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Consumer Choice Plan at a Glance |
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Features/Covered Services |
In-Network |
Out-of-Network |
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Annual deductible (includes medical and prescription) |
$1,500 single coverage $3,000 family coverage |
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Annual out-of-pocket maximum1 (includes medical and prescription) |
$5,000 single coverage $10,000 family coverage |
$10,000 single coverage $20,000 family coverage |
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Plan pays: |
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Primary care physician office visits |
80% after deductible |
60% after deductible |
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Specialist office visits
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80% after deductible |
60% after deductible |
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Preventive care/well baby care |
100%, no deductible |
60% after deductible |
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Plan pays: |
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Allergy injections |
80% after deductible |
60% after deductible |
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Urgent care facility |
80% after deductible |
60% after deductible |
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Emergency room for medical emergencies |
80% after deductible |
80% after deductible |
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Non-emergency use of an emergency room is not covered |
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CT scans and MRIs |
80% after deductible |
60% after deductible |
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Outpatient surgery (physician’s office or surgical facility) |
80% after deductible |
60% after deductible |
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Inpatient hospitalization |
80% after deductible |
60% after deductible |
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Chiropractic care (up to 24 visits/person/per calendar year) |
80% after deductible |
60% after deductible |
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Maternity care
Maternity Care |
80% after deductible |
60% after deductible |
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Mental health treatment |
80% after deductible |
60% after deductible |
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· Inpatient maximum annual benefit · Outpatient maximum annual benefit |
Max 30 days/per calendar year2 Max 45 visits/per calendar year2 |
Max 30 days/per calendar year2 Max 20 visits/per calendar year2 |
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Chemical dependency treatment |
80% after deductible |
60% after deductible |
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· Inpatient maximum annual benefit · Outpatient maximum annual benefit |
Max 30 days/per calendar year2 Max 45 visits/per calendar year2 |
Max 30 days/per calendar year2 Max 20 visits/per calendar year2 |
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Prescription drugs |
80% after deductible |
60% after deductible |
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Lifetime maximum |
$2,000,000 combined benefit for all ACS-sponsored medical plans |
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[1] The out-of-pocket maximum includes all covered expenses you pay out of your pocket, including the annual deductible.
[2] Maximums include both in- and out-of-network services. Mental health and chemical dependency treatments, visits and day maximums are also combined.
Questions about your employee benefits or other Human Resources issues? Contact the Workplace Solutions Center at (888) 471-2271.