Medical & Prescription
High Deductible Health Plan:
An HDHP means you pay a higher up-front deductible AND receive a monthly Health Savings Account (HSA) contribution from FirstFleet to help offset those costs.
PPO Plan:
With this Preferred Provider Organization option, you will save when using in-network services. See the chart for specific deductible and out-of-pocket maximums.
More Benefits to Keep You Healthy
Teladoc:
With any Medical Plan coverage option, you automatically receive Teladoc telehealth program services, including urgent care. Teladoc is a convenient, easy and cost-effective way to access a doctor from home, work or while traveling. Teladoc is available 24/7.
You can also get support for mental health, dermatology, neck/back care, nutritional counselling and help to quit smoking.
NurseLine:
If you’re not sure if you should go to the ER, or if you need medical advice while at home or on the road, call Nurseline anytime, day or night at 800-818-8581. A registered nurse will help you decide what kind of care you need or help you with your issue. Nurseline is a free service.
Step Therapy for Prescriptions:
To ensure you are getting reasonably priced and effective medications, all Medical Plan options include a step therapy protocol for certain medications your physician prescribes. When applicable, step therapy requires you to use the lowest cost alternative first, or in other cases, receive prior authorization.
Home Delivery or Plus90 Retail Network for Prescriptions:
If you require ongoing “maintenance medications,” you can take advantage of the Home Delivery service or Plus90 Retail Network to receive a 90-day supply of medications for only two times the regular monthly copay.
Hearing Care through HearUSA:
With Medical Plan coverage you automatically receive hearing care coverage. HearUSA provides benefits toward the purchase of a hearing aid for each ear, once every three years.
Special Sleep Apnea Benefit:
Enhanced benefits for sleep apnea are included under the PPO Plan option. Certain non-surgical services and supplies to treat sleep apnea do not require you to first meet the calendar-year deductible. Sleep apnea benefits are covered under the HDHP option but subject to the calendar-year deductible.
Medical and Prescription Plan Options
You have the following two medical plans from which to choose for the 2024 plan year.
| Highlights | HDHP | PPO Plan | ||
|---|---|---|---|---|
| Office Visit Primary Care Physicians | 80%1 | 60%1 | $45 | 60%1 |
| Specialists | 80%1 | 60%1 | $60 | 60%1 |
| Teladoc | Varies2 | N/A | $20 | N/A |
| Calendar Year Deductible per Individual | $3,200 | $6,000 | $2,350 | $4,700 |
| Family Maximum | $6,000 | $12,000 | $4,700 | $9,400 |
| Coinsurance | 80% | 60% | 80% | 60% |
| Out-of-Pocket Maximum per Individual | $6,000 | $12,000 | $7,000 | $14,000 |
| Family Maximum | $12,000 | $24,000 | $14,000 | $28,000 |
| Emergency Services | 80%1 | 80%1 | 80%1 | 80%1 |
| Preventive Services | 100% | 60% | 100% | 60% |
| Inpatient Services, Outpatient Services, Non-Routine Diagnostic Services and Most Other Medical Services | 80% | 60%1 | 80% | 60%1 |
| Therapeutic Services (# of visits limited) | 80%1 | 60%1 | 80% | 60%1 |
| Provider-administered Specialty Drugs | 80%1 | 60%1 | $300 copay | 60%1 |
| Retail Prescription (up to 30 days) Generic | 80%1/$10* | 60%1 | $15 | 60%1 |
| Preferred Brand | 80%1/$35* | 60%1 | $50 | 60%1 |
| Non-Preferred Brand | 80%1/$70* | 60%1 | $100 | 60%1 |
| Home Delivery/Plus90 Network Options Prescription (up to 90 days) Generic | 80%1/$20* | 60%1 | $30 | 60%1 |
| Preferred Brand | 80%1/$70* | 60%1 | $100 | 60%1 |
| Non-Preferred Brand | 80%1/$140 | 60%1 | $200 | 60%1 |
| Specialty Drug Copay | N/A | N/A | 25%4 | N/A |
| Wellness Discount | Without Discount | Wellness Discount | Without Discount | |
| Weekly Medical Premiums Employee Only | $8.00 | $23.00 | $50.00 | $65.00 |
| Employee + Spouse | $23.00 | $38.00 | $117.00 | $132.00 |
| Employee + Child(ren) | $20.00 | $35.00 | $101.00 | $116.00 |
| Employee + Family | $30.00 | $45.00 | $130.00 | $145.00 |
| Monthly HSA Contribution from FirstFleet Only available with HDHP participation Employee Only | $50 | |||
| Employee + Spouse | $95 | |||
| Employee + Child(ren) Employee + Family | $90 | |||
| Employee + Family | $110 | |||
| 1 After deductible | 2 Covered at 80% coinsurance after deductible; contracted charge/use varies according to service type.3 No additional copay | 4 Not to exceed $300 |
NOTE: See the Summary Plan Descriptions for all details, including plan limits, conditions and exclusions.