Page 9 - GBS OE Brochure - Generic Hospitality

MEDICAL/RX BENEFITS
ESTIMATE HEALTH CARE COSTS
You have easy-to-use tools on www.mycigna.com so you can see what a treatment or procedure typically costs. You can also estimate costs of prescriptions and see what your share of expenses may be. Visit: www.mycigna.com or www.kp.org for more information.
WHICH MEDICAL PLAN IS RIGHT FOR YOU?
The chart below gives you some basic information about our medical plan options and how they compare when it comes to important plan features such as out-of-pocket costs (including team member contributions), preventive care and prescription drug bene ts.
Kaiser HMO
Gold
Gold In-Network
Team Member Payroll Costs
Lowest
Middle
Highest
Preventive Care
Eligible in-network preventive care services are covered at 100%, no copay, deductible or co-insurance applies.
Primary Care & Specialty Visits
For in-network visits: you pay a copay that counts toward the out-of-pocket maximum.
In-Network and Out-of-Network Coverage
No coverage for Out-of-Network
providers and services.
Out-of-pocket expenses are typically lower for services other than preventive care. Copays (with no deductible) apply to many covered services. The deductibles are lower and apply to a limited number of received services, such as hospitalization, outpatient surgery and sophisticated diagnostic services (e.g., MRI and CT scans).
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