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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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Chemical dependency treatment |
80% after deductible |
60% after deductible |
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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.
Questions about your employee benefits or other Human Resources issues? Contact the Workplace Solutions Center at (888) 471-2271.