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UnitedHealthcare Original Proposal
<br /> Current Plans UnitedHealthcare O tion 1: Curcent Plans Uni tedHealthcare 0 on 2: Akernate Plans
<br /> NCACC-PPO NCACC-HMO POS: HMO POS HSA
<br /> 20ll 2011 2012 2012 2012
<br /> 2012
<br /> Irr-Network ImNetwork In-Network ImNetwork ImNetwork In-Network
<br />Primary Gre
<br />Physidan
<br />visits $15 $15 $15 $15 520 80%afterDed.
<br />Specialist
<br />Physician
<br />Ysns $30 $3D $30 $30 540 90%aher Ded.
<br />Preventive
<br />Gre 100% 100% 100% 100% 100% 100%
<br />Deductible $250 $250 $250 $750 5750 $1,500
<br />Deductible -
<br />Famlly Max $750 $750 $750 $750 $2,250 53,000
<br />Coinsurance
<br />Umft $1,000 $0 $1,000 $0 $1,000 52,000
<br />Coinsurance
<br />Umit -Family
<br />Max $3,000 $0 $3,000 $0 $3,000 $2,000
<br />In-patient
<br />Hosprol
<br />Services 90%after Ded. 100%after Ded. 90%after Ded. 100%after Ded. 8096 after Ded. 80%after Ded.
<br />out-patient
<br />Hospital
<br />Services 90%after Ded. 100%after Ded. 90%after Ded. 100% after Ded. 80%after Ded. 8096 after Ded.
<br />Emergenry
<br />Room $150 5150 $150 $150 ~ $200 ~ 80%ah:erDed.
<br /> Ded/$10/530/550 up
<br />Pharmary $o/SLS/53D SO/535/530 59/525/$45 59/$25/545 57/530/550 to OOP
<br />Ufetime
<br />Maximum Unlimited Unlimited Unlimted Unlimted Unlimted Unlimted
<br />Rata Subs Monthly Prcmlum Subs Monthly Premium Monthty Premium Monthly Premium Monthly Premium Monthly Premium
<br />Employee
<br />Only 64 $509.02 $32,577.28 457 $531.44 $242,868.08 $628.94 $40,252.16 $621.38 $283,970.66 $560.63 $256,207.91 $457.68 $29,29152
<br />Employee &
<br />Spouse 12 $1A74.02 $12,888.24 85 51,121.32 $95,312.20 $1,327.06 $15,924.72 $1,311.11 $111,444.35 $1,182.92 $100,548.20 $965.71 $11,58852
<br />EmpMyee &
<br />Child 12 $712.62 $8,551.44 115 $743.98 $85,557.70 $1,018.88 $12,22656 $1,006.64 $115,763.60 $906.22 $104,445.30 $74L45 $8,897.40
<br />Employee &
<br />Children 10 $982.42 $9,824.20 77 $1,025.66 $78,975.92 $1,016.88 $10,168.80 $1,006.64 $77,511.28 $908.22 $69,932.94 $741.45 $7,41450
<br />Employee &
<br />Famiy 19 $1,527.08 $29,01452 78 $1,594.28 $124,353.84 $1,886.81 535,849.39 $1,864.14 $145,402.92 $1,681.88 $131,186.64 $1,373.05 $26,087.95
<br />
<br />Monthty Cost 117 $92,855.68 612 $627,067.64 5114,441.63 $734,092.81 $662,320.99 $$3,279.89
<br /> HSA ContrWutfon
<br /> 5750 $67,750.00
<br />Mnual $1,114,268.16. $7524,911.68 $1,373,29956 $8,809,113.72 $7,947,851.86 $1,087,108.68
<br /> Total $8,639,079.64 $10,182,413.28 59,034,96056
<br />Increase over
<br />86%
<br />117
<br />-Firm
<br />104.58%
<br />current .
<br />J
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