City of Eagle Pass Health Coverage Year 2023 – 2024
| Coverage | Total Rate | City Rate | Employee Rate (semi-monthly) |
| EE | $ 604.00 | $604.00 | $ 0 |
| EE+Spouse | $1,321.98 | $604.00 | $150.00 |
| EE+Child (1-2) | $ 904.00 | $699.64 | $150.00 |
| +Per additional child $ 80.00 | $ 0 | $ 40.00 | |
| EE+Family (2-3) $1,621.98 | $604.00 | $508.99 | |
|
Plan Features |
OA EPO (Elect Choice)
Flexed EPO $1000 80% |
|
| In | Out | |
| Coinsurance | 80% | N/A |
| Deductible Ind/Fam | $1,000 / $2,000 | N/A |
| Member Payment Limit Ind / Fam | $7,350 / $14,700 | N/A |
| Office Visit Copay / Specialist Copay |
$20 / $40 |
N/A |
| Hospital Inpatient | 80% | N/A |
| Hospital Outpatient | 80% | N/A |
| Emergency Room / Urgent Care | 80% after $500/
$60 |
N/A |
| Lab | 80% | N/A |
| X-Ray | 80% | N/A |
| Complex Imaging | 80% | N/A |
| Rx Deductible Ind/Fam | $0 / $0 | |
| Rx Drug G/F/B | $10/$35/$70 | |
| Rx Mail Order Delivery | $25/$87.50/$175 | |
| Rx Specialty | $150 / $300 | |
| *Rx Formulary | Aetna Value Plus Open | |
| Rx Retail Network | Aetna National Network | |
