Page 8 - Solid Rock Benefits Guide
P. 8
Solid Rock Major Medical Plans
Rates
THC HMO 5000 HDHP with GAP THC HMO 5000 with Copays and GAP
Download Medical Summary Here - Rx Summary Here Download Medical Summary Here - Rx Summary Here
(Recommended for low cost Rx) (Recommended for high cost Rx)
Tier Bi Weekly Rate Tier Bi Weekly Rate
Employee Only $0 Employee Only $24.65
Employee + 1 $0 Employee + 1 $49.31
Family $65.02 Family $106.43
THC 500 1500 POS Optional GAP Rates for POS Plan
Download Medical Summary Here - Rx Summary Here 2500 Inpatient Benefit / 1250 Out Patient Benefit
Tier Bi Weekly Rate Tier Bi Weekly Rate
Employee Only $192.42 Employee Only $31.36
Employee + 1 $407.03 Employee + 1 $46.61
Family $663.84 Family $68.52
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