Medical Plan: Aetna

1. Open Choice I- In-network Deductible 0/0; MOOP $3500/7k; PCP $10 copay; Spec $20 copay; Hosp $75/day X 5 days max; ER $100; UC $28
2. Open Choice II- In-network Deductible 0/0; MOOP $5k/10k; PCP $20 copay; Spec $40 copay; Hosp $350 copay; ER $100; UC $28
3. Open Choice III- In-network Deductible $1100/$2200; MOOP $3500/$7k; PCP $25 copay; Spec $50 copay, Hosp $200 copay; ER $100; UC $50
4. BMCS POS- Referrals Needed; In-network Deductible 0/0; MOOP $3500/$7k; PCP $15; Spec $25; Eye Exam $25 copay 1 x 24 mos; Hosp $250; ER $100; UC $24

Medical Waiver- If spouses work for Upper Dublin: Only one spouse will enroll in Medical, Rx, Dental, and Vision, the other must WAIVE. The other spouse is not eligible for the medical WAIVER; The amounts are different depending on the bargaining unit. They receive the WAIVER payment in their biweekly paychecks over 21 pays. Employees must provide Jenny Windle with a copy of their insurance card after completing the enrollment process via email to [email protected]