Medical Comparison
Options for you and your family's health and financial well-being
Choosing the right medical plan is like choosing the right car. When buying a car, you take into consideration the cost of the car along with related expenses such as insurance and gas.
Apply the same logic to making the right medical plan decision. First consider the premium. Then think about expenses the plans does not cover such as deductibles and coinsurance.
The Preferred Provider Organization (PPO) plan includes an FSA in which you can contribute pre-tax dollars to use for eligible medical expenses. Each time you visit the doctor or receive health care services, you can use your pre-tax dollars towards the expenses.
The High Deductible Health Plan (HDHP) plan includes an HSA which covers incurred expenses by paying them from this allocation until the contribution dollars are exhausted.
Coverage Information and Rates
PPO
In Network | Out Of Network | |
---|---|---|
General Services | ||
Annual Deductible/Individual | $800 | $1,600 |
Annual Deductible/Family | $1,600 Embedded | $3,200 Embedded |
Annual Out-of-Pocket Limit/Individual | $3,500 | $7,000 |
Annual Out-of-Pocket Limit/Family | $7,000 | $14,000 |
Office Services | ||
Office Visit/Exam | $20 | 40% coinsurance |
Specialist Visit | $40 | 40% coinsurance |
Urgent Care | $40 | 40% coinsurance |
Preventative Services | 100% Covered | 40% coinsurance |
Hospital Services | ||
Inpatient Hospital | 20% After Deductible | 40% coinsurance |
Outpatient Surgery | 20% After Deductible | 40% coinsurance |
Emergency Room | $300 + 20% After Deductible | 40% coinsurance |
Prescription Drugs | ||
Retail (30 day supply) | ||
Generic | $10 | No Coverage |
Brand | $30 | No Coverage |
Non-Formulary | $50 | No Coverage |
Specialty | $200 | No Coverage |
Retail Maintenance (90 day supply) | ||
Generic | $30 | No Coverage |
Brand | $90 | No Coverage |
Non-Formulary | $150 | No Coverage |
Specialty | Available 30 days retail only | No Coverage |
Mail Order (90 day supply) | ||
Generic | $30 | No Coverage |
Brand | $90 | No Coverage |
Non-Formulary | $150 | No Coverage |
Specialty | Available only 30 days retail | No Coverage |
HDHP
In Network | Out Of Network | |
---|---|---|
General Services | ||
Annual Deductible/Individual | $1,800 | $3,600 |
Annual Deductible/Family | $3,600 Non-Embedded | $7,200 Non-Embedded |
Annual Out-of-Pocket Limit/Individual | $4,000 | $8,000 |
Annual Out-of-Pocket Limit/Family | $8,000 | $16,000 |
Office Services | ||
Office Visit/Exam | 20% After Deductible | 40% After Deductible |
Specialist Visit | 20% After Deductible | 40% After Deductible |
Urgent Care | 20% After Deductible | 40% After Deductible |
Preventative Services | 100% Covered | 40% coinsurance |
Hospital Services | ||
Inpatient Hospital | 20% After Deductible | 40% After Deductible |
Outpatient Surgery | 20% After Deductible | 40% After Deductible |
Emergency Room | 20% After Deductible | 40% After Deductible |
Prescription Drugs | ||
Retail (30 day supply) | ||
Generic | $10 After Deductible | No Coverage |
Brand | $30 After Deductible | No Coverage |
Non-Formulary | $50 After Deductible | No Coverage |
Specialty | $200 After Deductible | No Coverage |
Retail Maintenance (90 day supply) | ||
Generic | $30 After Deductible | No Coverage |
Brand | $90 After Deductible | No Coverage |
Non-Formulary | $150 After Deductible | No Coverage |
Specialty | Available 30 days retail only | No Coverage |
Mail Order (90 day supply) | ||
Generic | $30 After Deductible | No Coverage |
Brand | $90 After Deductible | No Coverage |
Non-Formulary | $150 After Deductible | No Coverage |
Specialty | Available only 30 days retail | No Coverage |
Employee | Monthly Premium | FORVIS' portion | Employee portion |
---|---|---|---|
Employee Only | 707.00 | 489.00 | 218.00 |
Employee & Spouse | 1,545.00 | 1,067.00 | 478.00 |
Employee & Child(ren) | 1,326.00 | 902.00 | 424.00 |
Employee & Family | 2,208.00 | 1,568.00 | 640.00 |
Employee | Monthly Premium | FORVIS' portion | Employee portion |
---|---|---|---|
Employee Only | 516.00 | 402.00 | 114.00 |
Employee & Spouse | 1,128.00 | 880.00 | 248.00 |
Employee & Child(ren) | 968.00 | 754.00 | 214.00 |
Employee & Family | 1,612.00 | 1,258.00 | 354.00 |
*Partner pays total monthly premium.