2025–2026
NFP webinars: — invites sent separately
Mon 7/14 @ 10am
Wed 7/16 @ 4pm
OOP Max: $6,000 / $12,000
PCP / Specialist: $25 / $35 copay
Urgent Care: $50 copay
ER: $225 copay
Coinsurance: 20%
OOP Max: $6,000 / $12,000
PCP / Specialist: $20 / $30 copay
Urgent Care: $50 copay
ER: $225 copay
Coinsurance: 20%
OOP Max (in): $4,000 / $10,000
PCP / Specialist: $10 / $30 copay
ER: $225 copay
Coinsurance: 20% in / 50% out
HRA Funding: Employer covers first $1,000 of deductible (up to $1,000/$2,500)
All plans include Rx via ProAct · Retail 30-day: $0 / $25 / $60 · Mail order 90-day: 2× retail · Rx deductible: $50/$100 · Preventive care: $0. EPO plans cover in-network only — out-of-network claims are not paid except in a life/limb emergency. Medical rates include vision coverage costs.
| Coverage Level | Semi-Monthly Rate | Rate w/ Spousal Surcharge |
|---|---|---|
| EPO Low Plan (includes Vision) | ||
| Employee Only | $100.00 | $150.00 |
| Employee + Spouse / DP | $319.00 | $394.00 |
| Employee + Child(ren) | $277.50 | $327.50 |
| Family | $459.00 | $559.00 |
| EPO Medium Plan (includes Vision) | ||
| Employee Only | $130.00 | $180.00 |
| Employee + Spouse / DP | $370.00 | $445.00 |
| Employee + Child(ren) | $315.00 | $365.00 |
| Family | $525.00 | $625.00 |
| PPO High Plan (includes Vision) | ||
| Employee Only | $255.00 | $305.00 |
| Employee + Spouse / DP | $520.00 | $595.00 |
| Employee + Child(ren) | $487.50 | $537.50 |
| Family | $860.00 | $960.00 |
| Dental — The Standard (no spousal surcharge) | ||
| Employee Only | $15.00 | No surcharge |
| Employee + Spouse / DP | $27.50 | No surcharge |
| Employee + Child(ren) | $32.00 | No surcharge |
| Family | $45.00 | No surcharge |
All contributions are pre-tax. The spousal surcharge ($100/month = $50 semi-monthly) applies when your spouse has access to employer-sponsored coverage elsewhere. Submit the Spousal Surcharge Affidavit to HR to waive it.
Option 2 — Quit program: Complete WellRight "No Butts" + "Tobacco Cessation University" or "Health Coach" challenge within 3 months.
New participants: 60 days / by Oct 1.
Basic (fillings): Ded, then 80%
Major (crowns): Ded, then 50%
Annual max: $1,500 · Ded: $50/$150
Max Rollover: Unused balance rolls over (up to $1,000).
Lenses: $10 copay (every 12 mo)
Frames: $150 allowance + 20% off
Contacts: $150 allowance
Included free with any medical election. Network: Costco, Walmart, LensCrafters, Target Optical.
AD&D: Up to 100% additional
Accelerated death: Up to 80% if terminal
Age reductions: 35% at 65 · 50% at 70.
Begins: 8th day of injury / illness
Duration: Up to 90 days
Eligible: 1st of month after 30 days of hire
Premium varies by age. Example at 40 ($50k salary): ~$12.69/mo.
Dependent Care FSA: Up to $5,000/yr ($2,500 filing separately)
Commuter: Up to $325/mo for transit + parking separately.
Eligible 1st of month after 30 days. Cash paid directly to you. All policies fully portable.
Your elections are locked in for the full plan year unless you experience a Qualifying Life Event (QLE). Contact HR within 30 days of the event to make a change.
#PASTE-URL-HERE in the HTML with that URL. Each file will open in a new tab.
Plan Guides
Required Forms — Submit to HR
Genomic Life Program
Questions? Email hrofficebenefits@alliance.us or call NFP Client Advocate Nancy Reis at 914-712-6260 x22196.