blue cross blue shield of kansas benefits plan options
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Blue Cross Blue Shield of Kansas Benefits Plan Options. USD 336 Holton. Current Triple Option Plan. Deductible Option 1: $500/$1000 Option 2: $1000/$2000 Option 3: $1500/$3000 Coinsurance - $1000/$2000 (80/20\%) Office Visit Copay - $20 no limits

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slide2
Current Triple Option Plan
  • Deductible
    • Option 1: $500/$1000
    • Option 2: $1000/$2000
    • Option 3: $1500/$3000
  • Coinsurance - $1000/$2000 (80/20%)
  • Office Visit Copay- $20 no limits
  • Accident Coverage – Subject to deductible / coinsurance
  • Prescription Drugs - $15/30/45 copay, Mail order $37.50/75/112.50
slide3
High Deductible Health Plan 1 (HDHP)
  • Deductible - $2500/$5000
  • Coinsurance - $0
  • Office Visit Copay– Subject to deductible / coinsurance
  • Accident Coverage – Subject to deductible / coinsurance
  • Prescription Drugs – Subject to deductible/coinsurance, then
    • $15/50/75 copay, Mail order $37.50/125/187.50
slide4
AffordaBlue Triple Option
  • Deductible
    • Option 1: $500/$1500
    • Option 2: $1000/$3000
    • Option 3: $2000/$6000
  • Coinsurance - $1000/$3000 (80/20%)
  • Office Visit Copay- $25, limited to 5 visits per person, 15 per family
  • Accident Coverage – $50 copay for initial visit
  • Prescription Drugs - $100 / $300 deductible, then 50%
slide5
High Deductible Health Plan 2 (HDHP)
  • Deductible - $3000/$6000
  • Coinsurance - $0
  • Office Visit Copay– Subject to deductible / coinsurance
  • Accident Coverage – Subject to deductible / coinsurance
  • Prescription Drugs – Subject to deductible/coinsurance, then
    • $15/50/75 copay, Mail order $37.50/125/187.50
slide6
Comprehensive Major Medical
  • Deductible - $1500/3000
  • Coinsurance - $2000/$4000 (60/40%)
  • Office Visit Copay- $30 Primary Care (PCP) or $60 Specialist,
  • limited to 5 visit per person / 15 family
  • Accident Coverage – Pays 100% up to $1000 per person, then
  • subject to deductible/coinsurance
  • Prescription Drugs - $15/50/75/150 copay, Mail order
  • $37.50/125/187.50/375
slide7
High Deductible Health Plan 3 (HDHP)
  • Deductible - $5000/$10,000
  • Coinsurance - $0
  • Office Visit Copay– Subject to deductible / coinsurance
  • Accident Coverage – Subject to deductible / coinsurance
  • Prescription Drugs – Subject to deductible/coinsurance, then
    • $15/50/75 copay, Mail order $37.50/125/187.50
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