Page 11 - 2021 Miami Marlins Front Office Benefits Guide

MEDICAL COVERAGE VALUE PLAN PPO

70/50 PPO MLB Value Plan

Plan Provision In-Network Out-of-Network

Annual Deductible
1
Individual $4,500 $9,000
Family $9,000 $18,000

Out-of-Pocket Maximum (Includes Deductible)
Individual $6,350 $12,700
Family $12,700 $25,400

Lifetime Maximum Unlimited

Preventive Care 100% 50% after Deductible

Primary Physician Office Visit 70% after Deductible 50% after Deductible

Specialist Office Visit 70% after Deductible 50% after Deductible

X-Ray and Lab 70% after Deductible 50% after Deductible

Inpatient Hospital Services 70% after Deductible 50% after Deductible

Outpatient Hospital Services 70% after Deductible 50% after Deductible

Urgent Care 70% after Deductible 50% after Deductible

Emergency Room Care 70% after Deductible

The above is a brief summary of this benefit option.

Click here for more detailed information on this available benefit option.

Note: This is a summary only of your coverage. In-network services are based on negotiated charges; out-of-network services are based on reasonable and customary
(R&C) charges.
Miami Marlins Front Office Employee Benefit Guide Page 11