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FOCUS ON BENEFITS 2021

Goodwill-Easter Seals Minnesota

Terms to know

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Below are brief descriptions of commonly used terminology when talking about health
benefits:

Premiums – The amount you pay using payroll deductions (pre-tax for medical) to be enrolled

in the medical plan.

Deductible - The amount you pay for covered medical service before your insurance plan
begins to pay.

For example: If your deductible is $3,000, you must pay that amount before the

insurance plan begins to pay.

Co-Insurance - The percentage of the cost you pay for the medical service after you have paid
your deductible.

For example: You pay 20% of the cost of your medical bill after you have met the full
deductible.

Out of Pocket Maximum – The most you will pay in the plan year for your covered medical

services. This cost does not include your bi-weekly premiums.

For example: If your out of pocket maximum is $5,000, once you have paid this amount
for covered medical expenses in the year, your insurance plan will pay 100% of the plan

year’s qualified medical expenses.

Network – A group of medical providers (doctors, clinics, hospitals, pharmacies) that medical
plans contract with to bring members the best rate for their care. It is important to know that

the providers you see are within your network to reduce the amount of money you spend on
covered medical expenses.

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