Agenda - 09-11-2014 - 2 - Laserfiche WebLink

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J W 5 UnitedHealthcare 100K/12/12/120% 2014 UnitedHealthcare 125K/Paid/12/120% 2015 - 6 Month Renewal Current Renewal: Option 1 Current POS Current HSA Current POS Current HSA In- Network In- Network In- Network In- Network Primary Care Physician Visits $20 Deduct /20% $20 Deduct /20% Specialist Physician Visits $40 Deduct /20% $40 Deduct /20% Preventive Care 100% 100% 100% 100% Deductible $500 $1,500 $500 $1,500 Deductible - Family Maximum $1,500 $3,000 $1,500 $3,000 Out of Pocket Limit (includes deductible) $1,500 $3,500 $1,500 $3,500 Out of Pocket Limit - Family Max $4,500 $5,000 $4,500 $5,000 Radiology Ded uct /20% Ded uct /20% Ded uct /20% Ded uct /20% Minor Surgery in Office Office Copay Deduct /20% Office Copay Deduct /20% Hospital Services Deduct /20% Deduct /20% Deduct /20% Deduct /20% Urgent Care $50 Deduct /20% $50 Deduct /20% Emergency Room $150 Deduct /20% $150 Deduct /20% Pharmacy $4/$25/$45 Deduct /20% $4/$25/$45 Deduct /20% Vision Hardware Not covered Not covered Not covered Not covered HSA $1,416.00 $1,416.00 Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Change N/A 13% POS HSA POS HSA County Employee County Employee County Employee County Employee Change 115.50% 100.00% 115.50% 100.00% Employee Only $631.18 $0.00 $628.15 $0.00 $729.01 $0.00 $725.51 $0.00 Employee and Spouse $922.61 $409.19 $922.61 $271.80 $1,065.61 $409.19 $1,065.61 $271.80 Employee and Children 1 $792.62 1 $229.90 $792.62 $151.82 $915.48 $229.90 $915.48 $151.82 Employee and Family 1 $1,158.71 1 $734.83 $1,158.71 $489.74 $1,338.31 $734.83 $1,338.31 $489.74 5