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14 <br /> Attachment 3 <br /> September 5, 1995 <br /> Differences Between Traditional and <br /> Preferred Provider (Covering Hospitals and Physicians) Health Plans <br /> Section A: General Services <br /> Category Traditional Plan PPO PP <br /> Preferred Non-Preferred <br /> Deductible $200 $200 $300 <br /> $600 p/family $600 p/family $900 p/family <br /> Coinsurance 20% 10% 20% <br /> Maximum Out of $1,000 p/member $1,000 p/member $2,000 p/member <br /> Pocket Annually $2,000 p/family $4,000 p/family <br /> Lifetime Maximum $1,000,000 $1,000,000 $1,000,000 <br /> Physician Services <br /> Office Visits 80%covered 90% covered 80%PRC* <br /> Inpatient Care 80%covered 90% covered 80%PRC <br /> Surgery 80%covered 90%covered 80%PRC <br /> Outpatient Diagnostic 80%covered 90%covered 80%PRC <br /> Maternity Care 80%covered 90%covered 80%PRC <br /> Chemical Dependency 80%covered 90%covered 80%PRC <br /> Routine Physicals not covered not covered not covered <br /> Immunizations not covered not covered not covered <br /> * Provider's Reasonable Charge <br />