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Brown University ̱бBrown University
Ȩ л, ȯ, ýĮ, Ʈ, ⱹϽô ݰ е ϽǼ ִ Դϴ.
Ͻø û ۼ ֽðų ̸ ֽø ˴ϴ.
ǽð Ͻø MSN ȭ ߰ ֽø ܱ ô Ǹ ϽǼ ֽϴ.

 

  

 

 

 

  Brown University DBغ ǥԴϴ

 

 

 

 

 

Insurance  Provider

 

б

DBغ

 

 

Lifetime MaximumBenefit

 

 

$500,000

Unlimited

 

 

Benefit

 

 

  $500,000 

 

$100,000 per Sickness or Injury

 

Deductible

 

   $200 per Policy Year

$0

 

 

º̿/ȸδ

 

 

PREFERRED

PROVIDERS:   100%

100%

 

 

º/ȸδ

 

 

OUT OF NETWORK

PROVIDERS:   70%

100%

 

 

Out-of-Pocket Maximum

(per Policy Year)

 

δ

 

 

 $5,000 per insured

 

δݾ

Ambulance Service

 

÷

 

 

PREFERRED

PROVIDERS: 80%

 

 

OUT OF NETWORK

PROVIDERS: 70%

 

100%

 

 

 

Prescription Drug

 

(పδ)

 

 

$10 Co-pay ~ $40 Co-pay

 

/30ϰ

 

$2,500 per Policy Year maximum

δ 100%

Premium

(Annual)

 

Student: $2,348

Spouse:$1,971

     Child:$1,971

 

Student: $480

     Spouse:$480

  Child:$480



 

 

 

 

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