Medical and Pharmacy Coverage
Yates LLC offers the following plans through Meritain Health. Insurance Carrier:
Meritain Health Medical Insurance
Medical Plan Number:
Basic Plan
Standard Plan
HSA Plan
In-Network:
$25 Copay, then 100% Deductible waived $50 Copay, then 100% Deductible waived $50 Copay, then 100% Deductible waived $200 Copay, then 100% Deductible waived
$20 Copay, then 100% Deductible waived $40 Copay, then 100% Deductible waived $50 Copay, then 100% Deductible waived $200 Copay, then 100% Deductible waived
Office Visit Copay - Primary Care
100% after Deductible
Office Visit Copay - Specialist Care
100% after Deductible
Urgent Care Copay
100% after Deductible
Emergency Room Care
100% after Deductible
Preventative Visit Copay
100% Deductible waived
100% Deductible waived
100% Deductible waived
Diagnostic Testing & Blood Work
70% after Deductible
80% after Deductible
100% after Deductible
Bloodwork-Quest Diagnostics
100%
100%
100% after Deductible
Imaging
70% after Deductible
80% after Deductible
100% after Deductible
$250 Copay, then Deductible waived
$250 Copay, then Deductible waived
Imaging - US imaging
100% after Deductible
Coinsurance
70%
80%
100%
Employee Deductible
$1,000
$2,000
$5,000
Family Deductible
$3,000
$6,000
$10,000
Employee Out-of-Pocket Max
$5,500
$5,000
$5,000
Family Out-of-Pocket Max
$12,700
$12,700
$10,000
Inpatient Hospital
70% after Deductible
80% after Deductible
100% after Deductible
Outpatient Hospital or Facility
70% after Deductible
80% after Deductible
100% after Deductible
Inpatient/Outpatient Physician Fees
70% after Deductible
100% Deductible waived
100% after Deductible
Out-of-Network: Coinsurance
50%
60%
50%
Employee Deductible
$4,000
$3,000
$7,000
Family Deductible
$12,000
$9,000
$21,000
Employee Out-of-Pocket Max
$11,500
$9,000
$14,000
Family Out-of-Pocket Max
$34,500
$27,000
$42,000
Prescription Drugs: ( 30 Day Supply) Tier 1 - Generic
$7 Copay
$7 Copay
100% after Deductible
Tier 2 - Formulary
$40 Copay
$40 Copay
100% after Deductible
Tier 3 - Non-Formulary
$70 Copay
$70 Copay
100% after Deductible
Tier 4 - Specialty
Contact ShaRx @ 314-451-3555, Option 1 or sharx@sharxplan.com
Mail Order
(90 Day Supply)
2x Copay
100% after Deductible
Semi-Monthly Deduction Employee Only
$100.00 $250.00 $200.00 $330.00
$112.50 $262.50 $217.50 $357.50
$75.00 $187.50 $137.50 $250.00
Employee + Spouse Employee + Child(ren)
Family
*HSA PLAN - YATES WILL MATCH $1,000 FOR INDIVIDUAL / $2,000 FOR FAMILY TO SAVINGS ACCOUNT*
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YATES LLC 2023 BENEFIT GUIDE
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