Skip to main content

2026-2027 Moderno Porcelain LLC Benefits Summary - English

Page 1

2026-2027 Employee Benef its Summary

Working Towards Wellness

Medical Coverage

Medical Provider: Aetna

Network: Open Access (OAP)

Aetna Choice POS $2,000

Aetna EPO $4,000

Aetna Select PPO HDHP $6,500

Open Access Network (OAP)

Open Access Network (OAP)

Open Access Network (OAP)

In-Network

Out-of-Network

In-Network

Out-of-Network

In-Network

Out-of- Network

Calendar Year Deductible Individual Family

$2,000 $4,000

$4,000 $12,000

$4,000 $8,000

N/A N/A

$6,500 $13,000

N/A N/A

Out-of-Pocket Maximum Includes deductible Individual Family

$6,000 $12,000

$14,000 $42,000

$7,500 $15,000

N/A N/A

$7,500 $15,000

N/A N/A

You have a choice of three medical plans through Aetna; two PPO plans and an HDHP with HSA plan. Retail and Mail Order Pharmacy benefits are included with your coverage.

Medical

You Pay

You Pay

You Pay

Preventive Care

$0

50%¹

$0

Not covered

$0

Not covered

Telemedicine Physician Specialist

$25 copay $75 copay

50%¹

$40 copay $80 copay

Not covered

$0 after deductible

Not covered

Primary Care Physician

$25 copay

50%¹

$40 copay

Not covered

$0 after deductible

Not covered

Specialist

$75 copay

50%¹

$80 copay

Not covered

$0 after deductible

Not covered

Urgent Care

$75 copay

50%¹

$100 copay

Not covered

$0 after deductible

Not covered

Health Savings Account

Telemedicine

With the election of the HDHP/ HSA plan, you have the option of opening an HSA administered by HSA Bank. The account allows for the accumulation of tax-free funds to pay for qualified health care expenses.

24/7/365 telemedicine services through CVS MinuteClinic are part of your medical plan benefits. Virtual visits have a $0 copay on the PPO plans and a $48 copay on the HDHP/HSA plan. Use telemedicine services as a convenient way to obtain care for non-life-threatening medical issues. Doctors can diagnose and prescribe medications, if needed.

Scan to see your full benefits.


Turn static files into dynamic content formats.

Create a flipbook
2026-2027 Moderno Porcelain LLC Benefits Summary - English by Higginbotham Public Sector - Issuu