2014-2015 Plan Benefit Summary Comparison Plan Deductible per person/ per plan year Medical Drugs A&M Care $700* A&M Care $500 65 Plus A&M Care $500* JPlan Grad Plan $350 Copayments Primary Physician Specialist Generic Drug Formulary Drug Non-formulary Drug Hospitalization Percent Plan/Employee $50 $30* $45* $10 $35 $60 80/20 $50 N/A N/A $10 $35 $60 80/20 $50 $30* $45* $10 $35 $60 75/25 $15 at campus health center max, $40 retail 80/20 $0 $35, no charge $35; no charge $15 at campus $15 at campus if using campus if using campus health center health center health center health center max, $15 retail max, $30 retail *These benefits presume you use a network doctor. Annual Maximum Out-of-Pocket Expense $5,000/person plus $700 deductible $10,000 family plus $2,100 deductible $1,400/person plus $500 deductible $5,000/person plus $500 deductible $6,350/person plus $350 deductible $12,700/family plus $1,050 deductible
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