Medical Benefits

MTC Holding Corporation pays 100% of the premium for employee only and employee + child(ren) coverage. Costs are deducted on a semi-monthly basis. To find a doctor in the Preferred Care Blue Network, please visit www.bluekc.com. Plan documents can be found below.

Click the button below to watch a video to learn more about your medical benefits.

Medical Benefits

	In-Network	Out-of-Network
Deductible (Individual/Family)	$750/$1,500	$1,500/$3,000
Out-of-Pocket Max (Individual/Family)	$3,500/$7,000	$10,500/$21,000
Member Coinsurance	10%	30%
Primary Care Visit	$25 Copay	Deductible + 30%
Specialist Visit	$50 Copay	Deductible + 30%
Preventive Care	Covered at 100%	Deductible + 30%
Urgent Care	$50 Copay	Deductible + 30%
Inpatient Surgery	Deductible + 10%	Deductible + 30%
Outpatient Surgery	Deductible + 10%	Deductible + 30%
Emergency Room	$300 Copay + Deductible + 10% (Copay Waived if Admitted)	$300 Copay + Deductible + 10% (Copay Waived if Admitted)

Prescription Drugs	In-Network	Out-of-Network
Tier 1	$20 Copay	Copay + 50%
Tier 2	$35 Copay	Copay + 50%
Tier 3	$55 Copay	Copay + 50%

Mail Order Drugs	In-Network	Out-of-Network
Tier 1	$40 Copay	Copay + 50%
Tier 2	$70 Copay	Copay + 50%
Tier 3	$110 Copay	Copay + 50%

	Employee Per Pay Period Cost	MTC Per Pay Period Cost
Employee Only	$0	$580.90
Employee + Spouse	$255	$991
Employee + Child(ren)	$0	$1,157
Employee + Family	$255	$1,567

Downloads

Summary of Benefits

Plan Summary

Wellness Benefit

How to File a Wellness Claim

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Participation in this plan allows you to open and contribute to a Health Savings Account (HSA).

Click the button below to watch a video to learn more about your medical benefits.

Medical Benefits

	In-Network	Out-of-Network
Deductible (Individual/Family)	$3,300/$6,600	$6,600/$13,200
Out-of-Pocket Max (Individual/Family)	$3,300/$6,600	$8,100/$16,200
Member Coinsurance	0%	20%
Primary Care Visit	Deductible	Deductible + 20%
Specialist Visit	Deductible	Deductible + 20%
Preventive Care	Covered at 100%	Deductible + 20%
Urgent Care	Deductible	Deductible + 20%
Inpatient Surgery	Deductible	Deductible + 20%
Outpatient Surgery	Deductible	Deductible + 20%
Emergency Room	Deductible	Deductible