Overview
Medical Plan Overview
The following table provides an overview of the medical plan offered by ARAG. ARAG’s plan continues to exceed market standards and we pay most of the medical premiums for team members. Please refer to the Summary of Benefits and Coverage for complete details.
| ARAG Medical Plan | ||
|---|---|---|
| Plan Design | In-Network Coverage | Out-of-Network Coverage |
| Calendar Year Deductible | $750 Individual / $1,500 Family | $750 Individual / $1,500 Family |
| Calendar Year Out-of-Pocket Maximum (OOP) | $3,000 Individual / $6,000 Family | $3,000 Individual / $6,000 Family |
| Annual Coinsurance | 20% after deductible; up to the out-of-pocket maximum | 30% after deductible; up to the out-of-pocket maximum |
| Preventive Care (routine exam, cancer screenings, well-child care) | 100% coverage | 30% after deductible |
| Physician Office Visit - Visits for Illness or Injury - Chiropractic Care | 20% coinsurance; deductible does not apply | 30% after deductible |
| X-Ray & Lab Services | 20% coinsurance; deductible does not apply | 30% after deductible |
| Emergency Room Visit | 20% after deductible | 30% after deductible |
| Inpatient Hospital | 20% after deductible | 30% after deductible |
| Outpatient Hospital | 20% after deductible | 30% after deductible |
| Mental Health Services - Office Visit | 20% coinsurance; deductible does not apply | 30% after deductible |
| Prescription Drug Coverage |
||
| Retail Pharmacy Copays (30-day supply) | Tier 1 Generic - $8 Tier 2 Brand Formulary - $30 Tier 3 All other Brands - $50 Specialty Drugs - $100 | Not Applicable |
| Mail Order Copays (90-day supply) | Tier 1 Generic - $24 Tier 2 Brand Formulary - $90 Tier 3 All other Brands - $150 | Not Applicable |
Medical Plan Premiums
Medical Plan Premiums
| 2021 Team Member Cost Per Month | |
|---|---|
| Wellmark Medical Plan Premiums | |
| Employee | $97.57 |
| Employee + Spouse or Child | $221.15 |
| Family | $341.48 |
**Please Note: The premiums listed above assume participation in the annual biometric screening **
Find a Provider
Find a Medical Provider
To see if your medical provider participates in the network, visit Wellmark’s website at www.wellmark.com/finder or call the customer service number on the back of your ID card.
BeWell
BeWell
Life can get stressful sometimes – like when your toddler has a fever at midnight, or you are trying to help an elderly parent schedule a medical appointment. Luckily, there’s BeWell 24/7 – a service exclusively for Wellmark members.
It’s so much more than a nurse line. It’s real help from real people – 24/7. With BeWell 24/7, you will have access to:
- Health Advocacy—Get personalized help coordinating care, locating specialists, scheduling home-care services, transferring medical records and more.
- Nurse Support—Having side effects from a new drug? Want to better understand a diagnosis? A registered nurse can provide trusted insight and recommend next steps.
- Care Navigation—Receive information from health professionals who can help you better understand your health condition and learn more about how Wellmark can help.
Get even more answers with myWellmark. Use myWellmark to access all your health information in one place. Register at Wellmark.com.
Summary of Benefits and Coverage
HIPPA Notice
This notice describes how the medical information about you may be used and disclosed and how you can get access to this information. Please refer to the document below for more information: