Medical
P2S LP is pleased to offer medical coverage through Anthem. When deciding which medical plan is the best fit for you and your family, it’s important to consider the total cost of coverage. This includes what you pay in premiums out of your paycheck and what you pay for services.
While each medical plan covers preventive screenings in full, the medical plans vary on annual deductibles, copays, and levels of coinsurance. This means you may pay more out-of-pocket costs with one plan versus another. The ideal medical plan should cover most of your health plan with out-of-pocket costs that meet your budget.
The medical plan comparison highlights features of each plan to assist you in choosing the plan that meets your individual needs.
| Anthem EPO | Anthem Classic PPO | ||
| Network Only | In-Network | Out-of-Network | |
| Preventative Care | Covered | Covered | Not Covered |
| Deductible* (individual / family) | $0 | $500 / $1,000 | $1,000 / $2,000 |
| Office Visits | $10 Copay | $15 Copay | 30% Coinsurance |
| Specialist Visits | $30 Copay | $15 Copay | 30% Coinsurance |
| Diagnostic Lab & X-Ray | 0% Coinsurance | 0% Coinsurance | Lab Not Covered/ X-Ray 30% Coinsurance |
| Complex Imaging | 0% Coinsurance | 10% Coinsurance | 30% Coinsurance |
| Emergency Services | |||
| Emergency Room | $100 Copay (waived if admitted) | $100 Copay | Covered as In-Network |
| Urgent Care | $10 Copay | $10 Copay | 30% Coinsurance |
| Ambulance | 0% Coinsurance | 10% Coinsurance | Covered as In-Network |
| Prescription Drugs | |||
| Retail/ Mail Order | Retail/ Mail Order | Retail/ Mail Order | |
| Tier 1 | $5/ $5 | $5/ $5 | $5/ Not Covered |
| Tier 2 | $25/ $65 | $25/ $65 | $25/ Not Covered |
| Tier 3 | $45/ $125 | $45/ $125 | $45/ Not Covered |
| Specialty | $45/ $45 | $45/ $45 | Not Covered |
| Out-of-Pocket Maximum* (individual / family) |
$1,500 / $3,000 | $2,500 / $5,000 | $5,000 / $10,000 |
*Deductibles and Out-of-Pocket Maximums reset every calendar year (1/1-12/31).
Wellness Incentive:
Employees who take advantage of the optional biometric screening benefit in multiple ways. Successful completion of the screening results in employees receiving a discounted incentive rate on their Anthem employee health plans.
More information will be provided by HR during onboarding.
Anthem Classic PPO Medical Plan
The PPO medical plan gives you the option to seek medical treatment from a contracted medical provider, at negotiated rates, or from an out-of-network provider, at an additional cost. You must pay a copay for select services, with the exception of preventive care, which is covered in full.
Other services may be subject to the annual deductible and coinsurance. Once you reach the out-of-pocket maximum, the plan will pay 100% for all eligible expenses for the remainder of the plan year. While you can visit any doctor, you’ll save the most money by using in-network providers.
Supplemental Information:
Anthem EPO Medical Plan
An exclusive provider organization (EPO) health insurance plan requires you to use the doctors and hospitals within its own network, much like a Health Maintenance Organization (HMO). With the EPO you don't have to get referrals to see specialists. As an EPO member, you cannot go outside your plan's network for care. There are no out-of-network benefits under an EPO health insurance plan.
Supplemental Information:
Additional Resource for Medical Members: