Standard Plan (80/20 PPO)

The Standard Plan offers a combination of copayments (a set dollar amount) and coinsurance (a percentage of the service cost). Your out-of-pocket expenses are kept low by choosing in-network providers; however, you have the flexibility to choose out-of-network care for a higher cost.

The City pays 100% of the cost of the employee premium and subsidizes a portion of dependent care premiums.

Plan highlights include (for in-network providers):

  • No deductible.

  • $25 copay for primary care visits/$50 copay for specialists

  • 20% coinsurance for diagnostic tests (such as x-rays and blood work) and imaging (CT/PET scans, MRIs, etc.)

  • 20% coinsurance for outpatient surgery

  • $50 copay per day for in-patient hospital stays

  • If you choose out-of-network care, your cost will be 40% coinsurance for most services.

Out-of-Pocket Maximums:
These are the limits for the most you will pay during a coverage period (usually one year) for your share of the costs of covered services. If you reach this limit in a plan year, any remaining service costs will be covered 100% by the plan (not including premiums).

  • $2,000 individual / $4,000 family for in-network care;

  • $4,000 individual / $8,000 family for out-of-network care .

  • Prescription Expenses: $1,000 individual / $3,000 for family.

Plan Rates for Full-Time Employees

Employee Only

Annual employee cost: $0

Plan value: $6,784.07

$0/paycheck

Employee + Spouse

Annual employee cost: $4,176

Plan value: $14,246.72

$174/paycheck

Employee + Child(ren)

Annual employee cost: $3,432

Plan value: $12,889.79

$143.00/paycheck

Family

Annual employee cost: $5,700

Plan value: $20,352.32

$237.50/paycheck

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See rates for Part-Time Employees

City of Urbana | 400 S. Vine St., Urbana, IL. 61801 | 217/384-2459

The City of Urbana Welcomes Diversity! 
We foster an environment that values and encourages mutual respect, inclusion of all people, and utilizing differences and similarities as an organizational asset. EOE.