Medical Plans
Plan 1 - Core 6000 - Iowa Network POS
This plan offers lower weekly premium in exchange for; co-pays, higher annual out-of-pocket maximums, and no access to an HSA.
| PPO COST TO EMPLOYEE | 32 Weeks Weekly Cost | 52 Weeks Weekly Cost |
|---|---|---|
| Employee Only | $20 | $20 |
| Employee + Spouse | $20 | $20 |
| Employee + Children | $20 | $20 |
| Family | $20 | $20 |
Plan 2 - HDHP Iowa Network POS
This new in-Iowa network plan offers access to an HSA, no co-pays, and lower annual out-of-pocket maximum in exchange for a higher premium. If you do not elect changes and are on the current HDHP plan, you will be moved to this new HDHP POS plan.
| HDHP POS COST TO EMPLOYEE | 32 Weeks Weekly Cost | 52 Weeks Weekly Cost | Salary Weekly Cost |
|---|---|---|---|
| Employee Only | $26.73 | $16.45 | $35.64 |
| Employee + Spouse | $128.01 | $78.77 | $170.68 |
| Employee + Children | $131.80 | $81.11 | $175.73 |
| Family | $228.91 | $140.87 | $305.22 |
Plan 3 - HDHP National Network PPO
This is our existing HDHP plan network which offers out-of-state coverage and also offers access to an HSA, no co-pays, and lower annual out-of-pocket maximum in exchange for a higher premium.
| HDHP PPO COST TO EMPLOYEE | 32 Weeks Weekly Cost | 52 Weeks Weekly Cost | Salary Weekly Cost |
|---|---|---|---|
| Employee Only | $28.34 | $17.44 | $37.78 |
| Employee + Spouse | $136.50 | $84.00 | $182.01 |
| Employee + Children | $140.52 | $86.47 | $187.36 |
| Family | $244.41 | $150.41 | $325.88 |
Benefits & Coverage by Plan
| Services | Plan 1 Copay POS | Plan 2 HDHP POS | Plan 3 HDHP PPO |
|---|---|---|---|
| Primary Care Visit Specialist Visit | $50 Copay $100 Copay | Deductible | Deductible |
| Deductible (Calendar Year) | $6,000 Single $12,000 Family | $3,300 Single $6,600 Family | $3,300 Single $6,600 Family |
| Out-of-Pocket | $8,150 Single $16,300 Family | $3,300 Single $6,600 Family | $3,300 Single $6,600 Family |
| Coinsurance | 30% | 0% | 0% |
| Emergency Services | $600 Copay | Deductible | Deductible |
| Network Access Mayo Clinic University of Iowa | Out-of-Network In-Network | Out-of-Network In-Network | In-Network In-Network |
| Preventive Care/Screening | No Charge | No Charge | No Charge |
| Telemed Visits – Teladoc | $0 Copay | $0 Copay | $0 Copay |
| Retail Prescription Drug Coverage (30 day supply) | $200 Single/$400 Family Tier 1 – $15 Tier 2 – $45 Tier 3 – $85 Specialty Preferred – $100 Specialty Non-Preferred – 50% Coinsurance | - - Deductible - - - | - - Deductible - - - |
| Mail Order (90 day supply) | 3 Copayments | Deductible | Deductible |
