How does the reduction in the medical out-of-pocket maximum benefit me?
The out-of-pocket maximum, a provision in all SU medical plans, provides a cap on certain medical expenses such as co-payments, deductibles, and coinsurances. The reduction in this out-of-pocket maximum, part of both Group 1 and Group 2 assistance, will provide extra protection for those employees who have high medical expenses during the year. For example, the out-of-pocket maximum for SUBlue Level 1 claims is normally $2,000 for an individual. SUMAP-assisted employees’ SUBlue Level 1 claim out-of-pocket maximum is $500. • Are there expenses that are not counted toward the medical out-of-pocket maximum? Yes. Employee contributions, prescription drug coinsurances and co-payments, and the difference between the submitted charges and the allowable amounts for out-of-network medical providers are some of the expenses that do not count toward the medical out-of-pocket maximum. • Does SUMAP offer assistance with other benefits such as dental and vision? No. SUMAP is limited to the SU medica
