Page 5 - 2016 Nortek Enrollment Guide
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Medical Plan Options UHC Account-based Plans Glossary
Let’s take a look at the key features of each plan. Premium: The amount you contribute
Health Reimbursement Health Savings Account each month from your paycheck for
Arrangement insurance coverage.
Out-of-
Out-of-
In-Network Network In-Network Network Deductible: A set dollar amount
Calendar Year Deductible you have to pay for your healthcare
Individual $1,750 $3,500 $3,000 $6,000 expenses before the company starts
Family $3,500 $7,000 $6,000 $12,000 to share costs with you. Deductibles
Coinsurance 80% 60% 80% 60% vary by plan and by coverage levels.
Out-of-Pocket Includes Deductible Includes Deductible Coinsurance: Once you’ve satisied
Maximum the deductible, this is a set percentage
Individual $3,500 $7,000 $6,000 $12,000 of the remaining costs which are your
Family $7,000 $14,000 $12,000 $24,000 responsibility, until you reach your out-
Preventive care 100% Not available 100% Not available
Ofice Visit Copay of-pocket max.
Primary care $30 copay Ded/60% Ded/80% Ded/60% Copay: A set dollar amount you pay
physician for services every time you use them.
Specialist $60 copay Ded/60% Ded/80% Ded/60%
Emergency room $200 copay; $200 copay; Ded/80% Ded/80% Out of pocket max: Generally, the
Ded/80% Ded/80% most you can spend on healthcare for
Urgent Care $60 copay Ded/60% Ded/80% Ded/60% the year, not including your monthly
Virtual Visits $20 copay N/A Ded/80% N/A premiums.
Prescription Drugs HRA: A Health Reimbursement
Pharmacy Out-of-Pocket Maximum Arrangement includes an account
Individual $3,100 N/A Pharmacy expenses are that the company establishes for
included in your medical out
Family $6,200 N/A of pocket maximum you. HRAs do not accept employee
Retail contributions.
Tier 1 $10 copay $10 copay Ded/80% Ded/60% HSA: A Health Savings Account is
Tier 2 $30 copay $30 copay Ded/80% Ded/60% a personal bank account you own
Tier 3 $60 copay $60 copay Ded/80% Ded/60% and is used to pay for qualiied
Tier 4 $90 copay $90 copay Ded/80% Ded/60% medical expenses. Whatever money
Mail Order you contribute or accumulate is
Tier 1 $20 copay Ded/80% yours for life. Employees can make
Tier 2 $60 copay Ded/80% contributions to the account up to
Tier 3 $120 copay Not available Ded/80% Not available the allowed maximum contribution
Tier 4 Not available Not available limits. The IRS contribution limits for
2016 are $3,350 for individuals and
Please refer to your Summary Plan Description (SPD) for complete details of plan beneits, $6,750 for families. These funds can
limitations, and exclusions. In the event of a conlict between the SPD and this description, the be withdrawn at any time to cover
terms of the SPD will prevail.
qualiied medical expenses as deined
by the IRS.
2016 Open Enrollment
Medical Plan Options UHC Account-based Plans Glossary
Let’s take a look at the key features of each plan. Premium: The amount you contribute
Health Reimbursement Health Savings Account each month from your paycheck for
Arrangement insurance coverage.
Out-of-
Out-of-
In-Network Network In-Network Network Deductible: A set dollar amount
Calendar Year Deductible you have to pay for your healthcare
Individual $1,750 $3,500 $3,000 $6,000 expenses before the company starts
Family $3,500 $7,000 $6,000 $12,000 to share costs with you. Deductibles
Coinsurance 80% 60% 80% 60% vary by plan and by coverage levels.
Out-of-Pocket Includes Deductible Includes Deductible Coinsurance: Once you’ve satisied
Maximum the deductible, this is a set percentage
Individual $3,500 $7,000 $6,000 $12,000 of the remaining costs which are your
Family $7,000 $14,000 $12,000 $24,000 responsibility, until you reach your out-
Preventive care 100% Not available 100% Not available
Ofice Visit Copay of-pocket max.
Primary care $30 copay Ded/60% Ded/80% Ded/60% Copay: A set dollar amount you pay
physician for services every time you use them.
Specialist $60 copay Ded/60% Ded/80% Ded/60%
Emergency room $200 copay; $200 copay; Ded/80% Ded/80% Out of pocket max: Generally, the
Ded/80% Ded/80% most you can spend on healthcare for
Urgent Care $60 copay Ded/60% Ded/80% Ded/60% the year, not including your monthly
Virtual Visits $20 copay N/A Ded/80% N/A premiums.
Prescription Drugs HRA: A Health Reimbursement
Pharmacy Out-of-Pocket Maximum Arrangement includes an account
Individual $3,100 N/A Pharmacy expenses are that the company establishes for
included in your medical out
Family $6,200 N/A of pocket maximum you. HRAs do not accept employee
Retail contributions.
Tier 1 $10 copay $10 copay Ded/80% Ded/60% HSA: A Health Savings Account is
Tier 2 $30 copay $30 copay Ded/80% Ded/60% a personal bank account you own
Tier 3 $60 copay $60 copay Ded/80% Ded/60% and is used to pay for qualiied
Tier 4 $90 copay $90 copay Ded/80% Ded/60% medical expenses. Whatever money
Mail Order you contribute or accumulate is
Tier 1 $20 copay Ded/80% yours for life. Employees can make
Tier 2 $60 copay Ded/80% contributions to the account up to
Tier 3 $120 copay Not available Ded/80% Not available the allowed maximum contribution
Tier 4 Not available Not available limits. The IRS contribution limits for
2016 are $3,350 for individuals and
Please refer to your Summary Plan Description (SPD) for complete details of plan beneits, $6,750 for families. These funds can
limitations, and exclusions. In the event of a conlict between the SPD and this description, the be withdrawn at any time to cover
terms of the SPD will prevail.
qualiied medical expenses as deined
by the IRS.
2016 Open Enrollment
