Teammate Open Enrollment 2021
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Medicare Plans
PERS Select
PERS Choice
PERSCare
CAHP Medicare Supplement (Association Plan)
PORAC (Association Plan)
PPO
Non-PPO
PPO
Non-PPO
PPO
Non-PPO
BENEFITS
Calendar Year Deductible
Individual
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
Family
Maximum Calendar Year Copay or Co-insurance (excluding pharmacy)
$3,000 (co- insurance)
N/A
N/A
N/A
Individual
N/A
N/A
Family
N/A
N/A
N/A
N/A
N/A
Hospital (including Mental Health and Substance Abuse) Inpatient No Charge
No Charge
No Charge
No Charge
No Charge
Outpatient Facility/ Surgery Services
No Charge
No Charge
No Charge
No Charge
No Charge
Skilled Nursing Facility (up to 100 days/benefit period) No Charge
No Charge
No Charge
No Charge
No Charge
Home Health Services
No Charge
No Charge
No Charge
No Charge
No Charge
Hospice
No Charge
No Charge
No Charge
No Charge
No Charge
2021 Health Benefit Summary | 25
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