Page 8 - PageGroup | 2022 Benefits Guide | Temp Employees
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BRIEF SUMMARY OF AETNA MEDICAL PLAN BENEFITS
BENEFIT HIGHLIGHTS
Employer Paid HRA Funding Deductible Coinsurance Out-of-Pocket Maximum Adult Preventative Care Primary Care Office Visit Copay Specialty Care Office Visit Copay Complex Imaging Hospital Outpatient Diagnostic X-Ray/Labs Hospital Inpatient Emergency Room Lifetime Maximum
Pharmacy Copays (Retail Store) Pharmacy Copays Mail Order
OAMC HRA
In-Network Coverage Out-of-Network Coverage
$500 Individual / $1,000 Family
$1,250 Individual / $2,500 Family
$3,000 Individual / $6,000 Family
10% after deductible
10% after deductible
10% after deductible
$3,000 Individual / $6,000 Family
$6,000 Individual / $12,000 Family
30% after deductible
30% after deductible
30% after deductible
10%
30%
No Charge
30% after deductible
10% after deductible
30% after deductible
10% after deductible
30% after deductible
10% after deductible
30% after deductible
10% after deductible
Unlimited
Unlimited
$5 Generic (Tier 1)
$20 Brand (Tier 2)
$40 Non-preferred Brand (Tier 3)
20% of submitted cost; after applicable copay
$10 / $40 / $80
N/A
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2022 BENEFITS GUIDE
Please refer to full Summary of Benefits enclosure for fee schedule for more services.
PageGroup
HRA Medical Plan
Scenario:
Amy leads a healthy lifestyle. In
a typical year, She has an annual physical (covered at 100%), along with her spouse and two children.
This year, Amy’s son, Matt, comes down with pneumonia ($800). Unfortunately, shortly thereafter, Amy and her son are involved
in an unexpected car accident. Both Amy and Matt received in-network care following their accident.
Here is an estimate of what Amy would have to pay using her HRA plan:
