Medical and Pharmacy Coverage
Sterling Estates offers the following Medical plans through Anthem BlueCross BlueShield and offers “In and Out-of-Network” benefits. Insurance Carrier: Anthem BlueCross BlueShield Medical Insurance Medical Plan: $1,500 / 20% Coinsurance Plan In-Network: Office Visit Copay - Primary Care $30 Office Visit Copay - Specialist Care $60 Urgent Care Copay $75 Emergency Room Care $350; then 20% Coinsurance Preventative Visit Copay $0 Diagnostic Testing & Blood Work (Office) $60 Imaging Deductible; then 20% Coinsurance Coinsurance 80% Employee Deductible $1,500 Family Deductible $4,500 Employee Out-of-Pocket Max $4,500 Family Out-of-Pocket Max $9,000 Inpatient Hospital Deductible; then 20% Coinsurance Outpatient Hospital or Facility Deductible; then 20% Coinsurance Out-of-Network: Coinsurance 50% Employee Deductible $4,500 Family Deductible $13,500 Employee Out-of-Pocket Max $13,500 Family Out-of-Pocket Max $27,000 Prescription Drugs: ( 30 Day Supply) Tier 1 - Typically Generic $15 Tier 2 - Typically Preferred Brand $35 Tier 3 - Typically Non-Preferred Brand $60 Tier 4 - Typically Specialty 25% Coinsurance up to $350 Employee Semi-Monthly Deduction Employee Only $88.75 Employee + Spouse $267.50 Employee + Child(ren) $198.75 Family $267.50
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STERLING ESTATES 2024 BENEFITS GUIDE
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