Major Medical: Overview

  In-Network Out-of-Network

CALENDAR YEAR DEDUCTIBLE1 (CYD)
Unless otherwise indicated, all benefits are subject to CYD.

$7,500 per member

OUT-OF-POCKET MAXIMUM2 (OOP)
Once the OOP maximum is met, benefits are provided at 100% for a member for the remainder of the calendar year. This applies to in-network provider services only. There is no Out of Pocket Maximum when out of network providers are used.

$15,000 individual

$30,000 family

 Unlimited

LIFETIME BENEFIT MAXIMUM

 Unlimited

FOOTNOTES

1 Deductible – the dollar amount of covered services that must be incurred and paid first by a member each calendar year before plan benefits begin.

2 Once the OOP maximum is met, benefits are provided at 100% for a member(s) for the remainder of the calendar year. This applies to in-network provider services only. There is no Out of Pocket Maximum when out of network providers are used.