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Utah State University ̱бUtah State 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.

 

 

  Utah State University б .

 

 

 

Insurance  Provider

б޺

DBغ

 

 

Life Maximum

 

 

$50,000

Unlimited

 

 

Major Benefit

 

 

$50,000

$50,000 per Sickness or Injury

Copayment

 

 

ȸ翡 ϴº

 

 

In Network: 80%

 

 

100%

 

 

Out of Network: 60%

 

 

 

Deductible

 

δ

$250 per policy year

No deductible

 

Out-of-Pocket Maximum

 

Ⱓδ

 

 

 

In Network: $6,000

 

 

δ

 

 

Out of Network: $8,000

 

 

 

Prescription Drugs

 

పδ

 

Medco Drug Card co-pay

 

$15 / $30

 

per 31 day supply

 

$1,000  per Policy year

 

ѵ

 

δ

 

Premium

(Annual)

 

 

Student:$1,177

Spouse:$2,911

Child:$1197

 

 

Student:$480

Spouse:$480

Child:$480

 



 

 

 

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