The University of Toledo : Medical Insurance<br>

Welcome

Medical Insurance

The plans cover all covered expenses for services, which are medically necessary, up to the pre-determined levels determined by the plan. A third party administrator processes and pays all claims. The highest rate of reimbursement is made when these providers are used.

Plan Type	PPO		POS		EPO
	Network	Out of Network	Network	Out of Network	Network	Out of Network
Lifetime limit on benefits	$2,000,000	$1,000,000	$2,000,000	$1,000,000	$2,000,000	No coverage
Annual per person deductible	$100	$100	$100	$100	$100	No coverage
Annual per family deductible	$300	$300	$300	$300	$300	No coverage
Annual Out-of-Pocket Limit per person	$500	$1,000	$500	$1,000	$500	No coverage
Annual Out-of-Pocket Limit per family	$1,500	$3,000	$1,500	$3,000	$1,500	No coverage

Co-insurance Plan Employee	90% 10%	70% 30%	90% 10%	70% 30%	90% 10%	No coverage
Primary Care Physician Office Visits	$10 co-pay	70%	$10 co-pay	70%	$10 co-pay	No coverage
Specialist Physician Office Visits	$20 co-pay	70%	$20 co-pay	70%	$20 co-pay	No coverage

Monthly Cost of Benefits (Medical/R_x)

Plan Option 1 - FrontPath/PPOM AAG (PPO)
2006				2007
Pay Range	Single	2-Party	Family	Pay Range	Single	2-Party	Family
< $30,900	$17.54	$35.55	$53.87	< $31,827	$18.76	$38.03	$57.65
$30,900 - $103,000	$23.30	$47.76	$72.20	$31,827- $106,090	$24.94	$51.11	$77.26
> $103,000	$42.86	$86.89	$130.88	> $106,090	$45.86	$92.98	$140.04

Plan Options 2-3 Paramount Health Care (POS) or Medical Mutual of Ohio (PPO)
	2006				2007
Pay Range	Single	2-Party	Family	Pay Range	Single	2-Party	Family
< $30,900	$8.36	$16.73	$25.08	< $31,827	$8.94	$17.91	$26.84
$30,900 - $103,000	$11.15	$22.31	$33.44	$31,827- $106,090	$11.93	$23.87	$35.78
> $103,000	$20.06	$40.16	$60.20	> $106,090	$21.47	$42.97	$64.41

Plan Options 4-5 Paramount Health Care or Medical Mutual of Ohio (EPO)
	2006				2007
Pay Range	Single	2-Party	Family	Pay Range	Single	2-Party	Family
< $30,900	$2.56	$5.10	$7.66	< $31,827	$2.74	$5.46	$8.20
$30,900 - $103,000	$3.40	$6.82	$10.22	$31,827- $106,090	$3.64	$7.29	$10.93
> $103,000	$6.13	$12.26	$18.39	> $106,090	$6.56	$13.12	$19.68

For information regarding the 2006 Network Choice program changes, please click here.

Page updated: March 14, 2008

Page top

UT Human Resources : Medical Insurance