Benefits Guide | 2026
VDHP/Traditional PPO with Ortho
Medical Plans Comparison
| Option 1: VDHP Medical Plan | Option 2: PPO Medical Plan | ||
|---|---|---|---|
| In-Network | Out-of-Network | ||
| Deductible* | |||
| Employee | $0 | $1,500 | $3,000 |
| Employee + Spouse or Child | $0 | $3,000 | $6,000 |
| Family or Employee + Children | $0 | $4,500 | $9,000 |
| Coinsurance | 0% | 80% | 30% |
| Teladoc | $0 | $0 | |
| Office Visit Copay | |||
| Copay PCP/Specialist | $30/$35 | $35/$45 | Deductible/Coinsurance |
| Preventive Care | 100% | 100% | Deductible/Coinsurance |
| Durable Medical Equipment | $100 | Deductible/Coinsurance | Deductible/Coinsurance |
| Urgent Care Copay | $40 | $50 | Deductible/Coinsurance |
| ER Copay | $250 emergency | $250 emergency, then Deductible and Coinsurance |
|
| Outpatient Services | $600 | 80% after Deductible | Deductible/Coinsurance |
| Inpatient Hospital | $1,200 | 80% after Deductible | Deductible/Coinsurance |
| Chiropractic | 80% after Deductible | 30% after Deductible | |
| Max per Visit | $20 | $20 | |
| Visit Limit | 26 visits/calendar year | 26 visits/calendar year | |
| Out-of-Pocket Max | |||
| Employee | $5,000 | $6,600 | Unlimited |
| Employee + Spouse or Child | $10,000 | $13,200 | |
| Family or Employee + Children | $10,000 | $13,200 | |
| Prescription Drug Coverage— Preferred Walgreens Retail | |||
| Annual Deductible | $75 (Brand-Name Drugs Only) | $75 (Brand-Name Drugs Only) | Use of a non-participating pharmacy requires payment for the prescription upfront. |
| Tier 1: Generic Drugs | $10 Copay | $10 Copay | |
| Tier 2: Preferred Brand-Name Drugs | 30% with a minimum of $20; max of $100 | 30% with a minimum of $20; max of $100 | |
| Tier 3: Nonpreferred Brand-Name Drugs | 40% with a minimum of $35; max of $150 | 40% with a minimum of $35; max of $150 | |
| Prescription Drug Coverage— Retail | |||
| Annual Deductible | $75 (Brand-Name Drugs Only) | $75 (Brand-Name Drugs Only) | Use of a non-participating pharmacy requires payment for the prescription upfront. |
| Tier 1: Generic Drugs | $15 Copay | $15 Copay | |
| Tier 2: Preferred Brand-Name Drugs | 30% with a minimum of $25; max of $100 | 30% with a minimum of $25; max of $100 | |
| Tier 3: Nonpreferred Brand-Name Drugs | 40% with a minimum of $40; max of $150 | 40% with a minimum of $40; max of $150 | |
| Prescription Drug Coverage—Mail | |||
| Annual Deductible | $75 (Brand-Name Drugs Only) | $75 (Brand-Name Drugs Only) | Not applicable |
| Tier 1: Generic Drugs | $25 Copay | $25 Copay | |
| Tier 2: Preferred Brand-Name Drugs | 20% with a minimum of $45; max of $200 | 20% with a minimum of $45; max of $200 | |
| Tier 3: Nonpreferred Brand-Name Drugs | 30% with a minimum of $75; max of $250 | 30% with a minimum of $75; max of $250 | |
| Specialty Prescription Drug Coverage | |||
| Annual Deductible | $500 | $500 | Not applicable |
| Tier 4: Specialty Drugs | 50% with a minimum of $150; max of $1,500 | 50% with a minimum of $150; max of $1,500 | |
*Deductibles and out-of-pocket maximums are 2 x for Employee + Spouse and Employee + Child. The limit is 3 x for Employee + Children and Family.
Contact Benefit Specialists at (800) 941-7089 for questions or assistance.
Enroll by Oct. 31 Open
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Feel free to call our Benefit Specialists to assist you with any questions or issues you have with the enrollment process.
(800) 941-7089