Health Insurance
Truckers Insurance Associates offers employee heath coverage through Wellmark.
Wellmark Group #057479-1002
Renewal Date: July 1, 2020
Below is a benefit summary of the two plan offered and is not intended to replace the actual contract.
Wellmark ERC Plan
| Covered Services | Network |
Out of Network |
| Deductible |
$1,000/Single $2,000/Family |
|
| Coinsurance | 80/20 | 70/30 |
| Out-of-Pocket Maximum | $2,000/Single
$4,000/Family |
|
| Lifetime Maximum | $2,000,000 | |
| Physician Office Visit | $20 Copay | Ded. Then 70/30 |
| Routine/Wellness | $20 Copay | Ded. Then 70/30 |
| Immunizations | $20 Copay | Ded. Then 70/30 |
| Mammograms | $20 Copay | Ded. Then 70/30 |
| Gynecological Exam | $20 Copay | Ded. Then 70/30 |
| Chiropractic Care | $20 Copay | Ded. Then 70/30 |
| Maternity Care
Physician Hospital |
Ded. Then 80/20 Ded. Then 80/20 |
Ded. Then 70/30 Ded. Then 70/30 |
| Inpatient Hospital | Ded. Then 80/20 | Ded. Then 70/30 |
| Outpatient Hospital | Ded. Then 80/20 | Ded. Then 70/30 |
| Emergency Services |
$150 Copay |
Ded. Then 70/30 |
| Mental Health /
Chemical Dependency (see policy limitations) |
Ded. Then 80/20 (inpatient) $20 Copay (office visits) |
Ded. Then 70/30 (inpatient) Ded. Then 70/30 (office visits) |
| Prescription |
$8/$35/$50 |
|
|
Rates Per Paycheck |
|
| Employee Only | $100.07 |
| Employee & Spouse | $405.59 |
| Employee & Child(ren) | $374.89 |
| Family | $607.79 |
Wellmark ERE Plan
| Covered Services | Network | Out of Network |
| Deductible | $2,000/Single
$4,000/Family |
|
| Coinsurance | 80/20 | 70/30 |
| Out-of-Pocket Maximum | $4,000/Single
$8,000/Family |
|
| Lifetime Maximum | $2,000,000 | |
| Physician Office Visit | $20 Copay | Ded. Then 70/30 |
| Routine/Wellness | $20 Copay | Ded. Then 70/30 |
| Immunizations | $20 Copay | Ded. Then 70/30 |
| Mammograms | $20 Copay | Ded. Then 70/30 |
| Gynecological Exam | $20 Copay | Ded. Then 70/30 |
| Chiropractic Care | $20 Copay | Ded. Then 70/30 |
| Maternity Care
Physician Hospital |
Ded. Then 80/20 Ded. Then 80/20 |
Ded. Then 70/30 Ded. Then 70/30 |
| Inpatient Hospital | Ded. Then 80/20 | Ded. Then 70/30 |
| Outpatient Hospital | Ded. Then 80/20 | Ded. Then 70/30 |
| Emergency Services | $150 Copay | Ded. Then 70/30 |
| Mental Health /
Chemical Dependency (see policy limitations) |
Ded. Then 80/20 (inpatient)
$20 Copay (office visits) |
Ded. Then 70/30
(inpatient) Ded. Then 70/30 (office visits) |
| Prescription | $8/$35/$50 | |
| Rates Per Paycheck | |
| Employee Only | $65.32 |
| Employee & Spouse | $334.43 |
| Employee & Child(ren) | $309.12 |
| Family | $501.15 |