Rates for the coming plan year, Employee Only

Rates for the coming plan year, Employee Only

HMO PPO* CDHP*

Biweekly Premium

$252.42 $102.24 $46.60

Annual Deductible None None $2000/$4000

Annual Out-of- Pocket Maximum

$4000 $6850 $6600/$12000

Medical Account No No HRA

Office Visit $20 $30/$50 20%/50%

Specialist $35 $50/$75 20%/50%

Emergency Care $125 $200 20%

Urgent Care $30 $30/$100 20%/50%

Prescriptions – Generic

$10 $20/$50 $10/50%

Prescriptions – Brand Name

$35 $40/$100 $50/50%

 

*Prices listed are In-Network/Out-of-Network

Knights Healthcare

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