Page 9 - 2024 Employee Benefits Guide

Medical, Vision & Pharmacy Benefits

The company’s medical plan is self-funded, which means when you incur
a medical expense, the company pays for your health care services. If
you are a wise consumer of medical care, it will save money for both you
and the company.
The medical plan is a Choice Plus PPO, which means you will have access
to a network of physicians and facilities which have agreed to provide
services at negotiated rates. You can search for an in-network provider
at myuhc.com, by using UnitedHealthcare’s mobile app, or by calling
UnitedHealthcare’s customer service.

Medical benefits summary

Benefit Description In-Network Out-of-Network

Preventive care office visits $0 copay

Virtual office visits (General) $0 copay
Mental health virtual office visit $0 copay
40% after deductible
Primary physician office visits $20 copay

Specialist physician office visits $45 copay
Surgical procedures performed in physician’s office 20% after deductible

Primary physicians are family and general practitioners, internal medicine physicians, pediatricians and
obstetricians/gynecologists. All other physicians are Specialists.

Individual / Family calendar year deductible $750 / $2,250 $1,500 / $4,500
Copays do not accumulate toward the In-network deductible Out-of-network
deductible. does not apply toward deductible does apply
out-of-network toward in-network
deductible. deductible
Benefit for non-copayment services 20% after deductible 40% after deductible

Individual / Family out-of-pocket maximum $3,000 / $7,000 $7,500 / $22,500
per calendar year
Out-of-pocket maximum includes medical, pharmacy copays and deductible. After the maximum has been
reached, the Plan pays 100% of covered expenses incurred during the rest of the calendar year.

Maximum lifetime benefit Unlimited

2024 Employee Benefits Guide 5