Benefits for 2024
Medical
SUMMARY OF COVERAGE
Aetna Choice POS II Network
HSA
BUY-UP
Employer Funding (Single/Family)
$600/$1,200
N/A
Deductible (Single / Family)
$3,000/$6,000
$1,000/$2,000
Out of PocketMaximum (Single/ Family)
$5,000/$10,000
$3,000/$6,000
Coinsurance
20% After Deductible
10% After Deductible
Preventive Care
100% Covered
100% Covered
Primary Care & Specialist Visit
20% After Deductible
$25Copay/ $40Copay
Inpatient Hospital
20% After Deductible
10% After Deductible
Outpatient Hospital
20% After Deductible
10% After Deductible
Urgent Care
20% After Deductible
$50Copay
Emergency Room
20% After Deductible
$150Copay
RxCopays
Deductible then $10 / $35 / $60
$10 / $35 / $60
OUT OF NETWORK*
Deductible
$2,500 / $5,000
$2,000 / $4,000
Coinsurance
40% After Deductible
40% After Deductible
Out of PocketMaximum
$6,250 / $12,500
$6,250 / $12,500
*If you see an out of networkprovideryou may be charged the difference betweenthe providerbill and the usualand customary amount ** For illustrativepurposes only. Please refer to the benefit summary on the HealthJoy app for all plan details
This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract.
2024 Employee Benefit Guide
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