Page 5 - Industrial Automation Benefits Guide
P. 5
Industrial Automation Major Medical Plans
US Health and Life + OptiMedGAP
*All Medical Plans come with GAP! Most employees will experience no out of pocket costs!
Learn how you GAP plan works here*
Peak PPO $3,500* High Deductible PPO $5,000*
Download Full Summary here Download Full Summary here
Service Benefit Service Benefit
$3,500 Single / $7,000 $5,000 Single /
Deductible Deductible
Family $10,000 Family
Coinsurance 20% Coinsurance 20%
Out of Pocket $6,350 Single / Out of Pocket $6,350 Single /
Maximum $12,700 Family Maximum $12,700 Family
Primary Care Visit Primary Care Visit 20% After Deductible
$30
Copay
Emergency Room 20% After Deductible
Emergency Room
$150
Copay Urgent Care 20% After Deductible
Urgent Care 20% After Deductible
Please note: These are brief descriptions. Read plan certificates for limitation, exclusions,
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and plan specifics.
