MEDICAL AND PHARMACY COVERAGE
Yates LLC offers the following plans through Meritain Health.
Insurance Carrier:
Meritain Health Medical Insurance
Basic Plan You pay:
Standard Plan You pay:
HSA Plan You pay:
In-Network:
Deductible (first dollar cost for covered in-network services) Individual / Family $1,000 / $3,000
$2,000 / $6,000
$5,000 / $10,000
Coinsurance (after you reach your deductible) Plan Pays 70%
80%
100%
Out-of-Pocket Maximum (includes deductibles, copays, prescription costs, and coinsurance) Individual / Family $5,500 / $12,700 $5,000 / $12,700
$5,000 / $10,000
Plan Features Preventive Care
100% deductible waived
100% deductible waived
100% deductible waived
Primary Care Visits
$25 Copay, then 100% deductible waived
$20 Copay, then 100% deductible waived
100% after deductible
Specialist Visits
$50 Copay, then 100% deductible waived
$40 Copay, then 100% deductible waived
100% after deductible
Urgent Care
$50 Copay, then 100% deductible waived
$50 Copay, then 100% deductible waived
100% after deductible
Emergency Room
$200 Copay, then 100% deductible waived
$200 Copay, then 100% deductible waived
100% after deductible
Diagnostic Testing & Blood Work
70% after deductible
80% after deductible
100% after deductible
Bloodwork - Quest Diagnostics
100% deductible waived
100% deductible waived
100% after deductible
Imaging
70% after deductible
80% after deductible
100% after deductible
Inpatient Hospital
70% after deductible
80% after deductible
100% after deductible
Outpatient Surgery
70% after deductible
80% after deductible
100% after deductible
Inpatient/Outpatient Physician Fees
70% after deductible
100% deductible waived
100% after deductible
Prescription Benefits 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 (per paycheck cost for coverage) Employee Only $110.00
$123.75
$82.50
$275.00
$288.75
$206.25
Employee + Spouse
$220.00
$239.25
$151.25
Employee + Child(ren)
$363.00
$393.25
$275.00
Family
*HSA PLAN - YATES WILL MATCH $1,000 FOR INDIVIDUAL / $2,000 FOR FAMILY TO SAVINGS ACCOUNT*
6 | Yates LLC 2024 Benefits Guide
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