Page 5 - Benefits Guide
P. 5
Medical and Prescription Important Terms
Drug Coverage Deductible—the amount you
pay toward medical and dental
For many of us, nothing is more important than our health and the health expenses each year before the
of our family members. This is why we offer a medical and pharmacy plan begins paying beneits
insurance program to our employees. We partner with Humana to offer Copayment—a lat fee you
two medical plan options; a Base plan and a Buy-Up plan. Both plans pay for medical services;
allow you to contribute to a health savings account (HSA) as described generally applies to physicians’
ofice visits and prescription
further on page 10. Employees who reside in Tennessee have a lower cost drugs; copayments do not apply
option for a more restrictive network, which is available for both the Base to the deductible
and the Buy-Up plans. You can choose between the Choice Care PPO Coinsurance—the percentage
plan which includes all area hospitals and the majority of physicians and of the medical or dental charges
the Choice POS plan which excludes Vanderbilt and St. Thomas hospitals, you pay after you have paid the
Advanced Diagnostic Imaging, Tennessee Ortho Alliance in Nashville, deductible
and Tennova and Tennova physicians in Knoxville. Preventive care under Out-of-pocket limit—the
both plans are covered at 100%, with no cost to you, according to the total amount an employee or
preventive care guidelines. dependent pays out-of-pocket
in a given plan year; once this
As you make your medical plan selection, you must irst select the Base maximum has been reached
or Buy-Up plan and your network, Choice Care PPO or Choice POS the plan pays 100% of eligible
expenses for the remainder of
(Tennessee residents only). Once you elect your plan and your network, the plan year
you will select either the tobacco or non-tobacco plans, which must
coincide with your tobacco afidavit. Premium—the amount an
employee pays for beneit
coverage
Network—group of doctors
or hospitals who agree to
negotiated rates with a health
insurance company
myNEXUS 5
Drug Coverage Deductible—the amount you
pay toward medical and dental
For many of us, nothing is more important than our health and the health expenses each year before the
of our family members. This is why we offer a medical and pharmacy plan begins paying beneits
insurance program to our employees. We partner with Humana to offer Copayment—a lat fee you
two medical plan options; a Base plan and a Buy-Up plan. Both plans pay for medical services;
allow you to contribute to a health savings account (HSA) as described generally applies to physicians’
ofice visits and prescription
further on page 10. Employees who reside in Tennessee have a lower cost drugs; copayments do not apply
option for a more restrictive network, which is available for both the Base to the deductible
and the Buy-Up plans. You can choose between the Choice Care PPO Coinsurance—the percentage
plan which includes all area hospitals and the majority of physicians and of the medical or dental charges
the Choice POS plan which excludes Vanderbilt and St. Thomas hospitals, you pay after you have paid the
Advanced Diagnostic Imaging, Tennessee Ortho Alliance in Nashville, deductible
and Tennova and Tennova physicians in Knoxville. Preventive care under Out-of-pocket limit—the
both plans are covered at 100%, with no cost to you, according to the total amount an employee or
preventive care guidelines. dependent pays out-of-pocket
in a given plan year; once this
As you make your medical plan selection, you must irst select the Base maximum has been reached
or Buy-Up plan and your network, Choice Care PPO or Choice POS the plan pays 100% of eligible
expenses for the remainder of
(Tennessee residents only). Once you elect your plan and your network, the plan year
you will select either the tobacco or non-tobacco plans, which must
coincide with your tobacco afidavit. Premium—the amount an
employee pays for beneit
coverage
Network—group of doctors
or hospitals who agree to
negotiated rates with a health
insurance company
myNEXUS 5
