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<br />e <br /> <br />e <br /> <br />. . <br /> <br />"Exhibit A" <br /> <br />HEALTH SERVICES PLAN DESIGN <br /> <br /> CURRENT PROPOSED FOR 2003 <br />MAXIMUM LIfETIME BENEfIT $1,000,000.00 $1,000,000.00 <br />CO-PAY <br />All doctors $15.00 $25.00 <br />DEDUCTIBLE <br />Individual: <br />In Network $200.00 $300.00 <br />Non-Network $400.00 $600.00 <br />Family (3 or more): <br />In Network $600.00 $900.00 <br />Non-Network $1,200.00 $1,800,00 <br />COINSURANCE <br />In Network 90% /10% 80% / 20% <br />Non-Network 70% / 30% 50% / 50% <br />OUT-Of-POCKET MAXIMUM (employee portion) <br />Individual: <br />In Network $1,000.00 $1,500.00 <br />Non-Network No maximum No maximum <br /> <br />Family: <br />In Network <br />Non-Network <br /> <br />$2,500.00 <br />No maximum <br /> <br />$3,000.00 <br />No maximum <br /> <br />PRESCRIPTIONS (Rx) <br />Deductible <br /> <br />$50.00 <br /> <br />$50.00 <br /> <br />Retail (employee portion): <br />Generic <br />Preferred (Formulary) <br />Non-Formulary + Others <br /> <br />10.00 <br />20.00 or 20%* <br />30.00 or 20%* <br /> <br />10.00 <br />25.00 or 20%* <br />40.00 or 20%* <br /> <br />Mail (employee portion): <br />Generic <br />Preferred (Formulary) <br />Non-Formulary + Others <br /> <br />20.00 <br />40.00 or 20%* <br />60.00 or 20%* <br /> <br />20.00 <br />50.00 or 20%* <br />80.00 or 20%* <br /> <br />· Whichever is the greater amount <br />