Medical Coverage – Medica
The Company’s medical plan is offered through Medica. Medica offers you a range of plan options and a support tool to help you determine the plan that best fits your needs and budget. Visit http://welcometomedica.com/kgpco
With the Traditional Plans, you pay more premium upfront and less out of your pocket when you seek care than on the Health Savings Account eligible plans. All plans offer 100% coverage for preventive care services.
How to find a Medica Provider
- Go to mymedica.com
- click on “Find a Doctor”
Medical Premium - Tobacco Surcharge
In order to help control rising medical costs, The Company requires employees and spouses enrolled in the medical plan to complete a Tobacco Use Affidavit each year. The Company will apply a per pay period Tobacco Surcharge to those who identify themselves as a tobacco user, as defined in the affidavit.
- Employees whose annual compensation is up to $45,000 will be charged a $25 per pay period Tobacco Surcharge.
- Employees whose annual compensation equals or is over $45,000 will be charged a $35 per pay period Tobacco Surcharge.
Medical Plan Details
Traditional Medical Plans – In-Network Benefits
Medica | Option A: $500 - $20 | Option B: $3,000 - $30 |
---|---|---|
Deductible | $500 Single $1,500 Family | $3,000 Single $9,000 Family |
Out-of-Pocket Maximum | $5,500 Single $11,000 Family | $6,500 Single $13,000 Family |
Preventive Care | 100% covered, no deductible | 100% covered, no deductible |
Office Visit | $20 copay | $30 copay |
Convenience Care | $15 copay | $15 copay |
Member Coinsurance | 20%, after deductible | 20%, after deductible |
Cost Per 24 Pay Periods | ||
Single | $136.89 | $86.89 |
Employee + Spouse | $411.56 | $306.54 |
Employee + Child(ren) | $359.38 | $249.32 |
Family | $575.70 | $410.69 |
Total Monthly Medical Premium | Option A: $500 - $20 | Option B: $3,000 - $30 | |||||
---|---|---|---|---|---|---|---|
EE Cost | Company Cost | Total Cost | EE Cost | Company Cost | Total Cost | ||
Single | $273.78 | $440.51 | $714.29 | $173.78 | $440.51 | $614.29 | |
Employee + Spouse | $823.13 | $667.29 | $1,500.42 | $613.07 | $667.29 | $1,290.36 | |
Employee + Child(ren) | $718.76 | $853.49 | $1,572.25 | $498.65 | $853.49 | $1,352.14 | |
Family | $1,151.41 | $1,205.90 | $2,357.31 | $821.38 | $1,205.90 | $2,027.28 |
HSA Medical Plans – In-Network Benefits
Medica | Option A: $3,200 - 20% | Option B: $5,250 - 20% |
---|---|---|
Deductible | $3,200 Single $6,400 Family | $5,250 Single $10,000 Family |
Out-of-Pocket Maximum | $6,500 Single $13,000 Family | $7,500 Single $15,000 Family |
Preventive Care | 100% covered, no deductible | 100% covered, no deductible |
Office Visit | 20%, after deductible | 20%, after deductible |
Member Coinsurance | 20%, after deductible | 20%, after deductible |
Cost Per 24 Pay Periods | ||
Single | $51.17 | $35.04 |
Employee + Spouse | $231.51 | $197.18 |
Employee + Child(ren) | $170.71 | $134.74 |
Family | $292.83 | $238.89 |
Total Monthly Medical Premium | Option A: $3,200 - 20% | Option B: $5,250 - 20% | |||||
---|---|---|---|---|---|---|---|
EE Cost | Company Cost | Total Cost | EE Cost | Company Cost | Total Cost | ||
Single | $102.34 | $440.51 | $542.85 | $70.08 | $440.51 | $510.59 | |
Employee + Spouse | $463.02 | $677.29 | $1,140.31 | $394.36 | $677.29 | $1,071.65 | |
Employee + Child(ren) | $341.42 | $853.49 | $1,194.91 | $269.47 | $853.49 | $1,122.96 | |
Family | $585.66 | $1,205.90 | $1,791.56 | $477.78 | $1,205.90 | $1,683.68 |
Prescription Drug Coverage – Medica
Prescription drug coverage is also administered by Medica through Express Scripts. Through The Company’s medical plan you also receive coverage for prescription drugs. Prescriptions can be purchased from retail pharmacies or by mail order.
Traditional Medical Plans | Option A: $500 - $20 | Option B: $3,000 - $30 |
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Retail Pharmacy Prescription Drug Coverage (31-day supply) | ||
Preventive (non-Specialty) | 100%, no copay | 100%, no copay |
Generic | $10 copay, no deductible | $12 copay, no deductible |
Preferred Brand | $50 copay, no deductible | $50 copay, no deductible |
Non-Preferred Brand | $90 copay, no deductible | $90 copay, no deductible |
Preferred Specialty | 20% to $200, no deductible | 20% to $200, no deductible |
Non-Preferred Specialty | 40%, no deductible | 40%, no deductible |
93-day Mail Order (non-Specialty) | 2 copays | 2 copays |
HSA Medical Plans | Option A: $3,200 - 20% | Option B: $5,250 - 20% |
---|---|---|
Retail Pharmacy Prescription Drug Coverage (31-day supply) | ||
Preventive (non-Specialty) | 100% covered, no deductible | 100% covered, no deductible |
Generic | 20%, after deductible | 20%, after deductible |
Preferred Brand | 20%, after deductible | 20%, after deductible |
Non-Preferred Brand | 40%, after deductible | 40% after deductible |
Preferred Specialty | 20% to $200, after deductible | 20% to $200, after deductible |
Non-Preferred Specialty | 40%, after deductible | 40%, after deductible |
Medica Drug Listings:
Call Member Services: 952-945-8000