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Data is dynamic from Plan Data - Compare one or many plans:
| Plan Tier | Acme Dental PPO | Acme Dental HMO |
|---|---|---|
| Employee Only | $163.35 | $161.09 |
| Employee and Spouse | $232.07 | $277.20 |
| Employee and Children | $289.65 | $462.24 |
| Family | $368.40 | $730.48 |
*Costs are shown on a per month basis.
Provider: Feeney-Cremin
Code: ACME-MED-SLV-2000
Description: Sample medical plan for demo purposes
| In-Network | Out of Network | |
|---|---|---|
| Individual Deductible | $1000 | $5000 |
| Family Deductible | $5000 | $4000 |
| Individual Oop Limit | $8000 | $15000 |
| Family Oop Limit | $10000 | $26000 |
| Pc Specialist | $30 Copay | 70% Coinsurance |
| Lab Xray | 30% Coinsurance | 70% Coinsurance |
| Inpatient Hospital | 30% Coinsurance | 50% Coinsurance |
| Outpatient Facility | 30% Coinsurance | 60% Coinsurance |
| Emergency Room | $300 Copay | 50% Coinsurance |
| Rx Generic | $10 Copay | $25 Copay |
| Rx Preferred | $40 Copay | $60 Copay |
| Rx Non Preferred | $60 Copay | $120 Copay |
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| Column 1 | Column 2 | Column 3 |
|---|---|---|
| Row 1 | Data A | Data B |
| Row 2 | Data C | Data D |
| Row 3 | Data E | Data F |
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