|
Insurance Provider
|
Çб³º¸ÇèÁ¦ÈÞ
Basic Accident and Sickness Plan
|
LIG¼ÕÇغ¸Çè |
|
Lifetime Maximum
|
$75,000 |
Unlimited |
|
Benefit
|
$75,000 |
$50,000 per Sickness or Injury |
|
Deductible |
Preferred Care:
$25 per accident/sickness
|
$0 |
|
Non-Preferred Care:
$100 per accident/sickness
|
|
Çù·Âº´¿øÀÌ¿ë½Ã/º¸Çèȸ»çºÎ´ãºñÀ²
|
Preferred Care:
100% of the Negotiated Charge up to $2,500, then 90%.
|
100% |
|
ºñÇù·Âº´¿ø/º¸Çèȸ»çºÎ´ãºñÀ²
|
Non-Preferred Care:
75% of the Negotiated Chargeup to $2,500, then 70%.
|
100% |
|
Prescription Drug
(¾à°ª°í°´ºÎ´ã±Ý)
|
Following a $10 Copay
for each Brand Name Prescription Drug or a $5 Copay for each Generic Prescription Drug. Covered Medical Expenses are payable up to a maximum of $5,000 per Policy Year.
|
º¸»óÇѵµ¿¡ Æ÷ÇÔ
°í°´ºÎ´ã ¾øÀ½ |
|
Premium
(Annual)
|
Student: $1,419
Spouse: $3,382
Child(ren): $1,801
|
Student: $492
Spouse: $492
Child: $492
|
¹Ì±¹´ëÇб³º¸Çè 
¹Ì±¹´ëÇб³º¸Çè
