The [Client Name] plan offers a choice of four (4) medical plans designed to help you and your family maintain good health and financial well-being. Deciding which plan is best for you depends on your specific health care needs, preferences, budget, and lifestyle.
Three (3) medical plans are offered through [company] using the [network]. [plan] is also still offered to currently enrolled members only.
Quick Resource Links:
- Team
If you need assistance finding a provider in the Intermountain Health network, please use this link and select either “Find a doctor” or “Find a location”
- Find care and compare costs for providers and services in your network
- View what’s covered under your plan and explore your unique benefit programs
- See your claim details and view progress toward your deductible
- View and share your health plan ID card with your doctor’s office
Example Plan #1
- $0,000/$0,000 In-Network Deductible (Individual/Family)
- $0,000/$0,000 In-Network Out-Of-Pocket Maximum (Individual/Family)
- Copays:
- Telemedicine - $0
- PCP - $0 copay per visit
- Specialist - $0 copay per visit
- Rx: $0/$00/$000/00%
- Urgent Care - $00 copay per visit
- ER: $000 per visit + 00% coinsurance
- Diagnostic Labs: $00 copay
- X-Rays and Complex Imaging: $000 copay
- Inpatient surgery: 00% coinsurance after deductible
Example Plan #2
- $000/$0,000 In-Network Deductible (Individual/Family)
- $0,000/$00,000 In-Network Out-Of-Pocket Maximum (Individual/Family)
- Copays:
- Telemedicine - $0
- PCP - $00 copay per visit
- Specialist - $00 copay per visit
- Rx: $0/$00/$000/00%
- Urgent Care - $00 copay per visit
- ER: $000 per visit + 00% coinsurance
- Diagnostic Labs: $00 copay
- X-Rays and Complex Imaging: $000 copay
- Inpatient surgery: 00% coinsurance after deductible
Example Plan #3
- $000/$000 In-Network Deductible (Individual/Family)
- $0,000/$0,000 In-Network Out-Of-Pocket Maximum (Individual/Family)
- Copays:
- Telemedicine - $0
- PCP - $00 copay per visit
- Specialist - $00 copay per visit
- Rx: $0/$00/$000/00%
- Urgent Care - $00 copay per visit
- ER: $000 per visit + 00% coinsurance
- Diagnostic Labs: $00 copay
- X-Rays and Complex Imaging: $000 copay
- Inpatient surgery: 00% coinsurance after deductible
Example Plan #4
- This plan is ONLY available to currently enrolled members.
- Employee premiums are age banded. Employee contribution is 10% of total premium. Cost is available in Employee Navigator.
- $0/$0 In-Network Deductible (Individual/Family)
- $0,000/$0,000 In-Network Out-Of-Pocket Maximum (Individual/Family)
- Copays:
- Telemedicine - $0
- PCP - $00 copay per visit
- Specialist - $00 copay per visit
- Rx: $0/$00/$00/00%
- Urgent Care - $00 copay per visit
- ER - $000 copay per visit
- Diagnostic Labs: $00 copay
- X-Rays: $00 copay
- Complex Imaging: $000 copay
- Inpatient surgery: 00% coinsurance after deductible
- Children's eye exam, glasses, and dental check-up - $0
Example Plans
EMPLOYEE COST PER MONTH
Where To Go For Care:
When you’re feeling sick or are injured, there are several places you can go for medical care:
- a doctor’s office
- an urgent care center
- a retail health clinic
- the emergency room
Your primary care doctor should be your first call in non-emergency situations. Your doctor knows you and your health history, including what medications you are taking and what chronic conditions might need to be considered in your treatment. Plus, the co-pay for a visit to your doctor’s office will cost far less than a trip to the emergency room.
If you can’t reach your doctor or need care outside of regular office hours, urgent care centers and retail health clinics are good options. Retail health clinics are walk-in clinics found in many large pharmacies and retail stores. They are staffed by nurse practitioners and physician assistants and are designed to treat simple conditions, like cold and flu, ear infections and skin conditions. Telemedicine is another great alternative.
Emergency rooms are designed to treat urgent, acute and life threatening conditions and aren’t the place for routine care or minor ailments. If you feel you are dealing with a health emergency, call 911 or go to the emergency room right away.
What Is An EOB?
EOB stands for Explanation of Benefits.
This is a document sent to you by your insurance administrator to let you know that a claim has been processed.
The most important thing to remember is that an EOB is NOT a bill, and you should not pay an in-network provider without receiving a matching EOB.
An EOB lets you know which healthcare provider has filed a claim on your behalf, what it was for, whether it was approved, and for how much.
You should always review your EOB to make sure it is correct.