Page 3 - Ingram Industries 2021 Highlights
P. 3
Medical Plans At a Glance A New Way to
The following is a snapshot of your in-network 2021 medical coverage. For a full list of benefit Enroll!
offerings and coverage levels, refer to your 2021 Benefits Guide or visit IngramBenefits.com.
Benefitsolver is the new platform that will
be available year-round to view your benefit
Signature PPO Plan Choice + HSA Plan Value + HSA Plan
Ingram Annual HSA Contribution elections, make changes during open
enrollment, or if you experience a qualifying
Individual Not eligible $500 $0 change in status event.
Family Not eligible $1,000 $0
Annual Deductible*
Individual $500 $1,600 $3,000 3 Ways to Access
Family $1,000 $3,200 $6,000 Benefitsolver Throughout
Out-of-Pocket Maximum** the Year
Individual $2,100 $3,500 $5,000
Family $4,200 $7,000 $10,000 z Visit MyIngramBenefits.com on your
Coinsurance desktop
20% 20% 20%
Preventive Care z Follow the ENROLL IN YOUR BENEFITS
link from iKnow, IngramWeb, or Ingram
$0 $0 $0
Well Baby/Childcare (includes immunizations and injections) Connect portals
$0 $0 $0 z Or, download the MyChoice App
Physician Office Visit
$25 copay 20% of charges, after 20% of charges, after What You Need to Enroll
deductible deductible
Specialist Office Visit z Social Security Numbers and birth
$40 copay 20% of charges, after 20% of charges, after dates for yourself and any eligible
deductible deductible dependent(s) you plan to enroll
PhysicianNow (virtual visit)
$0 $0 $0 z Documentation to verify your
Urgent Care dependents’ eligibility (marriage
$75 copay 20% of charges, after 20% of charges, after certificate, birth certificate, etc.)
deductible deductible
Emergency Room z Preferred email address
20% of charges, after 20% of charges, after 20% of charges, after
deductible deductible deductible When to Enroll
Inpatient Hospital (includes mental health and substance abuse)
20% of charges, after 20% of charges, after 20% of charges, after z October 19 - November 16
deductible deductible deductible z October 19 - November 30
* The Choice + HSA plan includes a non-embedded deductible. This means that if you are covering any dependents, the Family (for Marine Associates)
Deductible will apply to everyone. All family members’ expenses will be combined to meet the Family Deductible before the
plan begins contributing to your family’s health care expenses. However, if you have Associate Only coverage, only the Individual
Deductible will apply.
** In all three plans, the individual out-of-pocket (OOP) maximum is embedded in the family out-of-pocket (OOP) maximum. This
means that if one family member meets the OOP max, that individual doesn’t have to wait for the entire family OOP max to be
satisfied before the plan pays 100% of his/her covered services.
3
The following is a snapshot of your in-network 2021 medical coverage. For a full list of benefit Enroll!
offerings and coverage levels, refer to your 2021 Benefits Guide or visit IngramBenefits.com.
Benefitsolver is the new platform that will
be available year-round to view your benefit
Signature PPO Plan Choice + HSA Plan Value + HSA Plan
Ingram Annual HSA Contribution elections, make changes during open
enrollment, or if you experience a qualifying
Individual Not eligible $500 $0 change in status event.
Family Not eligible $1,000 $0
Annual Deductible*
Individual $500 $1,600 $3,000 3 Ways to Access
Family $1,000 $3,200 $6,000 Benefitsolver Throughout
Out-of-Pocket Maximum** the Year
Individual $2,100 $3,500 $5,000
Family $4,200 $7,000 $10,000 z Visit MyIngramBenefits.com on your
Coinsurance desktop
20% 20% 20%
Preventive Care z Follow the ENROLL IN YOUR BENEFITS
link from iKnow, IngramWeb, or Ingram
$0 $0 $0
Well Baby/Childcare (includes immunizations and injections) Connect portals
$0 $0 $0 z Or, download the MyChoice App
Physician Office Visit
$25 copay 20% of charges, after 20% of charges, after What You Need to Enroll
deductible deductible
Specialist Office Visit z Social Security Numbers and birth
$40 copay 20% of charges, after 20% of charges, after dates for yourself and any eligible
deductible deductible dependent(s) you plan to enroll
PhysicianNow (virtual visit)
$0 $0 $0 z Documentation to verify your
Urgent Care dependents’ eligibility (marriage
$75 copay 20% of charges, after 20% of charges, after certificate, birth certificate, etc.)
deductible deductible
Emergency Room z Preferred email address
20% of charges, after 20% of charges, after 20% of charges, after
deductible deductible deductible When to Enroll
Inpatient Hospital (includes mental health and substance abuse)
20% of charges, after 20% of charges, after 20% of charges, after z October 19 - November 16
deductible deductible deductible z October 19 - November 30
* The Choice + HSA plan includes a non-embedded deductible. This means that if you are covering any dependents, the Family (for Marine Associates)
Deductible will apply to everyone. All family members’ expenses will be combined to meet the Family Deductible before the
plan begins contributing to your family’s health care expenses. However, if you have Associate Only coverage, only the Individual
Deductible will apply.
** In all three plans, the individual out-of-pocket (OOP) maximum is embedded in the family out-of-pocket (OOP) maximum. This
means that if one family member meets the OOP max, that individual doesn’t have to wait for the entire family OOP max to be
satisfied before the plan pays 100% of his/her covered services.
3
