Common use of Traditional Plan Clause in Contracts

Traditional Plan. Specifications: Network Maximum Benefits Unlimited Deductibles $100/$200 Accumulation Period Calendar Year Co-Insurance Provision 80% 80% by the insurance carrier and 20% by the patient up to a yearly maximum out-of-pocket of $500 per individual or $1,000 for two or more family members. After the out-of-pocket has been met by the employee, 100% of eligible charges will be paid. Out-Patient Psychiatric/Substance Abuse: 80%, UCR up to 15 visits (30 visits if in Network PPO) per person, per year In-Patient Psychiatric: 31 days per person, per year Substance Abuse Preventative: Routine pap test, mammogram, and prostate cancer test once per year shall be a covered expense (unless found by a physician to be necessary more often).