CHOICES HEALTH CARE PLAN BENEFITS - MyAlcoaBenefits

Medical
PLAN OPTIONS
With Choices, you can choose from four medical
plan options or opt out of coverage. All medical plans
cover the same services, including preventive care,
and come with the same prescription drug coverage.
The differences are in the deductibles, coinsurance
amounts, and out-of-pocket maximums.
Medical Coverage
Basic Comprehensive HRA HSA
ANNUAL HRA/HSA CONTRIBUTION AMOUNT
Alcoa’s Contribution N/A N/A
$750/employee only
$1,500/two
or more people
$400/employee only*
$800/two
or more people*
Annual Employee
Contribution N/A N/A N/A
IN-NETWORK
Annual Deductible
$1,000/person
$2,000/family
$250/person
$500/family
$1,500/person
$3,000/family
Up to $2,850/person*
Up to $5,650/family*
$1,500/employee only
$2,500/two
or more people
(Medical + Drug)
Inpatient Facility
Deductible
$250 $250 $250 N/A
Coinsurance
Routine Preventive Care Alcoa pays 100%
no deductible
Alcoa pays 100%
no deductible
Alcoa pays 100%
no deductible
Alcoa pays 100%
no deductible
PCP Office Visits Alcoa pays 90%
no deductible
Alcoa pays 90%
no deductible
Alcoa pays 90%
after deductible
Alcoa pays 90%
after deductible
Specialist Office Visits
and ER Care
Alcoa pays 70%
no deductible
Alcoa pays 80%
after deductible
Alcoa pays 90%
after deductible
Alcoa pays 90%
after deductible
Other Services Alcoa pays 70%
after deductible
Alcoa pays 80%
after deductible
Alcoa pays 90%
after deductible
Alcoa pays 90%
after deductible
Annual Out-Of-Pocket
Maximum
$3,000/person
$4,500/family
$2,500/person
$3,750/family
$3,000/person
$6,000/family
$3,000/employee only
$4,500/two
or more people
(Medical + Drug)
* Per IRS, total maximum contributions are $3,250/$6,450. Individuals age 55 and older can make up to an additional $1,000
in “catch-up” contributions in 2013.
CHOICES HEALTH CARE PLAN BENEFITS 3