Page 7 - Emmis 2022 Benefit Guide

Medical And Pharmacy Plan Overview

We offer the choice of two medical plans through Anthem. All of the health plan
options include coverage for prescription drugs through CVS Caremark and dental
through Delta Dental. To select the plan that best suits your family, you should
consider the key differences between the plans, the cost of coverage (including
payroll deductions), and how the plan covers services throughout the year.

Understanding how your plan works

1: Your deductible 2: Your coverage 3: Your Out-of-Pocket Maximum *

You pay out-of-pocket for most medical Once your deductible is met, you and When you reach your out-of-pocket
and pharmacy expenses until you reach the plan share the cost of covered maximum, the plan pays 100% of
the deductible. medical and pharmacy expenses with covered medical and pharmacy
coinsurance (co-pays still apply for the expenses for the rest of the plan year.
You can pay for these expenses from PPO plan). The plan will pay a Your deductible and coinsurance apply
your HSA for the CDHP and your FSA for percentage of each eligible expense, toward the out-of-pocket maximum.
the PPO plan. and you will pay the rest.

Each person only needs to meet the individual deductible and out-of-pocket maximum before the plan begins paying its share for
that individual. (And, once two or more family members meet the family limits, the plan begins paying its share for all covered
family members.)

Making the most of your plan

Keep these important tips in mind when you use your plan:
• In-network providers and pharmacies: You will always pay less if you see a provider within the networks.

• Preventive care: In-network preventive care is covered at 100% (no cost to you). Preventive care is often received during an
annual physical exam and includes immunizations, lab tests, screenings and other preventative services.
• Pharmacy coverage: Medications are placed in categories (Generic, Brand preferred, Brand non-preferred, Specialty) based
on drug cost, safety and effectiveness. For additional details on these classifications, please visit the EmmisPlan Portal.
• Mail order pharmacy: If you take a medication on an ongoing basis for a condition like high cholesterol or high blood
pressure, you can fill your medication through CVS mail order pharmacy. Members will have choice but be incentivized after
the 2nd prescription fill to go to a CVS pharmacy and if they decide to continue to go to non-CVS pharmacy for 90 day
prescriptions they will pay more.

• LiveHealth Online: Sometimes you just need a doctor – whether you’re at home in the middle of the night, or in the middle
of a road trip. For non-life threatening concerns you can get expert advice, a treatment plan and prescriptions if needed.
And it costs the same or less than you’d pay for a regular doctor visit.

• Emergency care: Use the emergency room for emergencies only. Reduce your out of pocket costs by choosing LiveHealth
Online, Minute Clinics, or Urgent Care centers.

Your Benefits Guide 2022 6