Table 1.

Benefit structure of FFS and PPO plans by pay type

Hourly
Salaried
FFSPPOFFSPPO
DeductibleNoneNone*$300-*$600*None
CoinsuranceNoneNone†20%10%
Office visit0% coverage50-70% coverage‡80% coverage90% coverage§
FOBT∥100% coverage100% coverage100% coverage100% coverage
Sigmoidoscopy0% coverage0% coverage0% coverage0% coverage
Colonoscopy0% coverage0% coverage0% coverage0% coverage
DCBE0% coverage0% coverage0% coverage0% coverage

  • ↵* *$300 for individual coverage and *$600 for family coverage.

  • ↵† 80% coverage if enrollee goes out of approved network unless referred by network physician.

  • ↵‡ Plan-specific.

  • ↵§ 70% coverage if out-of-network physicians used; enrollee pays the balance.

  • ↵∥ Deductible and coinsurance provisions waived.

  • ↵ From 1995 through 1999, 100% covered if ordered for diagnostic purposes.