PERSONAL CHOICE 90/10 COINSURANCE PLAN

(Doctors, Hospitals, and Specialists)

A 90/10 Coinsurance means that the total cost of any In-Network service is shared between the Fund and the Participant at a percentage of the bill. When Participants visit providers who are in-network with Independence Administrators, the Fund pays 90% of the total Independence Administrator's allowance leaving the Participant with a coinsurance of only 10%. Participants are responsible for the coinsurance until they have met their out-of-pocket maximum (OOP)* (see graph below). Once an individual or family has reached their OOP Max, the Plan will pay 100% for all further In-Network claims for the duration of the Plan Year (May 1 through April 30).

Access your Independence Administrators personalized health care resource by visiting www.MyIBXTPAbenefits.com

Phone number for billing questions:

1-833-242-3330

*The $2,000 annual out-of-pocket maximum is a combined total between medical and mental health claims.

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HAVE ELIGIBLE OUT-OF-POCKET EXPENSES?

Submit them to your HRA for reimbursement.

MEDICAL COVERAGE FAQs