2012 Benefit Plan Choices Business Group Health Plan Member Benefits Home

2013 BENEFIT PLAN CHOICES

Medical

CMM HSA 100/0 Healthlink PPO. $2,500 Deductible, $2,500 OOP. Includes $100 preventive dental exam, $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Rx Pass Thru with mail order.

CMM HSA 100/0 Healthlink PPO. $5,000 deductible, $5,000 OOP. Includes $100 preventive dental exam, $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Rx Pass Thru with mail order.

CMM HSA 50/50 (In Network) 40/60 (Out of Network) Healthlink PPO. $2500 deductible, $5,000 OOP. Does not include $100 preventive dental exam. It does include $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Rx Pass Thru with mail order.

Health First 50/50 (In Network) 40/60 (Out of Network) Healthlink PPO. $2500 deductible, $7500 OOP. Includes $100 preventive dental exam, $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Drug Card with mail order.

Health First 50/50 (In Network) 40/60 (Out of Network) Healthlink PPO. $1,000 Deductible, $3,000 OOP. Includes $100 preventive dental exam, $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Drug Card with mail order. (optional)

NEW! Health First 50/50 (In Network) 40/60 (Out of Network) Healthlink PPO. $1,000 Deductible, $3,000 OOP. Includes $100 preventive dental exam, $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Rx Pass thru with mail order.

Health First 60/40 (In Network) 50/50 (Out of Network) Healthlink PPO. $500 Deductible, $2,000 OOP. Includes $100 preventive dental exam, $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Drug Card with mail order.

Health First 70/30 (In Network) 55/45 (Out of Network) Healthlink PPO. $500 Deductible, $2,000 OOP. Includes $100 preventive dental exam, $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Drug Card with mail order.

Health First 80/20 (In Network) 65/35 (Out of Network) Healthlink PPO. $1,500 Deductible, $1,500 OOP. Includes $100 preventive dental exam, $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Drug Card with mail order. (optional)

New! Health First 80/20 (In Network) 65/35 (Out of Network) Healthlink PPO. $1,500 Deductible, $1,500 OOP. Includes $100 preventive dental exam, $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Rx Pass thru with mail order.

CMM 50/50 (In Network) 40/60 (Out of Network) Healthlink PPO. $200 Deductible, $3,200 OOP. Includes $100 preventive dental exam, $10 VSP vision exam (details below), 100% of allowable fee paid on preventive services including mammography, colonoscopy, annual and well child exams. Rx Pass Thru with mail order.

Added Member Benefits

Up to $100 for preventive dental exam and/or oral prophylaxes (cleaning) for all each covered member.

VSP vision exam with $10 copayment for all COVERED MEMBERS. Discounts on frames and lenses.

Optional voluntary life insurance purchased individually for additional security for you and your employees.

CMM HSA PPO, CMM PPO, and NEW! Health First Options:
Prime Therapeutics Pass Thru with Mail Order.
All Health First PPO Options, except 80/20:
Mail order option available. $150 deductible (waived on generics).
Retail Pharmacy: $8/25/50% + $1,500 OOP on 50% tier only*
Mail Order Services: $16/50/50% + $1,500 OOP on 50% tier only*
*Once $1,500 OOP is met, non-formulary prescriptions are paid at 100%
Mandatory Generic l Contraceptives - All forms
Health First PPO 80/20
Mail order option available. $0 deductible.
Retail Pharmacy: $8/25/50% + $1,500 OOP on 50% tier only*
Mail Order Services: $16/50/50% + $1,500 OOP on 50% tier only*
*Once $1,500 OOP is met, non-formulary prescriptions are paid at 100% Mandatory Generic l Contraceptives - All forms