Insurance  Provider

학교제휴보험

Aggregate Maximum

$500,000

Unlimited

Major Benefit

$500,000

$50,000 per Sickness or Injury

Out-of-Pocket Maximum

(고객부담금)

$5,000 in network

$0

$10,000 out of network

 협력병원이용시/

보험회사 보상비율

In Network : 80%

100%

                   비협력병원 /

            보험회사 보상비율

Out of  Network:50%

100%

Deductible

(고객부담금)

$200

$0

Prescription Drug

(고객부담금)

$7,500 maximum per policy year

United Healthcare Network Pharmacy

(UHPS)/ $50 deductible per policy year

$15 copay per prescription for Tier 1

$30 copay per prescription for Tier 2

$60 copay per prescription for Tier 3

up to a 31-day supply per prescription

전액보상

Premium

(Annual)

Student:$1,115

Spouse:$2,295

Per Dependent :$1,380

Student:약$480

Spouse:약$480

Child:약$480