Page 5 - 2020 Recaro North America Assembly Benefits Guide
P. 5
RECARO North America Medical Plan Option
Blue Care Network
BCN HMO Gold $500
Download Full Summary here
Service Benefit
$500 per member /
Deductible
$1,500 for family
Coinsurance 20%
Coinsurance $5,000 per member /
Maximum $10,000 for family
Out of Pocket $8,150 per member /
Maximum $16,300 for family
Primary Care Visit
$30 Copay
Copay
Emergency Room
$250 After Deductible
Visit
Urgent Care Copay $35 Copay
Rx $10/$60/$80/20%
Please note: This is a brief description. Read plan certificates for limitation, exclusions, and 5
plan specifics.
