Page 4 - Murphy Research 2020-21 Employee Benefits
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12/1/2020-11/30/2021 Employee Benefits Brochure
Medical Plans – Blue Shield
Your Copay/ Coinsurance Platinum Access+ HMO 0/25 OffEx
In-Network
Calendar Year Deductible:
Individual None
Family None
Annual Out of Pocket Maximum:
Individual $2,350
Family $4,700
Hospital Services:
Inpatient $250 / day up to 3 days
Outpatient Surgery $100 / surgery
-Ambulatory surgery center
Emergency Room $250 / visit
Physician Services:
Office Visit (PCP/Specialist) $25 / $50
Urgent Care $25
Preventive Care: No charge
Prescription Drugs:
Rx Deductible None
Tier 1 $5
Tier 2 $15
Tier 3 $25
Tier 4 20% up to $250 per Rx
*Calendar year deductible applies
Please refer to carrier benefit summaries for more detailed information & out-of-network benefits
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