Common use of Health Maintenance Organizations Clause in Contracts

Health Maintenance Organizations. The University offers multiple HMO plans. All HMOs will offer two (2) levels of benefits - Enhanced and Standard. The chart below contains the key features of all HMOs. A detailed description, including how members will qualify for the Enhanced or Standard coverage, will be provided in the annual open enrollment materials that are distributed to each member. Enhanced Standard Deductible (Single/Family) $0 $200/$400 Co-Insurance N/A 80%/20% Out of Pocket Max (including deductible) N/A $2,200/$4,400 Office/Urgent Care Co-Pay $20 $30 Prescription Co-Pay Generic $7 $10 Preferred Brand Name $15 $20 Non-Preferred Brand Name $30 $50 Note: the Standard Prescription Co-Pays for Priority Health are $7/$15/$30 Information about Plan benefits, plan design, and open enrollment materials may be obtained from the University's Benefit and Compensation Service Office and will be provided by the medical carriers. All benefits of the HMO plans are subject to specific HMO policy provisions and the Group Operating Agreements between Oakland University and the HMO. Any employee enrolled in one (1) of the HMO offerings shall not be eligible for benefits set forth in paragraph 51.2A.

Health Maintenance Organizations. The University offers multiple three (3) HMO plans. All three HMOs will offer two (2) levels of benefits - Enhanced and Standard. The chart below contains the key features of all three (3) HMOs. A detailed description, including how members will qualify for the Enhanced or Standard coverage, will be provided in the annual open enrollment materials that are distributed to each member. Enhanced Standard Deductible (Single/Family) $0 $200/$400 Co-Insurance N/A 80%/20% Out of Pocket Max (including deductible) N/A $2,200/$4,400 Office/Urgent Care Co-Pay $20 $30 Prescription Co-Pay Generic $7 $10 Preferred Brand Name $15 $20 Non-Preferred Brand Name $30 $50 Note: the Standard Prescription Co-Pays for Priority Health are $7/$15/$30 Information about Plan benefits, plan design, and open enrollment materials may be obtained from the University's Benefit and Compensation Service Office and will be provided by the medical carriers. All benefits of the HMO plans are subject to specific HMO policy provisions and the Group Operating Agreements between Oakland University and the HMO. Any employee enrolled in one (1) of the HMO offerings shall not be eligible for benefits set forth in paragraph 51.2A.

Health Maintenance Organizations. ‌ The University offers multiple HMO plans. All HMOs will offer two (2) levels of benefits - Enhanced and Standard. The chart below contains the key features of all HMOs. A detailed description, including how members will qualify for the Enhanced or Standard coverage, will be provided in the annual open enrollment materials that are distributed to each member. Enhanced Standard Deductible (Single/Family) $0 $200/$400 Co-Insurance N/A 80%/20% Out of Pocket Max (including deductible) N/A $2,200/$4,400 Office/Urgent Care Co-Pay $20 $30 Prescription Co-Pay Generic $7 $10 Preferred Brand Name $15 $20 Non-Preferred Brand Name $30 $50 Note: the Standard Prescription Co-Pays for Priority Health are $7/$15/$30 Information about Plan benefits, plan design, and open enrollment materials may be obtained from the University's Benefit and Compensation Service Office and will be provided by the medical carriers. All benefits of the HMO plans are subject to specific HMO policy provisions and the Group Operating Agreements between Oakland University and the HMO. Any employee enrolled in one (1) of the HMO offerings shall not be eligible for benefits set forth in paragraph 51.2A.