Medical and Pharmacy Coverage
Slappey & Sadd, LLC offers the following plans through
Aetna and offers “in and out-of-network” benefits. Insurance Carrier:
Aetna Medical Insurance
Medical Plan:
$2,000 Copay Plan
In-Network: Office Visit Copay - Primary Care Office Visit Copay - Specialist Care
$25 Copay $75 Copay $75 Copay $500 Copay
Urgent Care Copay Emergency Room Care Preventative Visit Copay
No Copay
Diagnostic Testing (X-Ray / Blood Work)
0% Coinsurance after deductible 0% Coinsurance after deductible
Advanced Imaging
Coinsurance
100%
Employee Deductible Family Deductible
$2,000 $4,000 $5,000 $10,000
Employee Out-of-Pocket Max Family Out-of-Pocket Max
Inpatient Hospital
0% Coinsurance after deductible 0% Coinsurance after deductible
Outpatient Hospital or Facility
Out-of-Network: Coinsurance Employee Deductible
50%
$4,000 $12,000 $14,000 $42,000
Family Deductible
Employee Out-of-Pocket Max Family Out-of-Pocket Max
Prescription Drugs: ( 30 Day Supply) Tier 1 - Generic
$10 $45 $75
Tier 2 - Preferred
Tier 3 - Non-Preferred
Tier 4 - Specialty
20% Coinsurance up to $250
Employee Monthly Deduction: Employee Only
$0.00
Employee + Spouse Employee + Child(ren)
$726.94 $636.06
Family
$1,302.44
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SLAPPEY & SADD, LLC 2023 BENEFITS GUIDE
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