Page 7 - Willscot I Mobile Mini Open Enrollment Guide

Medical and
Prescription Drug Coverage
Key Words to Know:
Coinsurance: Percentage of the charge that your plan will pay, typically after you have met the deductible Copay: An amount you pay for a covered service each time you use that service, which usually does not apply
toward the deductible
Deductible: The amount you pay before the plan begins to pay
Out-of-Pocket Costs: Expenses you pay, such as deductibles, copays and the remaining amounts after plan coinsurance is paid
Out-of-Pocket Maximum: The maximum amount you pay for covered services in a year (you may need to pay additional amounts if coverage is received from an out-of-network provider)
Using In-Network Providers
You’ll save money when receiving care from an in-network provider. To access a list of in-network providers, click on the link provided on the Mercer Marketplace 365 enrollment site. Using an out-of-network provider could result in a higher out-of-pocket cost.
Prescription Drug Coverage
Your prescription drug coverage depends on the medical coverage level you choose. Medications are grouped into tiers, which determine your portion of the drug cost.
Tier
You Pay
What’s Covered
1 Lowest Cost Sharing
3 Highest Cost Sharing
Most Generic Prescription Drugs
Generic drugs that are equivalent to a brand product in dosage form, strength, quality and intended use
Non-Preferred Brand Name Drugs
Drugs sold under specific trade names that have a more cost-effective alternative on Tier 1 or Tier 2
2
Second-Lowest Cost Sharing
Preferred Brand Name Drugs
Drugs sold under specific trade names that are favorably priced by the pharmacy plan
Helpful Information about Deductibles and Out-Of-Pocket Maximums
When electing coverage for any family members in addition to yourself, deductibles and out-of-pocket maximums are applied differently for different plans.
Plan
Deductible
Out-of-Pocket Maximum
The entire Family Deductible must be met $1,500 Deductible Plan before benefits begin to pay out for any
family member
The entire Family Out-of-Pocket Maximum must be met before the plan pays in full for any family member
$3,000 Deductible Plan
Once one family member meets the Individual Deductible, benefits begin to be paid for that individual
Once one family member meets the Individual Out-of-Pocket Maximum, the plan pays covered benefits in full for that individual
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