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Provider Page

PAJCO

Tier 1 – Any Location

Provider Information

www.sehealth.org

www.missouridelta.com

bjccenterofexcellence.org/providers

stegenevievehospital.org/FindADoc/

semohealthnetwork.org

Tier 1 – Kentucky

For Kentucky Employees ONLY

firsthealthcomplementary.com

https://www.baptisthealth.com

Tier 1 – Illinois

For Illinois Employees ONLY

heartlandregional.com

Bronze

Deductibles

$3,000

Employee

$6,000

Family

Max Out of Pocket

$4,000

Employee

$8,000

Family

Silver

Deductibles

$2,000

Employee

$4,000

Family

Max Out of Pocket

$3,000

Employee

$6,000

Family

Gold

Deductibles

$1,000

Employee

$2,000

Family

Max Out of Pocket

$2,000

Employee

$4,000

Family

Tier 2

Provider Information

https://www.multiplan.us**

Bronze

Deductibles

$9,000

Employee

$18,000

Family

Max Out of Pocket

$12,000

Employee

$24,000

Family

Silver

Deductibles

$6,000

Employee

$12,000

Family

Max Out of Pocket

$9,000

Employee

$18,000

Family

Gold

Deductibles

$3,000

Employee

$6,000

Family

Max Out of Pocket

$6,000

Employee

$12,000

Family

** PHCS/Multiplan may include providers in their listings that could be in Tier 1 and may include out-of-network providers for your group or out-of-network for your plan. When selecting a provider from the multi-plan search, please refer to your summary of benefits to verify the tier for the provider chosen to avoid out-of-network charges.

Non-Network

Provider Information

Bronze, Silver, & Gold

Deductibles

NOT COVERED

Employee

NOT COVERED

Family

Max Out of Pocket

UNLIMITED

Employee

UNLIMITED

Family

Other Services

Provider Information

TPA (third-party
administrator)

https://consociate.veriben.net

Pre-Certification Services

Precedence

800-361-1492

Telehealth
Services

https://wmthealth.com/
consociate

Pharmacy
Networks

empirxhealth.com

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