PLAN FEATURES BEK HSA* MEDICAL PLAN BEK PPO MEDICAL PLAN Tax-free Company Contribution The Company contribution will be deposited into your account on the first of the month after you enroll. $1,000 individual/$2,000 family The amount you receive will be prorated, based on the number of months you are enrolled in the HSA. Unused dollars roll over for future use. None Make your own pre-tax contributions Up to $3,500 individual/$7,000 family; unused dollars roll over for future use None FOR IN-NETWORK CARE—YOU PAY: Preventive care $0—plan pays 100% Deductible $2,700 individual/$5,400 family $1,000 individual/$3,000 family Coinsurance 30% Out-of-pocket maximum $6,450 individual/$12,900 family $3,000 individual/$6,000 family Doctor office visits Deductible & 30% coinsurance until you reach your out-of-pocket maximum except $49 for virtual doctor visits •  $35 for primary care visit •  $50 for specialist visit •  $20 for virtual doctor visit Non-maintenance prescription drugs 30% coinsurance after you meet your annual deductible; use $ in your HSA or pay out of your own pocket $75 annual calendar year deductible per person • $15 generic •  $35 preferred brand-name • $75 non-preferred brand- name Maintenance Prescription Drugs 90-day supply 30% coinsurance after you meet your annual deductible; use $ in your HSA or pay out of your own pocket • $30 generic • $70 preferred brand-name • $150 non-preferred brand- name *  The IRS only allows HSA enrollment if you are not: 1) eligible for other medical coverage (like through your spouse); 2) claimed on someone else’s tax return or 3) enrolled in Medicare. Aren’t eligible to enroll in an HSA? Choose the BEK PPO Medical Plan. A look at our medical plans UnitedHealthcare (UHC)—myuhc.com or 844-587-8503 If you want health care in 2019, you can choose the BEK HSA Medical Plan or the BEK PPO Medical Plan. Both plans include: In-network preventive care + + + Coverage for children up to age 26 Rx coverage 30% coinsurance for in-network care MEDICAL ID CARD You will receive a medical ID card within two weeks of your eligibility date.