2019 Colonial Distributing Benefit Guide

MEDICAL INSURANCE

Colonial Distributing offers three medical plans through FloridaBlue. To find participating providers go to www.bcbsfl,com and click on “Find a Doctor”, then follow the prompts to complete the search. The chart below provides a brief overview of the medical plans. This chart is intended only to highlight the benefits available and should not be relied upon to fully determine your coverage.

If the below illustration of benefits conflicts in any way with the Summary Plan Description (SPD), the SPD shall prevail. It is recommended that you review your exact description of services and supplies that are covered, those which are excluded or limited, and other terms and conditions of coverage .

BlueOptions 05302 BRONZE PLAN

BlueCare 68 PREMIUM PLAN

BlueOptions 05770 DELUXE PLAN

IN-NETWORK: Plan Year or Calendar Year Basis

Calendar Year

Calendar Year

Calendar Year

Deductible (Individual / Family)

$5,000 / $10,000

$1,000 / $3,000

$1,000 / $3,000

Coinsurance

70% / 30%

80% / 20%

80% / 20%

Maximum Out-of-Pocket (Individual/Family) Maximum Out-of-Pocket Includes

$6,350 / $12,700

$4,500 / $9,000

$3,500 / $7,000

Deductible, Coinsurance & Copayments

Deductible, Coinsurance & Copayments

Deductible, Coinsurance & Copayments

Lifetime Maximum

Unlimited

Unlimited

Unlimited

PREVENTIVE CARE:

Wellness Immunizations Mammography/Colonoscopy COPAYMENTS: Referral Required

Covered 100%

Covered 100%

Covered 100%

No

No

No

Office Visits Consultations for

$30 Copayment

$35 Copayment

$25 Copayment

Illness/Injury

Specialist Visits

$55 Copayment

$60 Copayment

$45 Copayment

$500 Copay per Day $1,500 Max

Inpatient Hospital

Deductible & Coinsurance

Deductible & Coinsurance

Outpatient Surgery

Deductible & Coinsurance

$600 Copay

Deductible & Coinsurance

Emergency Room Urgent Care

$300 Copayment $60 Copay

$500 Copay $80 Copay

$200 Copayment $50 Copay

OUTPATIENT DIAGNOSTIC SERVICES: Independent/Freestanding Lab Complex Diagnostic (MRI, CT, PET, Etc.) – Freestanding Facility

100%

100%

100%

Deductible & Coinsurance

$500 Copay

$200 Copay

PRESCRIPTIONS:

Tier 1: $10 copay Tier 2: 20% Coinsurance Tier 3: Not Covered

Tier 1: $10 copay Tier 2: $50 copay Tier 3: $80 copay

Tier 1: $10 copay Tier 2: $50 copay Tier 3: $80 copay

Retail (30 day supply)

OUT-OF-NETWORK 2 Deductible (Individual / Family)

$10,000 / $30,000

Not Covered

$3,000 / $6,000

Maximum Out-of-Pocket (Individual/Family)

$20,000 / $40,000

Not Covered

$7,000 / $14,000

Coinsurance

50 / 50%

Not Covered

50 / 50%

3

Made with FlippingBook - professional solution for displaying marketing and sales documents online