Preferred Provider
Participating Provider
Out of Network
Annual Deductible Individual
$1,500 $3,000
$1,500 $3,000
$1,500 $3,000
Maximum per family
Out-of-Pocket Maximum Individual Maximum per family
$4,500 $9,500
$4,500 $9,500
$4,500 $9,500
Preventive Care Routine Exam
Covered in full
Covered in full
50%, after deductible
Laboratory Services
Physician Services Office Visits Specialist
$25 copay* $25 copay*
50%, after deductible 50%, after deductible
50%, after deductible 50%, after deductible
Outpatient X-Ray and Laboratory Services
30%*
50%, after deductible
50%, after deductible
Urgent Care
$45 copay*
50%, after deductible
50%, after deductible
Emergency Services
$300 copay then paid at 100%, deductible waived
Hospital Services
Inpatient and Outpatient
30%, after deductible
50%, after deductible
50%, after deductible
Outpatient Rehabilitation 20 visits per calendar year
$25 copay*
Mental Health Outpatient
Covered in full
50%, after deductible
50%, after deductible
Spinal Manipulations
20 visits per calendar year
$25 copay*
Acupuncture
20 visits per calendar year
$25 copay*
Massage Therapy
$25 copay*
*Deductible does not apply. Balance billing may occur with Out of Network Services.
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TAYLOR METAL PRODUCTS // OPEN ENROLLMENT GUIDE // EFFECTIVE JANUARY 1, 2024
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