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* Passport Select Option More Information Available at Chamber
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Independent Health
Flex Fit Select Options
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Independent Health
Encompass Essentials
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Univera
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Univera
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Doctor Office Visits: $35 Prescription: $7/100%/100%
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Flex-Fit
Active
Age 19
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Flex-Fit
Family
Age 23
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Flex-Fit
Independent
Age 26
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Encompass Essentials
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Univera Solutions B
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Simply Univera *No Out Of Network Coverage
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Doctor's Office Visits
Specialist
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Primary 0-18: $25
Primary 19+: $15
OB/GYN: $25
$40 copay all ages
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Primary 0-18: $0
Primary 19+: $25
OB/GYN: $25
$40 copay all ages
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Primary all ages: $25 copay
OB/GYN: $25
$40 copay all ages
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$25;
Age (0-18) $5
$40
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$20/$40 copay Single Plan
$25/$40 copay Family Plan
Routine OB/GYN: $20/$25
Children 19 & under no copay for Family Coverage well/sick visits
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$30 copay
OB/GYN: $30
Specialist $50
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X-rays
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$40 copay
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$40 copay
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$40 copay
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$25;
Age (0-18) $5
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$20 copay - Single Plan
$25 copay - Family Plan
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$30 Per Visit
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Pre-post natal maternity care
Maternity Radiology Tests
Hospital Delivery/Newborn
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Covered in full
$25 copay
$500 copay
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Covered in full
$25 copay
$0 copay
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Covered in full
$250 copay
$500 copay
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Covered in full
$500 per admission
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$500 Copay - Single
Family Covered in Full
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Single - $500 Copay per admission
Family Plan - $500 Copay per admission
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Out patient lab procedures
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Covered in full
|
Covered in full
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Covered in full
|
Covered in full
|
Covered in full
|
Covered in full
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Emergency room visits (waived if admitted)
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$50 copay
|
$50 copay
|
$50 copay
|
$100 copay
|
$100 copay
|
$100 copay
|
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In-patient hospitalization
|
$500 copay
|
$0 (0-18)
$500 (19+) copay
|
$500 copay
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$500 per admission
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$500 Copay Single
$500 Copay Family
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$500 copay per admission
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Prescriptions
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$10/$30/$100
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$10/$30/$100
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$10/$30/$100
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$15/$50/50%
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$10/$30/$50
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$7/$50/$100
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Community Blue HMO 100 (104 Plus)
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Community Blue POS 150D
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Doctor's Office Visits
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$25 copay-
obgyn - $25 copay
$40 Specialist copay
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$25 copay
$40 Specialist copay
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X-rays
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$40 copay
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Deductible & Coinsurance
(Deductible $500/$1,000)
(Coinsurance $5,000/$10,000)
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Pre-post natal maternity care
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Cover in full, delivery subject to copay, $25
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Cover in full after $25 Copay
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Out patient lab procedures
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Cover in full
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Deductible & Coinsurance
($500/$1,000) ($5,000/$10,000)
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Emergency room visits
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$100 copay
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Deductible & $100 copay
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In-patient hospitalization
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$500 copay
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Deductible & Coinsurance
($500/$1,000) ($5,000/$10,000)
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Prescriptions
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$10/30/50% copay
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$15/$50/50%
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This comparison is based on information provided, in part, by parties other than the insurance carriers. It is not a complete analysis and is to be read in conjunction with the appropriate contracts and corresponding brochures. The brief description of most benefits does not include all relevant conditions, limitations and exclusions. For complete information, refer to the appropriate contracts. Whenever this comparison differs from language in the contract, the contract language shall prevail. Any member applying for insurance must do so within 30 days of joining the Chamber and any new employees must apply within 30 days of hire date or within 30 days of end of probation period, if applicable. If these dates are missed, you can participate at the annual Open Enrollment effective April 1st. 12/3/08
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