NCBA Component 2: Sedera Health - Medical Cost Sharing

Initial Unsharable Amount Options
$500, $1,000, $1500, $2500, $5000
Needs over IUA Fully Sharable by Community
Fully Shared by Community
Limiting Out-of-Pocket Costs
Three (3) for Individual and five (5) where there are family members participating
Pre-existing Condition Limitation:
Year 1: No Sharing for that specific condition
Pre-existing Condition Limitation
Year 2: $15,000 Sharing for that specific condition
Pre-existing Condition Limitation
Year 3: $30,000 Sharing for that specific condition
Pre-existing Condition Limitation
Year 4 : Fully Sharable
Telemedicine - Teladoc
Included

 

 

SEDERA ACCESS Tier 1 Pricing When Paired with Apex HDHP/Basic MEC

Association / Membership Solutions

Tobacco Use (There will be a $75.00 Surcharge for Tobacco use)

500 IUA

500 IUA AGE 18-29 AGE 30-39 AGE 40-49 AGE 50-59 AGE 60-64
Member Only 191.84 219.39 245.92 300.00 542.85
Member+Spouse 364.28 418.36 472.45 580.31 1,066.32
Member+Child(ren) 352.02 403.06 454.08 557.14 1,018.36
Member+Family 528.57 607.14 685.71 841.83 1,546.93

 

1,000 IUA

1,000 IUA  AGE 18-29 AGE 30-39 AGE 40-49 AGE 50-59 AGE 60-64
Member Only 183.67 210.20 219.39 264.28 480.61
Member+Spouse 345.92 400.00 418.36 508.16 939.79
Member+Child(ren) 344.69 385.71 403.06 488.77 898.97
Member+Family 503.06 580.61 607.14 737.75 1,364.27

 

1,500 IUA

1,500 IUA    AGE 18-29 AGE 30-39 AGE 40-49 AGE 50-59 AGE 60-64
Member Only 165.30 191.84 201.02 245.92 453.06
Member+Spouse 310.20 364.28 382.65 472.45 886.73
Member+Child(ren) 300.00 352.04 368.36 454.08 847.95
Member+Family 450.00 528.57 555.10 685.71 1,285.70

 

2,500 IUA

2,500 IUA    AGE 18-29 AGE 30-39 AGE 40-49 AGE 50-59 AGE 60-64
Member Only 146.94 160.20 177.55 222.45 412.24
Member+Spouse 274.49 298.98 335.71 425.51 803.05
Member+Child(ren) 266.32 289.79 324.49 410.20 769.38
Member+Family 397.96 434.69 486.73 617.34 1,165.30

 

5,000 IUA

5,000 IUA    AGE 18-29 AGE 30-39 AGE 40-49 AGE 50-59 AGE 60-64
Member Only 111.22 138.77 154.08 177.55 334.69
Member+Spouse 202.04 256.12 288.77 335.71 648.97
Member+Child(ren) 197.96 248.98 279.59 324.49 621.42
Member+Family 293.88 372.45 419.38 486.73 940.81

 

 

SEDERA ACCESS Tier 3 Preferred Pricing When Paired with Apex Advantage Plan

Association / Membership Solutions

Tobacco Use (There will be a $75.00 Surcharge for Tobacco use)

500 IUA

500 IUA AGE 18-29 AGE 30-39 AGE 40-49 AGE 50-59 AGE 60-64
Member Only 167.35 189.79 212.24 258.16 462.24
Member+Spouse 318.36 364.28 409.18 500.00 908.16
Member+Child(ren) 308.16 351.02 394.89 480.61 868.36
Member+Family 465.30 530.61 596.93 728.57 1,320.40

 

1,000 IUA

1,000 IUA  AGE 18-29 AGE 30-39 AGE 40-49 AGE 50-59 AGE 60-64
Member Only 160.20 183.67 190.81 229.59 413.26
Member+Spouse 306.12 352.04 367.34 443.87 811.22
Member+Child(ren) 295.92 339.79 354.08 426.53 775.50
Member+Family 446.94 513.26 535.71 645.91 1,178.56

 

1,500 IUA

1,500 IUA    AGE 18-29 AGE 30-39 AGE 40-49 AGE 50-59 AGE 60-64
Member Only 144.90 168.37 175.51 214.28 389.79
Member+Spouse 275.51 321.43 336.73 413.26 765.30
Member+Child(ren) 267.34 310.20 325.51 397.96 732.65
Member+Family 402.04 468.36 490.81 602.04 1,1124.24

 

2,500 IUA

2,500 IUA    AGE 18-29 AGE 30-39 AGE 40-49 AGE 50-59 AGE 60-64
Member Only 129.59 140.82 156.12 193.88 355.10
Member+Spouse 244.90 226.32 296.94 373.47 694.89
Member+Child(ren) 237.75 258.16 287.75 360.20 665.30
Member+Family 358.16 388.77 433.67 549.87 1,010.20

 

5,000 IUA

5,000 IUA    AGE 18-29 AGE 30-39 AGE 40-49 AGE 50-59 AGE 60-64
Member Only

97.96

120.14 133.67 153.06 282.65
Member+Spouse 181.63 225.51 253.06 290.81 550.00
Member+Child(ren) 177.55 220.41 244.90 281.63 527.55
Member+Family 266.32 330.61 369.38 425.15 799.99