Welcome to Nationwide
We are excited to offer plan options putting you in the driver's seat when choosing what benefit will fit your needs. All employees who use tobacco products, will incur an additional premium with their health insurance plan. Specifically, tobacco users will be required to pay a premium surcharge of $60.00 per month for medical coverage under the plan.
Woodgrain offers a tobacco cessation program. Contact HealthJoy (800)500-3212. Click here for your benefit guide Need help searching for a provider click here! You can find an in-network provider by visiting www.askallegiance.com. Would you like to compare the plans? click here for a comparison guide. |
CO-PAY PPO
PPO is a traditional medical plan with lower deductibles and copay amounts for office visits. It has the highest monthly premiums, but in most cases it is the least expensive plan for total out of pocket costs if you or your dependents reach the out of pocket maximum. Woodgrain does not make any contributions to you in exchange for your enrollment in this plan.
PPO is a traditional medical plan with lower deductibles and copay amounts for office visits. It has the highest monthly premiums, but in most cases it is the least expensive plan for total out of pocket costs if you or your dependents reach the out of pocket maximum. Woodgrain does not make any contributions to you in exchange for your enrollment in this plan.
Calendar Year Benefits In-Network Out-of-Network
You Pay You Pay
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Deductible $1,500 / Person $5,000 / Family
$3,000 / Family $10,000 / Family
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Out-of-Pocket Maximum $3,000 / Person $10,000 / Person
$6,000 / Family $20,000 / Family
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Preventive Care Covered in Full 50% AD
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Office Visits
Primary Care $25 50% AD
Specialist $50 50% AD
Urgent Care 20% AD 50% AD
Telemedicine - HealthJoy Covered in Full Not Available
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Emergency Room 20% AD 20% AD
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Hospital Services
Minor Lab Testing & X-Ray 20% AD 50% AD
Major Diagnostic & Imaging Services 20% AD 50% AD
OP Mental Health/Substance Abuse 20% AD 50% AD
Inpatient Hospital 20% AD 50% AD
Outpatient Surgery 20% AD 50% AD
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Pharmacy Retail Mail Order
30 Day Supply 90 Day Supply
Tier 1 $10 $20
Tier 2 $25 $50
Tier 3 50% 50%
You Pay You Pay
_______________________________________________________________________________________
Deductible $1,500 / Person $5,000 / Family
$3,000 / Family $10,000 / Family
_____________________________________________________________________________________
Out-of-Pocket Maximum $3,000 / Person $10,000 / Person
$6,000 / Family $20,000 / Family
_____________________________________________________________________________________
Preventive Care Covered in Full 50% AD
_____________________________________________________________________________________
Office Visits
Primary Care $25 50% AD
Specialist $50 50% AD
Urgent Care 20% AD 50% AD
Telemedicine - HealthJoy Covered in Full Not Available
_____________________________________________________________________________
Emergency Room 20% AD 20% AD
_____________________________________________________________________________
Hospital Services
Minor Lab Testing & X-Ray 20% AD 50% AD
Major Diagnostic & Imaging Services 20% AD 50% AD
OP Mental Health/Substance Abuse 20% AD 50% AD
Inpatient Hospital 20% AD 50% AD
Outpatient Surgery 20% AD 50% AD
_____________________________________________________________________________
Pharmacy Retail Mail Order
30 Day Supply 90 Day Supply
Tier 1 $10 $20
Tier 2 $25 $50
Tier 3 50% 50%
2023 Premiums Per Pay Period (24 times per year)
Status Non-Tobacco User Tobacco User
Employee Only $85.02 $115.02
Employee + Spouse $180.72 $210.72
Employee + Child(ren) $159.14 $189.14
Family $269.48 $299.48
Status Non-Tobacco User Tobacco User
Employee Only $85.02 $115.02
Employee + Spouse $180.72 $210.72
Employee + Child(ren) $159.14 $189.14
Family $269.48 $299.48
Buy Up HSA
Buy up HSA requires 20% coinsurance for your medical and pharmacy needs. Woodgrain provides contributions to your Health Savings Account, which makes this the least expensive plan on a traditional network for you if you expect to have expenses close to the deductible amount.
Buy up HSA requires 20% coinsurance for your medical and pharmacy needs. Woodgrain provides contributions to your Health Savings Account, which makes this the least expensive plan on a traditional network for you if you expect to have expenses close to the deductible amount.
Base HSA
Base HSA is the least expensive plan by premiums and is a great option if you rarely see your doctor and have inexpensive or rarely require prescriptions. This plan will limit your potential out of pocket expenses if you find yourself on an unexpected medical journey as opposed to going without coverage. Woodgrain makes the highest contributions to your Health Savings Account if you elect this plan because it has the highest deductibles and out of pocket maximums.
Base HSA is the least expensive plan by premiums and is a great option if you rarely see your doctor and have inexpensive or rarely require prescriptions. This plan will limit your potential out of pocket expenses if you find yourself on an unexpected medical journey as opposed to going without coverage. Woodgrain makes the highest contributions to your Health Savings Account if you elect this plan because it has the highest deductibles and out of pocket maximums.
VBP HSA
VBP HSA utilizes PHCS’s network, which isn’t as widely accepted as our other networks. If this plan interests you, please ensure your doctors are in-network or will bill Health Plans Inc. (HPI) for your visits. The VBP HSA may require more administrative work from you to ensure claims are filed with the insurance company and the portion on your bill matches your Explanation of Benefits. Woodgrain provides contributions to your Health Savings Account if you elect this plan. Learn more about Value Base Pricing here.
Obtenga más información sobre VBP aquí
VBP HSA utilizes PHCS’s network, which isn’t as widely accepted as our other networks. If this plan interests you, please ensure your doctors are in-network or will bill Health Plans Inc. (HPI) for your visits. The VBP HSA may require more administrative work from you to ensure claims are filed with the insurance company and the portion on your bill matches your Explanation of Benefits. Woodgrain provides contributions to your Health Savings Account if you elect this plan. Learn more about Value Base Pricing here.
Obtenga más información sobre VBP aquí
