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Employee Benefits Renewal Analysis <br />Renewal Date: 3/1/2026 <br />Medical <br />CURRENT <br />UnitedHealthcare <br />UHC DUBL-M / Rx E27 UHC DU4Y-M / Rx E27 <br />NEGOTIATED RENEWAL - <br />UnitedHealthare <br />UHCEKPS M / FIX E27 UHC EKNK-M / Rx E27 <br />Provider Network <br />.11niSadHeaHhcere:Netwndc. •'•.'i; <br />_Upi(BtlHeanticgreiNetwotk <br />UnitedHeallhcareNelwork <br />UnitedHealthcareNetwork <br />Employee_ Primary Residence <br />`. •Nationwide `- <br />: Nationwide <br />Nationwide <br />Nationwide <br />Calendar Year Deductible <br />.::Enbeddede::; .5 <br />-. .Embedded, �..;; <br />_ _ _ <br />Embedded <br />_ _ _ _ _ <br />Em6ed_ded_ <br />------ --- <br />Individual Family <br />.51,000: -4zoao -' <br />$250-, '�" $500 :.`. <br />- <br />$1.000 $2,OD0 <br />----- <br />$250 5500 <br />The Plan Pays <br />- 100%, <br />-'100%": <br />100% <br />_ <br />100% <br />Calendar Year Out -of -Pocket Max <br />--Embeddedr '. <br />Etabeddedi <br />Embedded <br />Embedded_ <br />Individual j Family"-""- <br />.` '$6,850": .;; kS13,700' " '. <br />56,850_• ,r $13700'� - <br />$6.850 $13,700 <br />�__ 56,850 $13,70D <br />Physician & Emergency Care <br />Preventive Care <br />Covered 100%. <br />'.CoVereB100% '' <br />Covered 100% <br />Covered 100% <br />Urgent Care <br />.530 Cop 'y-," _ �, <br />" 530,Ggpliy;` <br />$30 Copay <br />$30 Copay <br />Emergency Room (In or out of network) <br />S500Cepaj/`, ` <br />is 55l>0 GtiR@Y„ <br />$500 Copay. <br />$500 Copay <br />Hospitalization & Outpatient Care <br />_ <br />Inpatient <br />'t'DadudBNe " <br />525,OPerAdmisBieri;DaAuctible <br />Deductible <br />Per Admission Deductible <br />Outpatient <br /><f_DedJcbble":+ <br />DedUed6(e; <br />___ _ <br />Deductible <br />_$250 <br />Deductible <br />Physician Fees <br />,iDedudt$19, ' <br />r De�lUcbble. <br />Deductible <br />Deductible <br />Independent Facility Care <br />Labs <br />Cp1i'erad'I09`>G. <br />'CoveredlpQ.1•g <br />Covered 100% <br />Covered 100% <br />X-rays <br />P <br />Covered 100% <br />Covered 100% <br />Complex Diagnostic Imaging <br />4 <br />$154 eopay't., <br />-V SIR C pay <br />$150 Copay <br />$150 Copay <br />Prescription Drugs <br />Tien <br />S,7nC11aYt3.$ .>.a - <br />$7Copay.'; <br />$7Copay <br />$7Copay <br />Tier <br />COW <br />epay!i, <br />$25 Copay. <br />$25 Copay <br />Tier 3 <br />;;;SqQ CPISeY. ; , t, . - > <br />+t .t a ;.:-_'(t $40 GdRta " <br />$40 Copay <br />$40 Copay <br />Specialty (GH, Self Injectable. etc.) <br />Appl(cabreQoa$jjQr>r, , _ _ ' <br />> ri4pp{kab(e?COtlC,ShafE <br />Applicable Coat Share <br />_ <br />Applicable Cost Share <br />Retail Mail Order- 90 day supply <br />;�;: ,,. , 25Xfail".,: r, ,5 ,�, <br />'. _ , ,, 2:6Xratall Copay;p„�„?, <br />2.5x retail copay <br />2.5x retail Copay <br />a <br />Deductible Individual I Family <br />`1' ;` i t �. kt , <br />3$YODpi, .`<a..:'$2g00' <br />$1,000 S2,000 <br />The Plan Pays <br />N/A <br />60%/40% <br />Out of Pocket Max <br />: <br />$13.7P0._ rt,.-:S2i,400, '' <br />$13.700 $27,400 <br />Balance Billing <br />a,.. , <br />Yea . <br />Yes <br />n <br />Employee <br />'- 105% ", -:'; <br />100%'"" <br />- 105% - <br />100% <br />Employee + Spouse <br />-. 8D% <br />76%' - <br />80% <br />76 % <br />Employee + Child(ran) <br />Employee + Family <br />82%; <br />79% <br />82%_ <br />73% 70% <br />_ <br />73 % <br />70% <br />Brown & Brown Insurance, Inc. <br />748 <br />