Page 4 - 2022 CPI Card Benefits Guide

Medical Plans

Medical coverage is provided through High Deductible Health Plan
UnitedHealthcare. You have a choice of three plans: (HDHP)
y Buy-Up PPO
y Base PPO The HDHP is similar to the PPO in that you have the
y HDHP with HSA option to choose any provider when you need care.
However, in exchange for a lower per-paycheck cost,
Preferred Provider Organization you must satisfy a higher deductible that applies to

(PPO) almost all health care expenses, including those for
prescription drugs and there are no co-pays. Once
This type of plan lets you visit the doctor of your your deductible has been met, you will continue to
choice. Although you may see a provider who doesn’t pay coinsurance until your out-of-pocket maximum is
participate in the plan’s network, in most cases met, then the plan pays 100%.
your benefits are greater (and your out-of-pocket If you enroll in the HDHP, you will be automatically
expenses smaller) when you see a network provider. enrolled in a Health Savings Account (HSA) through
You are not required to select a Primary Care Optum Bank. An HSA is a personal savings account
Physician under this option. which you can use to pay qualified out-of-pocket
In our PPO plans, doctor visits, emergency, urgent health care expenses with pretax dollars. For more
care, and prescription drugs cost you a flat dollar information on the HSA, see pages 8 and 9. In
amount, known as a copay. All other care is subject 2022, CPI will also automatically make quarterly
to a deductible. Once your care expenses reach the contributions to your Health Savings Account to get
deductible, you pay a portion of your care expense, your medical savings started.
known as coinsurance.
Employee Only $125 per quarter
Finally, once you reach the Individual or Family (totaling $500 annually)
out-of-pocket maximum in any calendar year, the Employee plus $250 per quarter
plan will pay 100% of additional covered expenses Dependent (totaling $1,000 annually)
you or your covered family members incur during
the rest of that year.

How the Deductible and Out-of-Pocket Maximum Work

A single employee is limited to the single deductible and
Out-of-Pocket (OOP) Maximum. Each individual member
of a family is also limited to the single deductible and OOP
Maximum. This means a single member of a family does not
have to meet the full family deductible for after-deductible
benefits to begin for that individual. A family is capped at
the family deductible and OOP Maximum.

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