Employee Cost Per Pay Period

Employee Only - $98.78

Employee + Child(ren) - $421.07

SUMMARY OF BENEFITS (click to view)

Network: S - FIND A DOCTOR (click to search)

Deductible $5,000

Out of Pocket Max $9,000

Coinsurance 50%

Office Visit $35 Copay

Specialists Visit: $75 Copay

Urgent Care $75 Copay

Virtual Care Visit $0 Copay

Wellcare Services 100%

Outpatient Surgery Ded/Coin

Emergency Room Ded/Coin

Rx $10 / $35 / $50 / $100 Copay

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