The College offers three additional medical plans that can provide greater total coverage for active employees and their dependents. Individuals covered by another health care plan may elect either option 2, 3, 4, or 5 rather than the regular Medical Benefits. Immediately if other coverage is lost, or at your option each January 1, you may change to regular Medical Benefits with the same Single or Family coverage you had under option 2 or 3. An individual covered under option 4 may change to regular Medical Benefits at any time. An individual may not be covered under both regular Medical Benefits and option 2, 3, 4 or 5, or under the Wrap-around plan through more than one employer. Except for the Maxi Plan, you may not be covered under a different option than your dependents without approval of the Plan Sponsor. Reasonable and customary determinations apply to each option. If the contractual benefits of your other health care plan, when combined with the Wrap-around or Supplemental Plans, are ever less than total benefits that would have been received under regular Medical Benefits, the Wrap-around or Supplemental Plans will pay the difference as a No Loss benefit.
The Supplemental Plan pays 100% (no deductible) for physician office visits related to an illness or injury, routine exams and related tests, immunizations, vaccinations, and allergy injections and the co-pays not paid by your spouse’s drug plan. If you do not have a drug card through your spouse, you will continue to have the ICC drug card, but the co-pays in this case will not be reimbursed.
The Maxi Plan covers the same scope of benefits as the regular Medical Benefits. Benefits are 100%, no deductible, except that the maximum paid on an inpatient hospital bill is $1,500 per admission. In addition, the Maxi Plan pays routine exams and related tests and immunizations and vaccinations in full as well as the co-pays under the ICC drug plan. An individual may change from the Maxi Plan to the Comprehensive Medical Benefits at any time. This plan is not available to ICC retirees.
In lieu of Major Medical Benefits, an individual may elect this option which covers the same benefits as the Maxi Plan. Office calls and physician charges are paid in full except that it does not cover inpatient or outpatient hospital charges, oncology expenses, or prescription drugs. An individual may change to the Maxi II from other medical coverage in the Plan, or vice-versa, at any time.
Employees covered under Tri-Care or another employer sponsored medical plan may increase overall benefits with the MRP. The MRP turns services covered under your other health plan into a 100% benefit plan. The MRP reimburses you in full for your other plan’s deductibles, co-insurance and co-pays (except your other plan’s non-PPO hospital charges unless an exception is made by this Plan).
If routine exams or office visits are not covered at all under your other health plan under any circumstances, these services will be reimbursed by the MRP at reasonable and customary allowances.