Page 15 - Your New Medical Plans with Centivo
P. 15

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
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