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April 8, 2003 <br /> <br />EMPLOYEE HEALTH CARE PROPOSAL <br /> <br />12-Month Contribution Schedule Effective July 1, 2003 <br /> <br /> Current Employer Contribution Current Employee/Retiree Contribution Proposed Employer Proposed Employee/Retiree <br /> Carilion Health Plan Carilion Health Plan Contribution Contribution <br /> Southern Health Southern Health <br /> <br /> HMO Point of Service HMO Point of Preferred Provider Preferred Provider <br /> Service Network Network <br /> Tiers Employee Retiree Employee Retiree Employee Retiree Employee Retiree Employee Retiree Employee Retiree <br /> <br />Employee 212 195 212 195 0 17 24 41 212 195 0 17 <br />Only <br />Employee + 212 195 212 195 210 227 225 242 212 195 233.20 250.20 <br />One <br />Employee + 212 195 212 195 422 439 497 514 212 195 487.39 504.39 <br />Family <br /> <br />Preferred Provider Organization (PPO) <br />$15 Co-pay for Primary Care Physician <br />$25 Co-pay for Specialist <br />Pays at 80 % after $1500 in-network, $1500 out-of-network deductible <br />Three Tier Prescription Drug Card - After $150 up-front deductible, co-pay of $10 generic, $30 formulary brand, or $55 non-formulary <br /> <br /> <br />