Page 5 - 2018-19 MYNEXUS Benefits Guide
P. 5
myNEXUS
MEDICAL AND Important Terms
PRESCRIPTION DRUG Deductible—the amount
you pay toward medical
COVERAGE and dental expenses each
year before the plan begins
For many of us, nothing is more important than our health and the health paying beneits
of our family members. This is why we offer a comprehensive medical and Copayment—a lat fee
pharmacy insurance program to our employees. We partner with Humana you pay for medical
to offer two medical plan options, a Base plan, and a Buy-Up plan with services; generally applies
preventive care under both plans covered at 100% in-network. Both plans to physicians’ oice visits
and prescription drugs;
allow you to contribute to a health savings account (HSA) as described further copayments do not apply to
on page 10. Employees who reside in Tennessee have a lower cost option for a the deductible
more restrictive network, which is available for both the Base and the Buy-Up
plans. You can choose between the Choice Care PPO plan which includes all Coinsurance—the
area hospitals and the majority of physicians and the Choice POS plan which percentage of the medical
or dental charges you pay
excludes Vanderbilt Hospital, Advanced Diagnostic Imaging, Tennessee Ortho after you have paid the
Alliance in Nashville, and Tennova and Tennova physicians in Knoxville. deductible
As you make your medical plan selection, you must first select the Base or Out-of-pocket limit—the
Buy-Up plan and your network, Choice Care PPO or Choice POS (Tennessee total amount an employee
residents only). Once you elect your plan and your network, you will select or dependent pays out-of-
pocket in a given plan year;
either the tobacco or non-tobacco plan, which must coincide with your once this maximum has
tobacco affidavit. More information regarding the tobacco surcharge can be been reached the plan pays
found on page 8. 100% of eligible expenses for
the remainder of the plan
year
Premium—the amount an
employee pays for beneit
coverage
Network—group of doctors
or hospitals who agree to
negotiated rates with a
health insurance company
5
MEDICAL AND Important Terms
PRESCRIPTION DRUG Deductible—the amount
you pay toward medical
COVERAGE and dental expenses each
year before the plan begins
For many of us, nothing is more important than our health and the health paying beneits
of our family members. This is why we offer a comprehensive medical and Copayment—a lat fee
pharmacy insurance program to our employees. We partner with Humana you pay for medical
to offer two medical plan options, a Base plan, and a Buy-Up plan with services; generally applies
preventive care under both plans covered at 100% in-network. Both plans to physicians’ oice visits
and prescription drugs;
allow you to contribute to a health savings account (HSA) as described further copayments do not apply to
on page 10. Employees who reside in Tennessee have a lower cost option for a the deductible
more restrictive network, which is available for both the Base and the Buy-Up
plans. You can choose between the Choice Care PPO plan which includes all Coinsurance—the
area hospitals and the majority of physicians and the Choice POS plan which percentage of the medical
or dental charges you pay
excludes Vanderbilt Hospital, Advanced Diagnostic Imaging, Tennessee Ortho after you have paid the
Alliance in Nashville, and Tennova and Tennova physicians in Knoxville. deductible
As you make your medical plan selection, you must first select the Base or Out-of-pocket limit—the
Buy-Up plan and your network, Choice Care PPO or Choice POS (Tennessee total amount an employee
residents only). Once you elect your plan and your network, you will select or dependent pays out-of-
pocket in a given plan year;
either the tobacco or non-tobacco plan, which must coincide with your once this maximum has
tobacco affidavit. More information regarding the tobacco surcharge can be been reached the plan pays
found on page 8. 100% of eligible expenses for
the remainder of the plan
year
Premium—the amount an
employee pays for beneit
coverage
Network—group of doctors
or hospitals who agree to
negotiated rates with a
health insurance company
5
