Medical Benefits

Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family.

Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit phpkc.com.
Step 1: Choose Network “Freedom Select Network”
Step 2: Input Search Criteria

	In-Network	Out-of-Network
Shared Coinsurance	20%	Not Covered
Deductible (Individual/Family)	$2,500/$5,000	Not Covered
Out-of-Pocket Max (Individual/Family)	$5,000/$10,000	Not Covered
Primary Care	$60 Copay	Not Covered
Routine Preventive	$0	Not Covered
Visits through One Medical	FREE	FREE
Specialist	$60 Copay	Not Covered
Inpatient Hospitalization	Deductible + 20%	Not Covered
Physician Services	Deductible + 20%	Not Covered
Outpatient Surgery	Deductible + 20%	Not Covered
Outpatient Diagnostics	Deductible + 20%	Not Covered
Urgent Care Visit	Deductible + 20%	Not Covered
Urgent Care at One Medical	FREE	FREE
Emergency Room Visit	Deductible + 20%	Not Covered
Prescription Drugs
Retail	$10/$35/$60/25% to $250	Not Covered
Mail Order	$20/$70/$120	Not Covered

Rate Per Pay Period	Value Plan-Non-Tobacco Rates	Value Plan-Tobacco Rates
Employee Only	$92.64	$105.14
Employee + Spouse	$325.33	$337.83
Employee + Child(ren)	$159.58	$172.08
Employee + Family	$436.90	$449.40

Downloads

Summary of Benefits

Auxiant Flyer

Health Joy Member Flyer

Pareto Health Flyer

MyZelis Quick Reference Guide

	In-Network	Out-of-Network
Shared Coinsurance	10%	30%
Deductible (Individual/Family)	$3,300/$6,600	$6,000/$12,000
Out-of-Pocket Max (Individual/Family)	$5,000/$10,000	$10,000/$20,000
Primary Care	Deductible + 10%	Deductible + 30%
Routine Preventive	$0	Not Covered
Visits through One Medical	$40	$40
Specialist	Deductible + 10%	Deductible + 30%
Inpatient Hospitalization	Deductible + 10%	Deductible + 30%
Physician Services	Deductible + 10%	Deductible + 30%
Outpatient Surgery	Deductible + 10%	Deductible + 30%
Outpatient Diagnostics	Deductible + 10%	Deductible + 30%
Urgent Care Visit	Deductible + 10%	Deductible + 30%
Urgent Care at One Medical	$40	$40
Emergency Room Visit	Deductible + 10%	Deductible + 10%
Prescription Drugs
Retail	$10/$35/$60/25% to $250	$10/$35/$60/25% to $250
Mail Order	$20/$70/$120	$20/$70/$120