01-07-2009, 09:41 AM
2009 Retiree Modified Healthcare Plan
Modified Plan Cost � Single (TCN)
� Single members monthly cost is $11
� 2009 deductible is $164
� 2009 Co-Insurance is $109
� The $164 deductible is paid for the first of any medical.
� After the deductible is paid, the co-insurance is billed at 10% of the medical expenses until the $109 is paid.
Modified Plan Cost � Family (TCN)
� Family members monthly cost is $23
� 2009 deductible is $328
� 2009 Co-Insurance is $218
� The $328 deductible is paid for the first of any medical.
� After the deductible is paid, the co-insurance is billed at 10% of the medical expenses until the $218 is paid.
Prescription Drug Coverage
Retail - Generic $5, Brand $11, ED $16
Mail Order - Generic $11, Brand $16, ED $20
Office Visits Co-pay 100%
Emergency Room Co-payment - $55, waived if admitted
Modified Plan Cost � Single (TCN)
� Single members monthly cost is $11
� 2009 deductible is $164
� 2009 Co-Insurance is $109
� The $164 deductible is paid for the first of any medical.
� After the deductible is paid, the co-insurance is billed at 10% of the medical expenses until the $109 is paid.
Modified Plan Cost � Family (TCN)
� Family members monthly cost is $23
� 2009 deductible is $328
� 2009 Co-Insurance is $218
� The $328 deductible is paid for the first of any medical.
� After the deductible is paid, the co-insurance is billed at 10% of the medical expenses until the $218 is paid.
Prescription Drug Coverage
Retail - Generic $5, Brand $11, ED $16
Mail Order - Generic $11, Brand $16, ED $20
Office Visits Co-pay 100%
Emergency Room Co-payment - $55, waived if admitted