Results for Medical

High-Performance Plan Option (for Employees in Eastern Wisconsin)

With the High-Performance Plan, you never have to worry about where to get care or what your care will cost—as long as you coordinate it through your primary care provider (PCP). You choose a primary care physician (PCP) from Centivo’s network of trusted, quality doctors and specialists. Your PCP drives your personal health care experience, including referrals to in-network specialists. You pay $0 for PCP visits—and have fewer hassles in getting the care you need at lower, more predictable costs.

Here’s what you pay in the High-Performance Plan option when you receive care.

 High-Performance Plan In-Network
(for employees in Eastern Wisconsin)
Deductible

None

Money from Rockwell Automation

N/A

The Plan Pays: Preventive Care

100% when you see your primary care physician

The Plan Pays: Doctor Office Visits

$0 primary care
(required)

The Plan Pays: Urgent Care Clinic

100% after your $50 copay

The Plan Pays: Emergency Room

100% after your $250 copay

The Plan Pays: Hospital Stay

100% after your $100 copay (no surgery)
or 100% after your $800 copay (with surgery)

Out-of-Pocket Maximum

You
$2,000

You + family
$4,000