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Medical Plan

Anthem Blue Cross Bronze Plan

You may visit in-network or out-of-network providers, but consider the cost difference before visiting the doctor.  Benefit Tip:  This plan has the highest deductible.  Coinsurance is the same in the Silver and Bronze plans, so consider whether you prefer a higher annual deductible and lower paycheck premiums (Bronze) or a lower annual deductible and higher paycheck premiums (Silver).

Click for Anthem Blue Cross Bronze Plan 2021.

Anthem Blue Cross Bronze Plan
In-Network
Out-of-Network
Calendar Year Deductible
Individual
$3,000
$3,000
Family
$6,000***
$6,000***
Calendar Year Out-of-Pocket Maximum (Includes Deductible)
Individual
$6,000
$11,000
Family
$11,000
$33,000
Coinsurance/Copays
You Pay
You Pay
Preventive Care
$0
50%*
Primary Care Physician
30%*
50%*
Specialist
30%*
50%*
Urgent Care
30%*
50%*
Emergency Room
30%*
30%*
Inpatient Hospital
30%*
50%*
Mental Health & Substance Abuse
You Pay
You Pay
Inpatient
30%*
50%*
Outpatient
30%*
50%*
Pharmacy Retail RX (up to 30-day supply)
You Pay
Preventive
$0
Generic
$10*
Preferred Brand
30%*: $25 min.**/$50 max.
Non-Preferred Brand
30%*: $50 min.**/$100 max.
Specialty
30%*: $75 min.**/$200 max.
Mail Order RX (up to 90-day supply)
You Pay
Preventive
$0
Generic
$20*
Preferred Brand
30%*: $65 min.**/$125 max.
Non-Preferred Brand
30%*: $125 min.**/$250 max.
Specialty (30-day supply only)
30%*: $75 min.**/$200 max.

*Copay/cost share applies after plan deductible is met.
**If the actual cost of the drug is less than the minimum, you pay the cost of the drug.
***For coverage types other than Employee Only, the deductible will automatically default to the family deductible.

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Medical Plan

Anthem Blue Cross Bronze Plan

You may visit in-network or out-of-network providers, but consider the cost difference before visiting the doctor.  Benefit Tip:  This plan has the highest deductible.  Coinsurance is the same in the Silver and Bronze plans, so consider whether you prefer a higher annual deductible and lower paycheck premiums (Bronze) or a lower annual deductible and higher paycheck premiums (Silver).

Click for Anthem Blue Cross Bronze Plan 2021.

Anthem Blue Cross Bronze Plan
In-Network
Out-of-Network
Calendar Year Deductible
Individual
$3,000
$3,000
Family
$6,000***
$6,000***
Calendar Year Out-of-Pocket Maximum (Includes Deductible)
Individual
$6,000
$11,000
Family
$11,000
$33,000
Coinsurance/Copays
You Pay
You Pay
Preventive Care
$0
50%*
Primary Care Physician
30%*
50%*
Specialist
30%*
50%*
Urgent Care
30%*
50%*
Emergency Room
30%*
30%*
Inpatient Hospital
30%*
50%*
Mental Health & Substance Abuse
You Pay
You Pay
Inpatient
30%*
50%*
Outpatient
30%*
50%*
Pharmacy Retail RX (up to 30-day supply)
You Pay
Preventive
$0
Generic
$10*
Preferred Brand
30%*: $25 min.**/$50 max.
Non-Preferred Brand
30%*: $50 min.**/$100 max.
Specialty
30%*: $75 min.**/$200 max.
Mail Order RX (up to 90-day supply)
You Pay
Preventive
$0
Generic
$20*
Preferred Brand
30%*: $65 min.**/$125 max.
Non-Preferred Brand
30%*: $125 min.**/$250 max.
Specialty (30-day supply only)
30%*: $75 min.**/$200 max.

*Copay/cost share applies after plan deductible is met.
**If the actual cost of the drug is less than the minimum, you pay the cost of the drug.
***For coverage types other than Employee Only, the deductible will automatically default to the family deductible.

Part-time and Temporary employees are eligible for a limited subset of benefits.  Union employees: refer to your collective bargaining agreement for your benefits eligibility.