The following changes will become effective September 1, 2009
2009 |
Classic Option |
Standard Option |
Office Visit Co-Payments |
$20.00 |
$35.00 |
|
|
|
Annual Brand Prescription (Rx) Deductible |
$100.00 |
$100.00 |
Retail Rx Co-Pays |
|
|
Generic |
$5.00 |
$10.00 |
Preferred-Brand |
$30.00 |
$40.00 |
Non-Preferred |
$60.00 |
$65.00 |
Mail Order Rx Co-Payments |
|
|
Generic |
$10.00 |
$20.00 |
Preferred-Brand |
$60.00 |
$80.00 |
Non-Preferred |
$120.00 |
$130.00 |
***At this time there are no changes to the current monthly premiums***