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Medical Plan

Anthem Blue Cross Silver Plan

Enjoy the freedom to visit either in-network or out-of-network providers, but keep in mind that your costs may be higher with out-of-network providers. Benefit Tip: This plan features a mid-range annual deductible and premiums from your paycheck – plus includes free money from the Company for your Health Savings Account.

Click for Anthem Blue Cross Silver Plan 2021.

 

 

Anthem Blue Cross Silver Plan
In-Network
Out-of-Network
Calendar Year Deductible
Individual
$2,000
$2,000
Family
$4,000***
$4,000***
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
20%*
50%*
Specialist
20%*
50%*
Urgent Care
20%*
50%*
Emergency Room
20%*
20%*
Inpatient Hospital
20%*
50%*
Mental Health & Substance Abuse
You Pay
You Pay
Inpatient
20%*
50%*
Outpatient
20%*
50%*
Pharmacy Retail RX (up to 30-day supply)
You Pay
Preventive
$0
Generic
$10*
Preferred Brand
20%*: $25 min.**/$50 max.
Non-Preferred Brand
20%*: $50 min.**/$100 max.
Specialty
20%*: $75 min.**/$200 max.
Mail Order RX (up to 90-day supply)
You Pay
Preventive
$0
Generic
$20*
Preferred Brand
20%*: $65 min.**/$125 max.
Non-Preferred Brand
20%*: $125 min.**/$250 max.
Specialty (30-day supply only)
20%*: $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 Silver Plan

Enjoy the freedom to visit either in-network or out-of-network providers, but keep in mind that your costs may be higher with out-of-network providers. Benefit Tip: This plan features a mid-range annual deductible and premiums from your paycheck – plus includes free money from the Company for your Health Savings Account.

Click for Anthem Blue Cross Silver Plan 2021.

 

 

Anthem Blue Cross Silver Plan
In-Network
Out-of-Network
Calendar Year Deductible
Individual
$2,000
$2,000
Family
$4,000***
$4,000***
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
20%*
50%*
Specialist
20%*
50%*
Urgent Care
20%*
50%*
Emergency Room
20%*
20%*
Inpatient Hospital
20%*
50%*
Mental Health & Substance Abuse
You Pay
You Pay
Inpatient
20%*
50%*
Outpatient
20%*
50%*
Pharmacy Retail RX (up to 30-day supply)
You Pay
Preventive
$0
Generic
$10*
Preferred Brand
20%*: $25 min.**/$50 max.
Non-Preferred Brand
20%*: $50 min.**/$100 max.
Specialty
20%*: $75 min.**/$200 max.
Mail Order RX (up to 90-day supply)
You Pay
Preventive
$0
Generic
$20*
Preferred Brand
20%*: $65 min.**/$125 max.
Non-Preferred Brand
20%*: $125 min.**/$250 max.
Specialty (30-day supply only)
20%*: $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.