Benefits

Maroon Plan (PPO)

The Maroon Plan is a Preferred Provider Option (PPO).  Each time you need care; you can visit any eligible licensed provider you choose.  Generally, you pay the deductible then the plan covers a percentage of the cost of your medically necessary care.  Once you reach your out-of-pocket maximum, the plan pays 100% of covered benefits for the rest of the year.  You can compare the Maroon Plan benefits to the other medical plans to determine if it will meet your medical needs.

Your cost for the plan depends on the coverage you select and your income.  Enrolling in the plan is limited to certain times or events during your employment.

Network Providers

If you visit a network provider, your care is considered “in-network,” and the plan covers a higher percentage of your costs. Your doctor submits your claims directly to the Maroon Plan claims administrator.

If you do not visit a network provider, your care is considered “out-of-network,” and the plan pays less.  You file your own claims with the Maroon Plan claims administrator.  Plus, if you are admitted to an out-of-network hospital, you must meet an additional $200 deductible before the plan pays benefits.  Amounts above the eligible or allowable charges are not covered and do not apply toward your deductible or your out-of-pocket maximum.

Wellness

In general routine preventive and wellness medical care will be covered at 100%.  Wellness benefits do not count towards your deductible or out-of-pocket maximums.

Prescription Drugs

The Maroon Plan covers prescription drugs and medicines dispensed by a licensed pharmacist or physician with a written prescription at a participating pharmacy or through the mail order program. Drugs must be approved by the U.S. Food and Drug Administration for general use by humans, including oral contraceptives. 

Participating Retail Pharmacy - For a 30-day supply

  • Generic - 100% after $8 Copayment
  • Preferred brand-name - 100% after $20 Copayment for preferred brand-name or
  • Non-Preferred brand-name - 100% after $35 Copayment

Mail Order - For 90-day supply

  • Generic - 100% after $16 Copayment
  • Preferred Brand-name - 100% after $40 Copayment
  • Non-Preferred brand-name - 100% after $70 Copayment