Plan 1 PPO $1,500- Large Network
Co-pay for Dr Visits
Virtual visits $10 Primary $25 Specialist $40 Well care 100%
Coinsurance
80% after ded
Deductible
Individual $1,500
Max out of pocket per year
$4,000
Hospital inpatient copay
$250 copay + ded + 80%
Emergency room
$100 then 100%
Surgery/services
80% after ded
Therapy services
$60 then 100%
Premium rates EE contributions per paycheck
$158.22
Plan 2 PPO Choice $1,500- Small Network (Illinois employees only)
Co-pay for Dr Visits
Virtual visits $10 Primary $25 Specialist $40 Well care 100%
Coinsurance
80% after ded
Deductible
Individual $1,500
Max out of pocket per year
$4,000
Hospital inpatient copay
$250 copay + ded + 80%
Emergency room
$100 then 100%
Surgery/services
80% after ded
Therapy services
$60 then 100%
Premium rates EE contributions per paycheck
$140.94
Plan 3 HMO IL HMOI
Co-pay for Dr Visits
Virtual visits N/A Primary $25 Specialist $40 Well care 100%
Coinsurance
100%
Deductible
Individual N/A
Max out of pocket per year
$3,000
Hospital inpatient copay
$750/day up to 3 day max then 100%
Emergency room
$200 then 100%
Surgery/services
100% $250 then 100%
Therapy services
$60 then 100%
Premium rates EE contributions per paycheck
$116.32
Plan 4 BA HMO Blue Advantage HMO
Co-pay for Dr Visits
Virtual visits N/A Primary $25 Specialist $40 Well care 100%
Coinsurance
100%
Deductible
Individual N/A
Max out of pocket per year
$3,000
Hospital inpatient copay
$750/day up to 3 day max then 100%
Emergency room
$200 then 100%
Surgery/services
100% $250 then 100%
Therapy services
$60 then 100%
Premium rates EE contributions per paycheck
$75.27
Plan 5 HDHP/HSA (PPO network)
Co-pay for Dr Visits
Virtual visits $44 up to ded then 80% Primary $44 up to ded then 80% Specialist 80% after ded Well care 100%: no ded
Coinsurance
80% after ded
Deductible
Individual $2,800
Max out of pocket per year
$5,000
Hospital inpatient copay
80% after ded
Emergency room
90% after deductible
Surgery/services
80% after deductible
Therapy services
80% after deductible
Premium rates EE contributions per paycheck
$121.98
Plan 6 HDHP/HSA Plan (PPO network)
Co-pay for Dr Visits
Virtual visits $44 up to ded then 80% Primary $44 up to ded then 80% Specialist 80% after ded Well care 100%: no ded
Coinsurance
80% after ded
Deductible
Individual $6,000
Max out of pocket per year
$6,350
Hospital inpatient copay
80% after ded
Emergency room
80% after deductible
Surgery/services
80% after deductible
Therapy services
80% after deductible
Premium rates EE contributions per paycheck
$53.37
submitted by /u/streetcowboygt06
[link] [comments]
Plan 1 PPO $1,500- Large Network Co-pay for Dr Visits
Virtual visits $10 Primary $25 Specialist $40 Well care 100%
Coinsurance
80% after ded
Deductible
Individual $1,500
Max out of pocket per year
$4,000
Hospital inpatient copay
$250 copay + ded + 80%
Emergency room
$100 then 100%
Surgery/services
80% after ded
Therapy services
$60 then 100%
Premium rates EE contributions per paycheck
$158.22
Plan 2 PPO Choice $1,500- Small Network (Illinois employees only) Co-pay for Dr Visits
Virtual visits $10 Primary $25 Specialist $40 Well care 100%
Coinsurance
80% after ded
Deductible
Individual $1,500
Max out of pocket per year
$4,000
Hospital inpatient copay
$250 copay + ded + 80%
Emergency room
$100 then 100%
Surgery/services
80% after ded
Therapy services
$60 then 100%
Premium rates EE contributions per paycheck
$140.94
Plan 3 HMO IL HMOI Co-pay for Dr Visits
Virtual visits N/A Primary $25 Specialist $40 Well care 100%
Coinsurance
100%
Deductible
Individual N/A
Max out of pocket per year
$3,000
Hospital inpatient copay
$750/day up to 3 day max then 100%
Emergency room
$200 then 100%
Surgery/services
100% $250 then 100%
Therapy services
$60 then 100%
Premium rates EE contributions per paycheck
$116.32
Plan 4 BA HMO Blue Advantage HMO Co-pay for Dr Visits
Virtual visits N/A Primary $25 Specialist $40 Well care 100%
Coinsurance
100%
Deductible
Individual N/A
Max out of pocket per year
$3,000
Hospital inpatient copay
$750/day up to 3 day max then 100%
Emergency room
$200 then 100%
Surgery/services
100% $250 then 100%
Therapy services
$60 then 100%
Premium rates EE contributions per paycheck
$75.27
Plan 5 HDHP/HSA (PPO network) Co-pay for Dr Visits
Virtual visits $44 up to ded then 80% Primary $44 up to ded then 80% Specialist 80% after ded Well care 100%: no ded
Coinsurance
80% after ded
Deductible
Individual $2,800
Max out of pocket per year
$5,000
Hospital inpatient copay
80% after ded
Emergency room
90% after deductible
Surgery/services
80% after deductible
Therapy services
80% after deductible
Premium rates EE contributions per paycheck
$121.98
Plan 6 HDHP/HSA Plan (PPO network) Co-pay for Dr Visits
Virtual visits $44 up to ded then 80% Primary $44 up to ded then 80% Specialist 80% after ded Well care 100%: no ded
Coinsurance
80% after ded
Deductible
Individual $6,000
Max out of pocket per year
$6,350
Hospital inpatient copay
80% after ded
Emergency room
80% after deductible
Surgery/services
80% after deductible
Therapy services
80% after deductible
Premium rates EE contributions per paycheck
$53.37
submitted by /u/streetcowboygt06 [link] [comments]Read Morer/HealthInsurance