Plan Benefits |
FlexFit and FlexFit Select (A=Active, F=Family) |
Evolve (HSA qualified and non-HSA qualified options available) |
---|---|---|
Primary Care Office Visit |
FlexFit
FlexFit Select A: Adult: $15 |
Deductible, then $30 |
Specialist Office Visit |
FlexFit: $25 |
Deductible, then $50 |
Inpatient |
A: $750 |
Deductible, then coinsurance capped at $1,000 per event |
Outpatient Surgery |
FlexFit A:$150 F:$125 |
Deductible, then coinsurance |
Out-of-Pocket Maximum |
N/A |
$5,000/$10,000 |
Deductible |
N/A |
$1,500/$3,000 |
Coinsurance |
N/A |
20% |
Wellness |
$250 benefit card to use for approved health and wellness expenses. |
FitWorksSM Reward Program (an Amazon.com Gift Card* claim code valued at $250 per subscriber and up to $250 per covered spouse) for participating in health and wellness challenges, completing preventive screenings, etc. |
Benefits vary by plan.
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