4-TIER PLAN
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90/50 |
90/50 |
VISION |
HMO |
VISION |
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In network deductible S F (3
or more) Out of network deductible S F (3 or more) |
$500 $1,500 $1,000 $3,000 |
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$250 Deductible Per Person |
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MO |
MO |
MO |
MO |
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Single |
109 |
+8= 117 |
82 |
+8=90 |
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Member/Children
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190 |
+15=205 |
148 |
+15=163 |
Groom |
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Member/Spouse |
205 |
+14=219 |
165 |
+14=179 |
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F/Member/Spouse/Children |
274 |
+22=296 |
221 |
+22=243 |
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Single |
211 |
+8=219 |
172 |
+8=180 |
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Member/Children |
315 |
+15=330 |
290 |
+15=305 |
Driver-Trainer |
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Member/Spouse |
407 |
+14=421 |
375 |
+14=389 |
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F/Member/Spouse/Children |
516 |
+22=538 |
475 |
+22=497 |
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Single |
250 |
+8=258 |
223 |
+8=231 |
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Member/Children |
309 |
+15=324 |
279 |
+15=294 |
Retired/TenureSurviving Spouse* |
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Member/Spouse |
414 |
+14=428 |
377 |
+14=391 |
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F/Member/Spouse/Children |
697 |
+22=719 |
634 |
+22=656 |
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*Surviving Spouse-Will be covered for a period up to ½ of the amount of time that a Member
had been a participant in the IHHA Insurance.program with a minimum coverage
period of 2 years. |
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