Medical Care Plan
The College provides a PPO plan with Health America to eligible employees with the following features:
- Benefits will be paid at a higher level when a participating physician and/or facility rather than at a non-participating provider who renders services.
- Participating Provider (for a list of providers please click on the link above for Preferred Healthcare System or call 1-800-238-9900)
100% minus applicable co-payments i.e. Office Visits $10, Emergency Room $25, etc.
- Non-Participating Provider
Subject to deductible of $300 for an individual or $600 for family. Then benefits are paid at 80% until the out-of-pocket maximum is met. The out-of-pocket maximum is $2,000 an individual or $4,000 for family. Payment is based upon Usual Customary and Reasonable (UCR) allowances.
- Prescription Drug Program
Offered for a co-payment of $10 for a generic drug, 10% of the cost of the drug with a minimum of $20 and a maximum of $100 for a preferred brand drug and 10 % of the cost of the drug with a minimum of $40 and a maximum of $100 for a non-preferred brand drug. There is a $50 annual deductible for each covered family member.
- There is also a mail in prescription program offered for medications you take on a regular, long-term basis. You will receive up to a 90 day supply at a reduced rate.
- The plan requires pre-certification 15 days prior to inpatient admission. More information is available here.
A 10% contribution by the employee is required for single coverage. For persons electing dependent coverage, the employee will contribute 20% of the monthly dependent premium. These premiums can be contributed on a pre-tax basis through a Section 125 Premium Conversion Plan. The monthly premium paid by the employee for single coverage is $44.92, two-person coverage is $144.97, family coverage is $195.14.
Employees who choose to waive health plan participation can receive a $750 annual incentive upon receipt of proof of other non-Juniata health plan coverage. The incentive can be paid through payroll (taxed) or deposited into a Health Reimbursement Account (HRA)(non-taxed).