| Active Employee Plans | Retiree Plan | ||
| wcagtext | 90/10 PPO Plan This plan pays for 90 percent of most health care costs after the deductible is met. You’ll pay the remaining 10 percent. | 80/20 PPO Plan This plan pays for 80 percent of most health care costs after the deductible is met. You’ll pay the remaining 20 percent. | 90/10 PPO Plan This plan pays for 90 percent of most health care costs after the deductible is met. You’ll pay the remaining 10 percent. |
|---|---|---|---|
In network: none $100 per person $300 (maximum) per family | None | In network: none $100 per person $300 (maximum) per family | |
$2,000 per person $4,000 per family | $2,500 per person $5,000 per family | $2,000 per person $6,000 per family | |
Services | You Pay | You Pay | You Pay |
Office visits | 10% | 20% | 10% |
Physical exams | $0 | $0 | $0 up to
|
Hospital room and board | 10% | 20% | 10% |
Surgical procedures | 10% | 20% | 10% |
Diagnostic tests | 10% | 20% | 10% |
Emergency room | 10% | 20% | 10% |
Ambulance | 10% | 20% | 10% |
Hearing aids One hearing aid per ear every 60 months | 10% | 20% | 10% |
Plan documents | 90/10 PPO Plan 2025-2026 Plan year | 80/20 PPO Plan 2025-2026 Plan year | 90/10 PPO Retiree Plan 2025 Plan year |
Annual physical exam | |||
Chiropractic services | |||
The out-of-pocket maximum is the most you'll have to pay per calendar year for covered health care services. Once you reach this amount, your plan pays 100 percent of the allowed amount for covered services excluding taxes.
There's a maximum for each person on the plan and a maximum for everyone on the plan.
A deductible is the fixed dollar amount you must pay each calendar year for certain services and products before your health plan pays.
Providers in our network agree to charge set rates for services or products.
Providers who aren't in our network are called out-of-network providers. It usually costs more to see these providers because they don't have a contract with us to provide you with services at a set fee. In addition, visits to out-of-network providers may not apply to your plan's deductible.
