Medical and Pharmacy Coverage
SteelBlue Building Components offers the following Medical plans through Anthem and offers “in and out-of-network” benefits.
Insurance Carrier:
Anthem Medical Insurance
Medical Plan:
$2,000 / 20% Buy-Up Plan
$4,000 / 100% Base Plan
In-Network: Office Visit Copay - Primary Care
$30
$25
Office Visit Copay - Specialist Care
$60
$50
Urgent Care Copay
$75
$75
Emergency Room Care
$500
$500
Preventative Visit Copay
$0
$0
Diagnostic Testing & Blood Work
Plan pays 80%
Plan pays 100%
Imaging
Plan pays 80%
Plan pays 100%
Coinsurance
80%
100%
Employee Deductible
$2,000
$4,000
Family Deductible
$4,000
$8,000
Employee Out-of-Pocket Max
$3,500 (includes deductible)
$7,000 (includes deductible)
Family Out-of-Pocket Max
$7,000 (includes deductible)
$14,000 (includes deductible)
Inpatient Hospital
Plan pays 80%
Plan pays 100%
Outpatient Hospital or Facility
Plan pays 80%
Plan pays 100%
Out-of-Network: Coinsurance
50%
50%
Employee Deductible
$6,000
$12,000
Family Deductible
$12,000
$24,000
Employee Out-of-Pocket Max
$10,500
$21,000
Family Out-of-Pocket Max
$21,000
$42,000
Prescription Drugs: ( 30 Day Supply) Tier 1 - Generic
$20
$20
Tier 2 - Preferred
$45
$45
Tier 3 - Non-Preferred
$80
$80
Tier 4 - Specialty
35% Coinsurance up to $450
35% Coinsurance up to $450
Employee Weekly Deduction Employee Only
$50.36
$31.66
Employee + Spouse
$105.77
$66.49
Employee + Child(ren)
$90.66
$56.99
Family
$146.06
$91.82
4 STEELBLUE BUILDING COMPONENTS 2023 BENEFITS GUIDE
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