Union - Shaw's Health Care Plan(s) Comparison
 
Shaw's currently offers three different medical plan options to its non-union workers: Shaw's EPO 90%, Shaw's PPO, and Shaw's EPO 80%. Outlined below is a comparison of the employee costs and level of benefits for the Local 791 UFCW National Health and Welfare Fund and the three medical plans offered by Shaw's..

Local 791 - Shaw's Healthcare Plans - Employee Weekly Co-Payment Comparison

 

UFCW National Plan

Shaw's EPO 90%

Shaw's PPO

Shaw's EPO 80%

Full Time and Exempt

 

 

 

 

Individual

$11.00

$24.71

$11.15

$5.50

Two-Person

$17.50

$50.75

$20.91

$8.50

Family

$22.00

$78.75

$32.64

$12.97

 

 

 

 

 

Part-Time
(5 or More Years)

 

 

 

 

Individual

$11.00

$24.71

$11.15

$5.50

Two-Person

$73.53

$79.38

$67.55

$40.48

Family

$126.48

$142.69

$119.22

$77.39

 

 

 

 

 

Part-Time
(3-5 Years)

 

 

 

 

Individual

$11.00

$24.71

$11.15

$5.50

Two-Person

$113.13

$122.12

$103.92

$62.28

Family

$194.58

$219.53

$183.42

$119.06

Part-Time
(Less than 3 Years)

 

 

 

 

Individual

$85.36

$81.18

$66.25

$47.32

Prescription Drugs

 Up to 30 Day Supply

 

UFCW National Plan

Shaw's EPO 90%

Shaw's PPO

Shaw's EPO 80%

Up to 30 Day Supply

Shaw/Star

Osco Pharmacy

Others in Network

Shaw/Star

Osco Pharmacy

Or Home Delivery

Others in Network

Shaw/Star

Osco Pharmacy

Or Home Delivery

Others in Network

Shaw/Star

Osco Pharmacy

Or Home Delivery

Others in Network

Generic

$5

$10

You pay 20% ($5 min - $10 max)

You pay 20% ($5 min - $15 max)

You pay 20% ($5 min)

You pay 20% ($5 min)

You pay 20% ($5 min - $9 max)

You pay 30% ($10 min $30 max)

Preferred Brand

$24

$29

You pay 20% ($10 min - $40 max)

You pay 20% ($15 min - $45 max)

You pay 20% ($10 min)

You pay 20% ($15 min)

You pay 20% ($10 min $30 max)

You pay 30% ($30 min - $90 max)

Non-Preferred Brand

$34

$39

You pay 30% ($25 min $80 max)

You pay 20% ($35 min $105 max)

You pay 30% ($25 min)

You pay 20% ($35 min)

You pay 30% ($25 min $75 max)

You pay 30% ($70 min - $210 max)

Up to 90 Day Supply

 

UFCW National Plan

Shaw's EPO 90%

Shaw's PPO

Shaw's EPO 80%

Up to 90 Day Supply

Shaw/Star Pharmacy

Others in Network

Shaw/Star

Osco Pharmacy

Or Home Delivery

Shaw/Star

Osco Pharmacy

Or Home Delivery

Shaw/Star

Osco Pharmacy

Or Home Delivery

Generic

$10

$20

You pay 20%

($15 min - $30 max)

You pay 20%

($5 min)

You pay 20%

($5 min - $9 max)

Preferred Brand

$48

$58

You pay 20%

($30 min - $120 max)

You pay 20%

($10 min)

You pay 20%

($10 min - $30 max)

Non-Preferred Brand

$102

$117

You pay 30%

($75 min - $240 max)

You pay 30%

($25 min)

You pay 30%

($25 min - $75 max)

·         In all Shaw's/Star preferred prescription drug plans, if brand name is purchased when generic is available, you pay the difference in price between the generic and brand name.

 

·        In the Shaw's/Star PPO prescription drug plan if your out-of-pocket cost for prescriptions exceeds $2500 during the plan year, your co-payment is reduced to 5% for the remainder of the plan year.

UFCW Local 791 vs. Shaw's Non-Union Healthcare Plan(s) Comparison

 

 

UFCW National Health and Welfare Fund

Shaw's EPO 90%

Shaw's PPO

Shaw's EPO 80%

 

In Network

Out of Network

In Network

Out of Network

In Network

Out of Network

In Network

Out of Network

Office Visit Co-pay

$20

 

$15

50% after deductible

$20

60% after deductible

$20

50% after deductible

Specialist

Services covered 100% in-network only after office visit co-pay: well child care, administration of injections & immunizations, routine physical exams, annual eye exams, hearing screening test, planning family services, lab tests and x-rays

$30

 

$25

50% after deductible

$30

60% after deductible

$30

50% after deductible

Deductible

$250 individual, $500 family

$800 individual, $1,600 family

$150 individual, $450 family

$150 individual, $450 family

$200 individual, $600 family

$500 individual, $1,500 family

$500 individual, $1,500 family

$500 individual, $1,500 family

Emergency Room Co-pay

90% after

$50 co-pay

Co-pay waived if admitted

 

90% after $100 co-pay

 

Co-pay waived if admitted

50% after $100 co-pay

 

Co-pay waived if admitted

80% after $100 co-pay

Co-pay waived if admitted

60% after $100 co-pay

 

Co-pay waived if admitted

80% after $100 co-pay

 

Co-pay waived if admitted

50% after $100 co-pay

 

Co-pay waived if admitted

Hospitalization:
Medical, Surgical and Maternity

Facility Charges & Maternity: 90%
Physician Service: 100%

50% after deductible

90% after deductible

50% after deductible

80% after deductible

60% after deductible

80% after deductible

50% after deductible

Outpatient Services

90%

50% after deductible

90% after deductible

50% after deductible

80% after deductible

60% after deductible

80% after deductible

50% after deductible

Diagnostic Lab Tests and X-Ray's

100% in Doctor's Office

100% in hospital after deductible

50% after deductible

90% after deductible

50% after deductible

80% after deductible

60% after deductible

80% after deductible

50% after deductible

Home Health Care

100%

50% after deductible

90% after deductible

50% after deductible

80% after deductible

60% after deductible

80% after deductible

50% after deductible

Includes skilled nursing care, home care services and prescribed private duty nursing

Ambulance

90% after deductible

90% after deductible

90% after deductible

90% after deductible

80% after deductible

80% after deductible

80% after deductible

80% after deductible

Chiropractic Care Co-pay

$30

60 consecutive days per year - per condition

70% after deductible

$25 - 15 visits per calendar year

50% after deductible

15 visits per plan

year

$30 - 15 visits per calendar year

60% after deductible -

15 visits per calendar year

$30 - 15 visits per calendar year

50% after deductible

15 visits per plan

year

Durable Medical Equipment

80%

50% after deductible

90% up to $5,000 a year

50% up to $1,500 a year

80% up to $5,000 a year

60% after deductible up to $1,500 a year

80% up to $5,000 a year

50% up to $1,500 a year

$1,500  per year max

Vision Exam Co-pay

100% after office visit co-pay

 

$20

 

$20

 

$20

 

 

Mental Health Care and Substance Abuse Care

 

 

UFCW National Health and Welfare Fund

Shaw's EPO 90%

Shaw's PPO

Shaw's EPO 80%

 

In Network

Out of Network

In Network

Out of Network

In Network

Out of Network

In Network

Out of Network

In-Patient - up to 60 days per year

90%

50% after deductible

90% after deductible

50% after deductible

80% after deductible

60% after deductible

80% after deductible

50% after deductible

Out-Patient up to 20 visits per year

100% after office visit co-pay

50% after deductible

$15

50% after deductible

$20

60% after deductible

$20

50% after deductible

Out of Pocket Maximum

$2000 individual
$4000 family

$2500 individual
$5000 family

$1,500 individual
$3,000 family

$10,000 individual
$15,000 family

$1,750 individual
$4,500 family

$4,500 individual
$9,000 family

$3,000 individual
$9,000 family

$10,000 individual
$15,000 family

Lifetime Maximum

 Combined In and Out-of-Network: $3,000,000

Combined in and out of network: $2,000,000

 

 
Shaw's/Star Welcome

 

 
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