 $468.70 $574.82 $667.75 $714.11
Family $231.04 $627.43 $699.17 $876.04 $978.81 $1054.44