Name: McNeile Pappas
Address: United States

	In-Network
Deductible (Individual/Family)	$4,000/$8,000
Member Coinsurance	100%/0%
Out-of-Pocket Max (Individual/Family)	$8,150/$16,300
Primary Care Visit	$25 Copay
Routine Preventive	No Charge
Specialist Visit	$75 Copay
Inpatient Hospital	Deductible
Outpatient Surgery	Deductible
Outpatient Diagnostics	Deductible
Urgent Care	$50 Copay
Emergency Room	$300 Copay ; Deductible

Medical Insurance Rates Monthly
Employee Only	$443.41
Employee + Spouse	$1,359.62
Employee + Child(ren)	$1,234.85
Employee + Family	$2,149.86

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	In-Network
Deductible (Individual/Family)	$4,000/$8,000
Member Coinsurance	80%/20%
Out-of-Pocket Max (Individual/Family)	$8,150/$16,300
Primary Care Visits	$25 Copay
Routine Preventive	No Charge
Specialist Visit	$75 Copay
Inpatient Hospital	Deductible + 20%
Outpatient Surgery	Deductible + 20%
Outpatient Diagnostics	Deductible + 20%
Urgent Care	$50 Copay
Emergency Room	$300 Copay; Deductible + 20%

Medical Insurance Rates-Monthly
Employee Only	$407.42
Employee + Spouse	$1,260.85
Employee + Child(ren)	$1,146.87
Employee + Family	$1,982.71

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	In-Network
Deductible (Individual/Family)	$5,000/$10,000
Member Coinsurance	100%
Out-of-Pocket Max (Individual/Family)	$5,000/$10,000
Primary Care Visit	Deductible
Routine Preventive	No Charge
Specialist	Deductible
Inpatient Hospital	Deductible
Outpatient Surgery	Deductible
Outpatient Diagnostics	Deductible
Urgent Care	Deductible
Emergency Room	Deductible

Medical Insurance Rates- Monthly
Employee Only	$428.65
Employee + Spouse	$1,365.24
Employee + Child(ren)	$1,244.90
Family	$2,127.44

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	In-Network
Deductible (Individual/Family)	$3,500/$7,000
Member Coinsurance	100%
Out-of-Pocket Max (Individual/Family)	$3,500/$7,000
Primary Care Visit	Deductible
Routine Preventive	No Charge
Specialist Visit	Deductible
Inpatient Hospital	Deductible
Outpatient Surgery	Deductible
Outpatient Diagnostics	Deductible
Urgent Care	Deductible
Emergency Room	Deductible

Medical Insurance Rates - Monthly
Employee Only	$498.43
Employee + Spouse	$1,580.30
Employee + Child(ren)	$1,439.03
Employee + Family	$2,475.07

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Medical Benefits