Eligibility |
All EE's work a minimum of 20 hours per week |
|
|
Waiting Period |
3 month waiting period |
Benefit Amount |
Flat $10,000 |
Flat $50,000 |
2X Annual Salary |
Benefit Amount |
Flat $10,000 |
Flat $50,000 |
2X Annual Salary |
Spouse |
- |
$10,000 |
$10,000 |
Child |
- |
$5,000 |
$5,000 |
Schedule |
- |
- |
66.67% of first $3,000 and 50% of the balance |
Elimination Period |
- |
- |
16 weeks |
Benefit Period |
- |
- |
To Age 65 |
Tax Status |
- |
- |
Non Taxable |
Amount |
- |
Flat $10,000 |
Flat $25,000 |
Plan Type |
Mandatory Generic |
Mandatory Generic |
Mandatory Generic |
Deductible |
Employee Pays Dispensing Fee |
None |
None |
Co-insurance |
80% |
80% |
100% |
Co-insurance |
100% |
100% |
100% |
Coverage Type |
Semi-Private |
Semi-Private |
Semi-Private |
Co-insurance |
100% |
100% |
100% |
Co-insurance |
- |
80% |
100% |
Maximum per calendar year |
- |
$300 Per Practitioner No Doctor Referral |
$500 Per Practitioner No Doctor Referral Required |
Co-insurance |
80% |
80% |
100% |
Coverage Type |
Eye Examination only; Does NOT include Eyewear |
Includes Eyewear $200 Every 24 months |
Includes Eyewear $300 Every 24 months |
Deductible |
$0 |
$0 |
$0 |
Recall Examination |
Every 9 Months |
Every 9 Months |
Every 9 Months |
Basic & Preventative |
80% Co-insurance |
80% Co-insurance |
100% Co-insurance |
Maximum |
$1,000 |
$1,500 |
$1,500 |
Major Dental |
- |
- |
- |
Maximum |
- |
- |
- |
|
Flexible Amount |
Flexible Amount |
Flexible Amount |