Page 6 - Owen Tree Service Benefits Guide
P. 6
Exceedent Major Medical Plan
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Service Benefit
Deductible $2,500 Single / $5,000 Family
Coinsurance 30%
Out Of Pocket Maximum $5,500 Single / $11,000 Family
Primary Care Visit Copay $30 Copay
Emergency Room Copay 30% After Deductible
Urgent Care Copay $50 Copay
Please note: These are brief descriptions. Read plan certificates for limitation, exclusions, and plan specifics. 6
