The Sleep Center offers three different Anthem policies.  Below are some of the basic benefits each offers.  Employees are responsible for a portion of the cost depending on which plan they choose.  Please see the administrator for more details if needed.

In Network Benefits	Anthem Healthkeepers	Anthem Healthkeepers	Anthem Healthkeepers
	HMO 25/2000	Value Adv 25/500/30%	HDHP 3000/100%
	Group 0B509701	Group 0B509803	Group 0B526502
Referrals Required?	No	No	No
Calendar Year Deductible	$2000 ind / $4000 family	$5000 ind / $1000 family	$3000 ind / $6000 family
Max Out-Of-Pocket	$5500 ind / $11000 family	$3000 ind / $6000 family	$4000 ind / $8000 family
Co-Insurance	0%	30%	0%
Office Visits	After deductible:  $25 PCP / $50 Specialist	$25 PCP / $25 Specialist	$0 after deductible
Urgent Care	After deductible:  $50 copay	$25	$0 after deductible
Inpatient Hospitalization	After deductible:  $350 per day up to $1750 per admission	30% after deductible	$0 after deductible
Outpatient Services	After deductible:  $300 copay	30% after deductible	$0 after deductible
Emergency Room	After deductible:  $250 copay	30% after deductible	$0 after deductible
Routine Vision Exam	$15 copay	$15 copay	$15 copay
Prescription Drugs	$150 deductible then:	$150 deductible then:	Tier 1 - $10
	Tier 1 - $10	Tier 1 - $10	Tier 2 - $60
	Tier 2 - $30	Tier 2 - $60	Tier 3 - $150 or 20% after deductible
	Tier 3 - $150 or 20%	Tier 3 - $150 or 20%
Mail Order Prescriptions	$150 deductible then:	$150 deductible then:	Tier 1 - $10
	Tier 1 - $10	Tier 1 - $10	Tier 2 - $60
	Tier 2 - $60	Tier 2 - $60	Tier 3 - $150 or 20% after deductible
	Tier 3 - $150 or 20%	Tier 3 - $150 or 20%
Out of Network Benefits	Anthem Healthkeepers	Anthem Healthkeepers	Anthem Healthkeepers
	HMO 25/2000	Value Adv 25/500/30%	HDHP 3000/100%
	Group 0B509701	Group 0B509803	Group 0B526502
Calendar Year Deductible	n/a	$1000 ind / $2000 family	$3500 ind / $7000 family
Max Out-Of-Pocket	n/a	$4250 ind / $8500 family	$6000 ind / $12000 family
Co-Insurance	n/a	30% after deductible	30% after deductible