For care coordinated by a Primary Care Physician (PCP), benefits are payable at the more cost-effective, in-network level, generally 100% after the applicable co-pay. Otherwise, benefits are payable out-of-network after satisfaction of the annual deductible. This plan is administered by Cigna.
Cost | In-Network Benefits | Out-of-Network Benefits |
PCP Office Visit and Convenience Care Clinic | $20 | 20% after deductible / N/A |
Specialist Office Visit | $35 | 20% after deductible |
Deductible | $0 | $1,500 per individual $4,500 per family |
Coinsurance | 0% | 20% |
Out-of-Pocket Maximum | $4,000 per individual $8,000 per family | $5,000 per individual $15,000 per family |