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Tutorials
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2. Submitting a Claim
3. Filling a Prescription
4. Plan Overview
5. How To Opt-Out
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If you require assistance with your claim or plan information, please contact moc.stifenebtnedutslca @ pleh or call us at 1-800-315-1108.
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Opens on
May. 1st
9:00 AM -
Opens on
May. 1st
9:00 AM -
Family
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Opens on
May. 1st
9:00 AM
Prescription Drugs |
80% co-insurance N/A |
90% co-insurance N/A |
70% co-insurance N/A |
70% co-insurance N/A |
Dental |
Maximum: $500 N/A |
Maximum: $400 N/A |
Maximum: $800 N/A |
Maximum: $500 N/A |
Extended Health |
Paramedical Practitioners: 80% N/A |
Paramedical Practitioners: 80% N/A |
Paramedical Practitioners: 80% N/A |
Paramedical Practitioners: 90% N/A |
Vision |
One eye exam covered and $100 for prescribed lenses and frames or contacts every 24 consecutive months N/A |
One eye exam covered and $80 for prescribed lenses and frames or contacts every 24 consecutive months N/A |
One eye exam covered and $80 for prescribed lenses and frames or contacts every 24 consecutive months N/A |
One eye exam covered and $150 for prescribed lenses and frames or contacts every 24 consecutive months N/A |
Current plan, no selection required | Current plan, no selection required | Current plan, no selection required | Current plan, no selection required |