Page 14 - Your New Medical Plans with Centivo

Your costs

Telemedicine through MDLIVE You can compare the payroll deductions for each plan below.

By enrolling in any of the health plan options, MONTHLY RATES MBA Centivo Plus MBA HSA High MBA HSA Low
you’ll get access to telemedicine (virtual care) Employee (EE) only $174.10 $94.50 $56.51
for primary care 24/7/365 through MDLIVE. Employee + spouse $432.47 $246.34 $129.96
Employee + child(ren) $385.47 $219.57 $115.84
Telemedicine offers an easy, low-cost Employee + family $582.89 $332.02 $175.17
alternative to urgent care for simple health
concerns, such as earaches, sore throats, You’ll see that the MBA Centivo Plus Plan offers substantial savings over the
vomiting, fever, and more.
PPO Plan offered last year - savings of $29.76 per month or $357.12 per year for
employee only coverage and $49.08 per month or $588.96 per year for families.

A year in comparison

Take a look at a few scenarios to understand your total out-of-pocket
costs, including payroll deductions, for each plan option.
An easy-to-use app In all 3 scenarios, you will pay
and member portal less out-of-pocket under the
MBA Centivo Plus Plan.
MBA Centivo Plus MBA HSA High MBA HSA Low
You’ll have access to the sponsored by MB Aerospace. SCENARIO A: LOW UTILIZATION
MBA Centivo Plus Plan,
Centivo app and member portal Subscriber Penelope Jacobs
Member ID ACME1654321 Annual EE contributions (for single coverage) $2,089 $1,134 $678
to help you get the most out of Employee + Family Annual physical $0 $0 $0
your plan during the year. PLAN INFO ACME1 2 PCP visits $20 $200 $200
Group ID
Payer ID 12345 1 urgent care visit $60 $250 $250
Network Centivo Network 100
Rx PCN XYZ 1 preferred brand Rx (for full year at retail) $580 $2,400 $2,400
Rx BIN 11111
Rx GRP ACME1 Total payroll deductions (fixed costs) $2,089 $1,134 $678
You can use the app or MEMBER COSTS $1,000 Total point of care costs (variable costs) $660 $2,850 $2,850
Deductible
member portal to: Primary Care Team $10 Total annual out-of-pocket costs $2,749 $3,984 $3,528
$50 $60
Specialist
Urgent Care $50 $60 SCENARIO B: MEDIUM UTILIZATION
• Find where to get care Remember to get referrals from your Primary Care Team Annual EE contributions (for single coverage) $2,089 $1,134 $678
for specialist care.
3 PCP visits $30 $300 $300
• Access your plan details 3 specialist visits $180 $1,050 $1,050
• View cost information and 1 outpatient surgery $1,600 $2,120 $3,055
$1,134
$2,089
$678
Total payroll deductions (fixed costs)
Explanation of Benefits Total point of care costs (variable costs) $1,810 $3,470 $4,405
statements (EOBs) for any Total annual out-of-pocket costs $3,899 $4,604 $5,083
healthcare you receive SCENARIO C: HIGH UTILIZATION
Annual EE contributions (for single coverage) $2,089 $1,134 $678
• View or print your electronic 2 PCP visits $20 $200 $200
ID card 3 specialist visits $180 $1,050 $1,050
1 ER visit $500 $2,100 $2,975
• Send a message to the Hospital stay $3,800 $3,000 $2,675
Centivo Concierge Team 1 inpatient surgery $500 $550 $0
• And more Total payroll deductions (fixed costs) $2,089 $1,134 $678
Total point of care costs (variable costs) $5,000 $6,900 $6,900
Total annual out-of-pocket costs $7,089 $8,034 $7,578