Comparison Chart (See Related Articles at Right)
Deductibles - Per Calendar Year
Medical:
|
PPO |
PPO |
PPO |
||
|
TRADITIONAL |
LOW DEDUCTIBLE |
HD WELLNESS |
HD HSA QUALIFIED |
|
|
SINGLE |
$200 |
$200 |
$1,000 |
$2,700 |
|
FAMILY |
$400 |
$400 |
$2,000 |
$5,400 |
Dental:
|
PPO |
PPO |
PPO |
||
|
TRADITIONAL |
LOW DEDUCTIBLE |
HD WELLNESS |
HD HSA QUALIFIED |
|
|
SINGLE |
$50 |
$50 |
$50 |
$50 |
|
FAMILY |
$100 |
$100 |
$100 |
$100 |
Prescription:
|
PPO |
PPO |
PPO |
||
|
TRADITIONAL |
LOW DEDUCTIBLE |
HD WELLNESS |
HD HSA QUALIFIED |
|
|
SINGLE |
$25 |
$25 |
$25 |
Included in Medical Deductible |
|
FAMILY |
$50 |
$50 |
$50 |
Included in Medical Deductible |
Descriptions
- PPO - This is a Preferred Provider Organization. A PPO is a network of doctors, hospitals and outpatient facilities (providers) who give employees a discount on their charges due to the use of the network. Covered members may choose to see any provider within the network and receive the regular benefit. If members choose to see providers who are not a part of the network, they do receive reduced benefits. You may access the list of eligible providers at www.ihnppo.com or 1-888-446-6670. Please see our PPO Plan Document in the Related Links at right.
- Endorsed Physicians - Physicians who follow established protocols of care. Physicians who practice preventive medicine. Neither too much nor too little care and Physicians who tend to get it right the first time. Look for AHDI next to your physicians name for endorsed physicians.
- Non-Endorsed Physicians - Physicians who do not necessarily have the lowest rates. Who may skimp on necessary care. Who may practice cut-rate medicine. Non-AHDI indicates physicians who do not meet the standards for endorsement. This only applies to physicians in the IHN network.
- Traditional - This is a 'standard' indemnity plan. Covered members will receive the regular benefit for any qualified provider. They will not receive discounts on their claims and will pay additional premiums due to the loss of discount to the Health Care Plan. Please see our Traditional Plan Document in Related Links at right.
Inquiries
- Claims - Contact Key Benefit Administrators at 1-800-871-2335 or 1-317-284-7100 enter group number 9009, or fax to 1-317-284-7469
- Eligibility - Contact PEB 1-765-285-8461
- Plan Questions - Contact PEB 1-765-285-8461
Premiums
|
PPO |
PPO |
PPO |
||
|
TRADITIONAL |
LOW DEDUCTIBLE |
HD WELLNESS |
HD HSA QUALIFIED |
|
|
FAMILY |
$571.42/mth |
$357.86/mth |
$303.46/mth |
$264.46/mth |
|
SINGLE |
$220.14/mth |
$137.86/mth |
$116.90/mth |
$101.88/mth |

