- Annual Maximum Benefit of $2 million dollars
- Hospital co-payments $50 per day for all services
- $15 co-payments for Physician Visits in network for Primary Care and Specialists
- Emergency Claims In Network covered at 100% with a $50 co-payment: click here for in-network ER hospitals
- Emergency Claims Out of Network covered at 100% * U/C Usual and Customary payment with a $50.00 co-payment. (For an explanation of the U/C Usual and Customary please click here.)
- Preventative services covered at first dollar with no co-payment required, click here to view these services
- Cover annual routine eye exam. To make an eye appointment, click here.
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