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Aetna - (PP0c) -
Click here for the detailed
plan summary.
Option #2 |
| This policy is a POS (Point of Service)
cost share plan (has in & out of network deductibles). The
plan has in & out of network coverage, & no referrals
needed. The is an in-network deductible $1,000 (single) &
$3,000 (family) with a 90% co-insurance. There is a $25 primary
& a $50 specialist in network office visit co-pay. With the
Hospital co-pay & Emergency room visit you must meet the deductible
& co-insurance first. The prescription drug card is 15/35/70
with no deductible. |
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Monthly |
Monthly |
Quarterly |
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Small
Group |
Sole Proprietor |
Sole Proprietor |
| Individual |
$462.00 |
N/A |
N/A |
| Individual
+ Spouse |
$1,105.00 |
N/A |
N/A |
| Individual + Child(ren) |
$934.00
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N/A |
N/A |
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Family |
$1,445.00 |
N/A |
N/A |
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Plan Selection |
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Instructions |
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Application |
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Enrollment Form |
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| Aetna
- (EPOc) -
Click here for the detailed
plan summary.
Option #1 |
| This policy is an EPO cost share plan
(has in network deductibles) with no out of network coverage,
& no referrals needed. There is a $25 primary & a $50
specialist office visit co-pay. The in network Deductible is $1000(single)
and $3000(family) with a 90% co-insurance.The Hospital co-pay
is subject to the deductible and co-insurance. The prescription
drug card is 15/35/70 with no deductible. |
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Monthly |
Monthly |
Quarterly |
| Small Group |
Sole
Proprietor |
Sole
Proprietor |
| Individual |
$403.00
|
N/A |
N/A |
| Individual
+ Spouse |
$963.00 |
N/A |
N/A |
| Individual + Child(ren) |
$814.00 |
N/A |
N/A |
| Family
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$1,259.00 |
N/A |
N/A |
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Plan Selection |
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Instructions |
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Application |
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Enrollment Form |
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