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Georgia Institute of Technology ̱бGeorgia Institute of Technology
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.

 

 

 

    Georgia Institute of Technology DBغ Ͽϴ.

 

 

 

Insurance  Provider

б޺

DBغ

 

 

Life Maximum

 

 

$1,000,000

Unlimited

benefits

 

Per Student: $300,000

 

 Per Dependent:

$50,000

 

 

$50,000 per Sickness or Injury

 

 

Deductible

 

δ

 

IN NETWORK:

 

student:$250 Family:$750

 

 

$0

 

OUT OF NETWORK:

 

student:$300 Family:$900

 

 

IN NETWORK

 

º̿

 

80%

100% ȸ翡

 

 

OUT OF NETWORK:

 

º̿

 

60%

100% ȸ翡

Maximum Out-of-Pocket

 

Ⱓδ

 

IN NETWORK:

 

student:  $10,000

 

Family:  $30,000

 

δ

 

OUT OF NETWORK:

 

student:  $15,000

 

Family:  $45,000

 

 

 

 

 

Prescription Drug

 

ప δ

౹̿:

 

100%after $15 generic copayment / $30 brand name copay per 30-day supply permonth.

Up to $1,500 maximum

per Policy Year.

δ

Premium

(Annual)

 

 

Student:$1,167

Spouse:$3,535

Child:$2,104

 

 

 

Student:$480

Spouse:$480

Child:$480



 

 

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