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Not all coverage is the right coverage.

The healthcare coverage you need is probably very different than the coverage some of your co-workers need. Age, family status, medical conditions, hobbies, lifestyle and a myriad of other factors will help you determine if you need a lot or a very little amount of health coverage. That’s why HealthEZ provides multiple coverage options, so you’re never caught paying too much money, or worse, having too little coverage.

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Summary Of Medical Benefits

Medical Plan

In-Network

Out-Of-Network

Deductible

Employee Only

Family

 

$500

$1,000

 

$500

$1,000

Out-Of-Pocket Maximum

Employee Only

Family

 

$1,000

$2,000

 

$2,000

$4,000

Preventive Care

$15 Copay

30%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$15 Copay

$15 Copay

10%*

 

30%*

30%*

30%*

Urgent Care Services

$15 Copay

30%*

Complex Imaging: MRI/CT/PET Scans

10%*

30%*

Inpatient Hospital Care

Facility Fee

Physician Fee

10%*

10%*

10%*

30%*

30%*

30%*

Outpatient Procedure

Facility Fee

Physician Fee

 

10%*

10%*

 

30%*

30%*

Emergency Room

Emergency Medical Transportation

10%*

10%*

10%*

10%*

Mental health/Chemical Dependency

Inpatient

Office Visit

 

10%*

$15 Copay

 

30%*

30%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty Generic

Specialty Preferred or Non Preferred

Retail 30 Day Supply

$5 Copay

$20 Copay

$20 Copay

$5 Copay

$20 Copay

Mail Order 90 day Supply

$5 Copay

$20 Copay

$20 Copay

Not Available

Not Available

Teladoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

No Charge

$15 Copay

No Charge

No Charge

No Charge

 

No Charge

$15 Copay

No Charge

No Charge

No Charge

NOTE: *Coinsurance after deductible

Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions

 

 

 

 

Dental

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$100

$200

 

$100

$200

Calendar Year Benefit Maximum

$3,500 Per Person

$3,500 Per Person

Preventive & Diagnostic Care

No Charge

No Charge

Basic Restorative Care

20%

20%

Major Restorative Care

50%

50%


If you prefer talking with a HealthEZ representative, call 866-768-9683