LOW PLAN – Preventative services are based on 100% UCR. Services are reimbursed based on a schedule for basic and major procedures. Economical premiums, has higher out of pocket costs than the High Plan.
HIGH PLAN - Services are reimbursed based on a percentage of
UCR (usual, customary and reasonable) Rates. Higher Premiums, less out
of pocket than Low Plan.
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| EMPLOYEE ONLY |
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| EMPLOYEE + Spouse |
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| EMPLOYEE +Child(ren) |
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| FAMILY |
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