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Xavier Universit ̱бXavier Universit
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.

 

 

 

 

   Xavier University Ͽϴ.

 

 

 

 

Insurance  Provider

б޺

DBغ

 

Life Maximum

 

$50,000

Unlimited

 

benefits

 

 

$50,000

 

 

$50,000 per Sickness or Injury

 

 

 

Deductible

 

δ

 

 

$25 Copay/Deductible per condition per Policy Year

 

$0

 

Preferred :

 

º̿

 

 

80% ~100% of the Negotiated Charge

100% ȸ翡

 

Non-Preferred:

 

º̿

 

 

50% of the Reasonable Charge

 

 

 

 

Prescription Drug

 

ప δ

 

౹̿:

 

100% of the Negotiated Charge following a $25 Copay for each Brand Name Prescription Drug

or a $15 Copay for each Generic Prescription Drug

 

maximum of $500 per Policy Year.

 

δ

Premium

(Annual)

 

Student:$1,026

Spouse:$1,516

Child:$1,493

 

 

Student:$480

Spouse:$480

Child:$480

 



 

 

 

 

 

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