Medical
Medical
Chubb offers the MCS PPO Plan to help cover the cost of your medical care, prescription medications, dental and vision care.
For more information about the plan, including out-of-network benefits and your premium costs, please visit the Chubb Benefits Portal.
MCS PPO Plan
| Benefit | In-network benefits |
|---|---|
|
Office visit (generalist/specialist/subspecialist) |
$10 co-pay/$15 co-pay/$15 co-pay |
|
Alivia (alternative medicine) |
$15 |
|
Inpatient hospital stays |
$75 co-pay |
|
Ambulatory surgery |
$50 co-pay |
|
Emergency room visits |
Accident: $0, Sickness: $50 |
|
Retail prescriptions (preferred, non-preferred, bioequivalent, maintenance) |
$10 co-pay |
|
Mail-order prescriptions (up to 90-day supply) |
$20 co-pay |
|
U.S. emergency care |
Covered through Major Medical 80%/20%, services will be reimbursed based on ordinary and customary rates. |
|
Labs and X-rays |
25% coinsurance |
|
Major medical deductible (employee/family) |
$100/$300 |
|
Out-of-pocket maximum (employee/family) |
$0 |
Coverage Level & Who Can Be Covered
Employee Only
Employee + Spouse/Partner
Employee + Child(ren)
Employee + Family
You may cover the following dependents as long as you are enrolled in a plan yourself and can provide documentation to confirm eligibility:
Your spouse/partner
You or your spouse/partner’s eligible children up to age 26 (their eligibility ends the last day of the month the child turns 26).
Your disabled children of any age, if they are covered under your medical plan and disabled prior to losing eligibility. They must also be legally or financial dependent as defined by the IRS for federal tax purposes).
What Will You Pay
You share the cost of medical insurance with Chubb in Pretax payroll deductions. You will see your bi-weekly costs for each plan as you enroll on the Chubb Benefits Portal. Your paycheck premiums for the medical plan will be based on the plan you choose, the network, the dependents your coverage and the following spousal surcharge:
Spousal
If an employee covers a spouse/partner who has access to medical coverage through his/her employer, a surcharge will be applied to your medical plan premiums.
| Monthly | Biweekly | |
|---|---|---|
|
Puerto Rico |
$50 |
$23.08 |
Your spouse’s/partner’s access to coverage. If you cover a spouse/partner who has access to medical coverage through his/her employer, a surcharge of $50 per month will be applied to your medical plan premiums.
Medical (including prescription drug, dental and vision) premium rates
Questions?
Visit the MCS Website or call 1-888-758-1616