Medical Benefits
Claim Administrator:
Anthem BlueCross BlueShield: 855-878-0128
Benefit Period: January 1st – December 31st
Annual Deductible: Before the Fund pays for most covered expenses, you pay the Annual Deductible of $400 per person or $800 per family (doubled for out-of-network). All claims are subject to the Annual Deductible, unless otherwise noted.
Maximum Out-Of-Pocket (MOOP) Limit: Your out-of-pocket expenses for essential health benefits are limited to $3,975 per person or $7,950 per family (doubled for out-of-network). MOOP Limit includes deductible, copayments, and coinsurance.
Coinsurance: Once you meet your Annual Deductible, the Fund pays 80%, then 100% after MOOP Limit is reached (60% for out-of-network). All claims are subject to the Coinsurance, unless otherwise noted.
Copayments: This will vary depending on where you seek treatment.
| Type of Provider | Copay |
|---|---|
|
LiveHealth Online |
Free - $0 |
|
Primary Care (Office Visit or Video Visit) |
$20 |
|
Specialist (Office Visit or Video Visit) |
$30 |
|
Urgent Care |
$50 |
|
Emergency Room |
$150 |