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Health Benefits
Eligibility

Full and part-time associates who work 20 or more hours per week are eligible to participate the first day of the month following 30 days of employment.

Choose between 2 options:

Aetna Low Option PPO
Comprehensive coverage with lower premiums. Annual $1,000 deductible (for hospital and out-patient services) with 20% coinsurance after deductible (non-participating providers have 40% coinsurance after deductible). Maximum annual out-of-pocket $2,000 (individual)/ $4,000 (family). Coverage for out-of-network providers requires deductible and coinsurance (40%).

Physician services:

  • Primary care providers (pediatrician, family practice, general practice or internal medicine) - $15 copayment for preventive health visit; otherwise, $30 copay for office visits at participating providers.
  • Specialists - $50 copay for participating providers.

Pharmacy:

  • Retail (30 day supply or less)
    • Generic - $15 copayment
    • Preferred Brand - $35 copayment
    • Non-Preferred - $60 copayment
  • Mail Order (90 day supply) – receive 3 month supply for the price of 2 retail copayments
    • Generic - $30 copayment
    • Preferred Brand - $70 copayment
    • Non-Preferred - $120 copayment

Diagnostic Procedures:

  • Outpatient lab and x-ray at a participating provider require a specialist copayment.
  • Non-participating providers covered at 60% after the annual deductible

Emergency Services: Covered at 100% after a $150 copayment

Hospital Services: Covered at 80% after annual deductible is met

Aetna High Option PPO

Same comprehensive coverage with higher premiums, but lower deductibles, copayments and coinsurance. Annual deductible for hospital and services and outpatient procedures is $500 with 10% coinsurance (or 30% coinsurance for non-participating providers). Maximum out of pocket limit is $1,500 (individual)/$3,000 (family).

Pharmacy benefits are the same as the Low Option PPO.

Other covered services: Mental health and substatnce abuse, Skilled Nursing, Hospice, Home Health, Chiropractic, Durable Medical Equipment.

Contact Human Resources at:
Main line: (816) 347-2127
Fax: (816) 246-9154
E-mail: jobs@jkv.org

 

 
 
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