Table 1.

Benefit structure of FFS and PPO plans by pay type

Hourly
Salaried
FFSPPOFFSPPO
DeductibleNoneNone*$300-*$600*None
CoinsuranceNoneNone20%10%
Office visit0% coverage50-70% coverage80% coverage90% coverage§
FOBT100% 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.