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ExclusiveCARE Plan

ExclusiveCARE Plan Overview

The ExclusiveCARE Plan is an Exclusive Provider Organization (EPO) plan. This means the ExclusiveCARE Plan will only help pay for the cost of care when you see in-network providers. This plan has the lowest deductible of the plans, but you will pay more in premiums each month than you would in the HealthSAVER Plan. You pay copays for some services, like in-network doctor’s visits. But for other services, like hospital stays, you pay a copay plus a percentage of the remaining cost (coinsurance). After you’ve reached your medical deductible, you and Nestlé share the cost for care until you’ve met your medical out-of-pocket maximum. Then, Nestlé pays 100% of your cost for medical care for the rest of the calendar year.

There is a separate deductible for prescription drugs; however, this is waived for eligible generic prescriptions. Once you meet this deductible, you and Nestlé will share the cost for your prescriptions until you’ve met your prescription out-of-pocket maximum. Then, Nestlé pays 100% of your cost for prescriptions for the rest of the calendar year.

ExclusiveCARE
In-Network Only
Nestlé HSA
Contribution


Employee Only

Family



N/A

N/A
Deductible

Employee Only

Family


$750

$750 per person up to $2,250
Out-of-pocket
Maximum


Employee Only

Family



$3,050

$3,050 per person up to $6,100
Preventive Care$0 no deductible
Primary care$40 copay
Specialists$70 copay
Outpatient Care
(Coinsurance)
20% after deductible
Hospital Stays
(Inpatient Care)
20% after $325 copay (no deductible)
Urgent Care20% after $70 copay (no deductible)
Emergency
Room
20% after $200 copay (no deductible)
Fertility Services
3 Smart Cycles per Lifetime
See Progyny Page for Details
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Preventive Care

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Fertility Benefits

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Video Visits

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Ask the Experts

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Notes About Family Coverage

Family coverage includes one or more dependents. An individual with family coverage will pay no more than $6,850 a year in in-network medical expenses.