RXinsider Benefits Guide 2025

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RXINSIDER 2025

PPO Plan

The PPO plan gives you the freedom to seek care from the provider of your choice.

However, you will maximize your bene�ts and reduce your out-of-pocket costs if you

choose a provider participating in the (carrier name/network name) network.

The calendar year deductible must be met before certain services are covered.

Blue Cross Blue Shield (BCBS) – Side-by-Side Medical Bene�t Summary

Medical Plan

PPO 500

In-Network

PPO 1500

In-Network

Deductible

• Employee Only

• Family

$500

$1,000

$1,500

$3,000

Out-of-Pocket Limit

• Employee Only

• Family

$1,800

$3,600

$6,000

$12,000

Preventive Care

Primary Care Visit (PCMH)

Primary Care Visit (Non PCMH)

Specialist Visit

Emergency Room

Urgent Care

No Charge

$10/Copay

$20/Copay

$30/Copay

$100/Copay

$50/Copay

No Charge

$20/Copay

$30/Copay

$40/Copay

$200/Copay

$100/Copay

Prescription Drugs

Retail

• Tier 1 Lowest Cost Generic Drugs

• Tier 2 Low-Cost Generic Drugs

• Tier 3 Higher Cost Generic and Preferred Brand Name Drugs

$10/Copay

$25/Copay

$35/Copay

$10/Copay

$40/Copay

$70/Copay

Mail Order

• Tier 1 Lowest Cost Generic Drugs

• Tier 2 Low-Cost Generic Drugs

• Tier 3 Higher Cost Generic and Preferred Brand Name Drugs

$25/Copay

$62.50/Copay

$87.50/Copay

$25/Copay

$100/Copay

$175/Copay

BCBS Medical Bene�ts

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