ACCMA
ACCMA
ACCMA Members Health Insurance Plan Benefit Summary
The PacifiCare PPO 100-50/3500 HAS compatible plan replaces the PacifiCare PPO 100-50/5000 HAS previously offered. All ACCMA members, their family, and ACCMA member staff are guaranteed issuance of coverage during the annual enrollment.
PacifiCare PPO 35/80-60/500  |
UnitedHealthCare PPO 70-50/3500(HSA) |
PacifiCare PPO 35/70-50/1000 |
PacifiCare HMO 20-40/500/3000 |
| Physician Office visit Co-pay $35 |
Physician Office visit 30% after deductible |
Physician Office visit Co-pay $35 |
Physician Office visit Co-pay $40 ($20-Specialist by ref.) |
| Calendar year deductible $500 indiv/$1000 family |
Calendar year deductible $3,500 indiv./$7000 family |
Calendar year deductible $1,000 indiv./$2,000 family |
Calendar year deductible NONE |
| Policy Maximum benefits $5,000,000 |
Policy Maximum benefits $5,000,000 |
Policy Maximum benefits $5,000,000 |
Policy Maximum benefits NONE |
| Co-ins. Annual Max $5,000 indiv/$10,000 family |
Co-ins. Annual Max 0% after deductible |
Co-ins. Annual Max $5,000 indiv/$10,000 family |
Co-ins. Annual Max $3,000 indiv/$5,000 family |
| OOP Annual Max $5,500 indiv/$11,000 family |
OOP Annual Max $5,000 indiv./$10,000 family | OOP Annual Max $6,000 indiv./$12,000 family |
OOP Annual Max $3,000 indiv/$5,000 family |
| Co-insurance 80/20% in PPO; 60/40% out of PPO |
Co-insurance 70/30% in PPO; 50/50% out of PPO |
Co-insurance 70/30% in PPO; 50/50% out of PPO |
Co-insurance NONE — but different Co-pays for listed benefits |
| Prescription Drugs 100% after co-pay of: $10 generic $35 brand name $50 non-formulary | Prescription Drugs 100% after deductible for generic, brand, non-formulary and mail order | Prescription Drugs 100% after co-pay of: $10 generic $35 brand name $50 non-formulary | Prescription Drugs 100% after co-pay of: $15 generic $35 brand name $50 non-formulary |