Racine County Benefits Racine County Health Plan RACINE

Racine County Benefits

Racine County Health Plan

RACINE COUNTY CITY OF RACINE In Net Out Net Deductible $1000 -S $2000 -F $2000 - S $4000 - F $3000 - S $6000 - F $6000 - S $12000 - F Out of Pocket Max $2500 -S $5000 -F $4000 - S $8000 - F $8000 - S $16000 - F N/A OC Spec $60 OV PCP $30 N/A Copay N/A Tele-med $49 ER $200 UC $75 HC $4 Co. Insurance 20% 40% 100% Except copays 80% KENOSHA COUNTY In Net NONE Out Net CITY OF KENOSHA In Net Out Net BROWN COUNTY RUSD In Net Out Net $600 S $1200 F (2) $1800 (3 +) $2500 - S $2, 700 ind. $5, 000 - F $5000 - S $5, 000 ind. $10, 000 - F $1500 – S $3000 - F $2500 – S $5000 - F $2000 -S $4000 -F $4000 – S $8000 - F $1750 S $3250 F $2, 500 - S $2, 700 ind. $5, 000 - F $15, 000 - S $15, 000 ind. $32, 500 - F $2000 – S $4000 - F $3000 – S $6000 - F $4000 -S $8000 -F $8000 – S $16000 - F $150 - ER $25 prescriptions $30 – office visit top tier $45 – office visit N/A $0 preventive $35 - other visits $100 -imaging $200 - ER $200 - UC N/A 25% N/A 2 nd tier 0% 20% 10% 30% 100% if top tier 80% if 2 nd tier N/A

SERVICES*: Preventative visits: NO COST TO YOU! Non-Preventative visits: NO COST TO YOU! Health Coaching: NO COST TO YOU! Labs and tests: NO COST TO YOU! Medications Dispensed: NO COST TO YOU! CALL FOR AN APPOINTMENT: CLINIC: 262 -6640 SCHEDULING LINE: 866 -959 -9355

Comparison of Dental Plans