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add insurance processor script

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.gitignore vendored
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# Virtual environments # Virtual environments
.venv .venv
.env .env
logs/

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rag/cigna_1000_classic.txt
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PLAN: Cigna 1000 Classic
UID: Cigna 1000 Classic
Category: Major Medical
Type: PPO
Marketing Name: Cigna-1,000 Classic
Average Price: $1278.66
Short Description: The Cigna 1000 Classic PPO is a low-deductible PPO that makes routine care affordable with low copays and full preventive coverage.
Long Description: The Cigna 1000 Classic Plan keeps things simple with just a $1,000 deductible. You’ll pay only $20 to see your doctor and $40 for specialists. Preventive care is always free. It’s a great option if you like knowing what to expect with your healthcare costs.
PRICING:
Coverage 4: $1946.85
Coverage 3: $1183.21
Coverage 2: $1310.48
Coverage 1: $674.13
DETAILS:
COVERAGE:
Notes: Yes.
If your plan doesn't meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Coverage Tier: All
Emergency Room: You pay the full cost until your deductible is met, then 20% of the covered amount.
Monthly Premium: None
Lifetime Maximum: No Maximum
Professoinal Fees: You pay the full cost until your deductible is met, then 20% of the covered amount.
Referral Required: No
Urgent Care Copay: 40
Employee Contribution: TBD by Group
Employer Contribution: TBD by Group
Inpatient Hospital Stay: You pay the full cost until your deductible is met, then 20% of the covered amount.
Habilitation - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Included no cost services: 40
Prescription Drug Deductible: You just pay low copays for medications right away—no deductible needs to be met.
Habilitation - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Home heslth care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Hospice services - In Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialist Copay - In Network: 40
Emergency Medical Transporation: You pay the full cost until your deductible is met, then 20% of the covered amount.
Primary Care Copay - In Network: 20
Your Rights to Continue Coverage: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievance or appeal. For more information about your rights, look at the explaination of benefits you will receivefor that medical claim. Your plan documents also provide complete information to submit a claim, appeal, or a grievance for any reason to your plan.For more information about your rights, this notice, or assistance, contact: Acuity at 1-866-872-6356 or Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform.
Deductible (Family) - In Network: 2000
Home heslth care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Hospice services - Out of Network: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is :Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Skilled nursing care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Specialist Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Your Grievance and Appeals Rights: Yes.
If you don't have Minimum Essential Coverage for a month, you'll have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month.
Specialty Drugs - Network Provider: 50% coinsurance
Primary Care Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Chiropractic Care Copay - In Network: 20
Deductible (Family) - Out of Network: 4000
Deductible (Individual) - In Netwok: 1000
Pregnancy office visits - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Skilled nursing care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Durable medical equipment - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Chiropractic Care Copay - Out of Network: NA
Deductible (individual) - Out of Netwok: 2000
Pregnancy office visits - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialty Drugs - Out of Network Provider: Not covered
Durable medical equipment - Out of Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out of Pocket Maximum (Family) - In Network: 10000
Routine Preventive Services (Non-Diagnostic): No Member Cost Sharing - Deductible Waived
Out of Pocket Maximum (family) - Out of Network: 20000
Does this plan meet the Minimum Value Standards?: None
Out of Pockert Maximum (Individual) - In Network: 5000
Cildbirth/delivery facility services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - In Network: 80% / 20%%
Does This Plan provide Minimum Essential Coverage?: For more information about limitations and exceptions, see the plan or policy document at https://www.acuity-grp.com
Out of Pocket Maximum (Individual) - Out of Network: 10000
Blood test to help diagnose a condition - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount.
Cildbirth/delivery facility services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Free Standing Lab & Diagnostic Services (Lab & x-ray): You pay the full cost until your deductible is met, then 0% of the covered amount.
Preventative Care/Screening/Immunization - In Network: 0% Coinsurance
Childbirth/delivery professional services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - Out of Network: 60% / 40%
Blood test to help diagnose a condition - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Preventative Care/Screening/Immunization - Out of Network: Not Covered
Childbirth/delivery professional services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out Patient Services, Surgical Services (Procedure & Anesthesia): You pay the full cost until your deductible is met, then 20% of the covered amount.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Generic medication (30-day supply) from a pharmacy in your plan’s network: $15 copay
Generic medication (31-90-day supply) from a pharmacy in your plan’s network: $45 copayemnt
Inpatient mental/ behavioral health, and substance abuse services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Complex Diagnositc Services (CT, MRI, Ultra Sound, PET, Nuclear Med.) (Network): You pay the full cost until your deductible is met, then 20% of the covered amount.
Outpatient mental/ behavioral health, and substance abuse services - In Network: $20 copay
Inpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Outpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Brand-name medication that’s on your plan’s preferred list (30-day supply from an in-network pharmacy): $45 copay
Brand-name medication that’s on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $90 copayemnt
Brand-name medication that’s not on your plan’s preferred list (30-day supply) from an in-network pharmacy): $85 copay
Brand-name medication that’s not on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $150 copayemnt

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rag/cigna_1500_classic.txt
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PLAN: Cigna 1500 Classic
UID: Cigna 1500 Classic
Category: Major Medical
Type: PPO
Marketing Name: Cigna - 1,500 Plan
Average Price: $1195.99
Short Description: A well-balanced PPO plan with manageable costs, ideal for those who use healthcare a few times a year.
Long Description: The Cigna 1500 Plan strikes a nice balance between premium and out-of-pocket costs. You get predictable copays ($30 for doctors, $60 for specialists) and solid coverage after your $1,500 deductible. It’s perfect for individuals or families who go to the doctor a few times a year.
PRICING:
Coverage 4: $1820.46
Coverage 3: $1106.79
Coverage 2: $1225.73
Coverage 1: $631.01
DETAILS:
COVERAGE:
Notes: Yes.
If your plan doesn't meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Coverage Tier: All
Emergency Room: You pay the full cost until your deductible is met, then 20% of the covered amount.
Monthly Premium: None
Lifetime Maximum: No Maximum
Professoinal Fees: You pay the full cost until your deductible is met, then 20% of the covered amount.
Referral Required: No
Urgent Care Copay: 80
Employee Contribution: TBD by Group
Employer Contribution: TBD by Group
Inpatient Hospital Stay: You pay the full cost until your deductible is met, then 20% of the covered amount.
Habilitation - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Included no cost services: 0% Copay Telemedicine, Virtual Primary Care, Advocay Services
Prescription Drug Deductible: You just pay low copays for medications right away—no deductible needs to be met.
Habilitation - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Home heslth care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Hospice services - In Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialist Copay - In Network: 60
Emergency Medical Transporation: You pay the full cost until your deductible is met, then 20% of the covered amount.
Primary Care Copay - In Network: 30
Your Rights to Continue Coverage: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievance or appeal. For more information about your rights, look at the explaination of benefits you will receivefor that medical claim. Your plan documents also provide complete information to submit a claim, appeal, or a grievance for any reason to your plan.For more information about your rights, this notice, or assistance, contact: Acuity at 1-866-872-6356 or Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform.
Deductible (Family) - In Network: 3000
Home heslth care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Hospice services - Out of Network: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is :Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Skilled nursing care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Specialist Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Your Grievance and Appeals Rights: Yes.
If you don't have Minimum Essential Coverage for a month, you'll have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month.
Specialty Drugs - Network Provider: 50% coinsurance
Primary Care Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Chiropractic Care Copay - In Network: 20
Deductible (Family) - Out of Network: 6000
Deductible (Individual) - In Netwok: 1500
Pregnancy office visits - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Skilled nursing care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Durable medical equipment - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Chiropractic Care Copay - Out of Network: NA
Deductible (individual) - Out of Netwok: 3000
Pregnancy office visits - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialty Drugs - Out of Network Provider: Not covered
Durable medical equipment - Out of Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out of Pocket Maximum (Family) - In Network: 14700
Routine Preventive Services (Non-Diagnostic): No Member Cost Sharing - Deductible Waived
Out of Pocket Maximum (family) - Out of Network: 29400
Does this plan meet the Minimum Value Standards?: None
Out of Pockert Maximum (Individual) - In Network: 7350
Cildbirth/delivery facility services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - In Network: 80% / 20%%
Does This Plan provide Minimum Essential Coverage?: For more information about limitations and exceptions, see the plan or policy document at https://www.acuity-grp.com
Out of Pocket Maximum (Individual) - Out of Network: 14700
Blood test to help diagnose a condition - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount.
Cildbirth/delivery facility services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Free Standing Lab & Diagnostic Services (Lab & x-ray): You pay the full cost until your deductible is met, then 0% of the covered amount.
Preventative Care/Screening/Immunization - In Network: 0% Coinsurance
Childbirth/delivery professional services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - Out of Network: 60% / 40%
Blood test to help diagnose a condition - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Preventative Care/Screening/Immunization - Out of Network: Not Covered
Childbirth/delivery professional services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out Patient Services, Surgical Services (Procedure & Anesthesia): You pay the full cost until your deductible is met, then 20% of the covered amount.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Generic medication (30-day supply) from a pharmacy in your plan’s network: $15 copay
Generic medication (31-90-day supply) from a pharmacy in your plan’s network: $45 copayemnt
Inpatient mental/ behavioral health, and substance abuse services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Complex Diagnositc Services (CT, MRI, Ultra Sound, PET, Nuclear Med.) (Network): You pay the full cost until your deductible is met, then 20% of the covered amount.
Outpatient mental/ behavioral health, and substance abuse services - In Network: $30 copay
Inpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Outpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Brand-name medication that’s on your plan’s preferred list (30-day supply from an in-network pharmacy): $45 copay
Brand-name medication that’s on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $90 copayemnt
Brand-name medication that’s not on your plan’s preferred list (30-day supply) from an in-network pharmacy): $85 copay
Brand-name medication that’s not on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $150 copayemnt

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rag/cigna_2500_classic.txt
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PLAN: Cigna 2500 Classic
UID: Cigna 2500 Classic
Category: Major Medical
Type: PPO
Marketing Name: Cigna - 2,500 Plan
Average Price: $1118.73
Short Description: A dependable PPO with a moderate deductible and consistent copays that make budgeting easier.
Long Description: The Cigna 2500 Plan is built for people who want reliable coverage with manageable costs. You’ll pay $30 for primary care and $60 for specialists, with preventive care fully covered. It’s a good middle-ground plan that works well for most people.
PRICING:
Coverage 4: $1702.35
Coverage 3: $1035.36
Coverage 2: $1146.52
Coverage 1: $590.71
DETAILS:
COVERAGE:
Notes: Yes.
If your plan doesn't meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Coverage Tier: All
Emergency Room: You pay the full cost until your deductible is met, then 20% of the covered amount.
Monthly Premium: None
Lifetime Maximum: No Maximum
Professoinal Fees: You pay the full cost until your deductible is met, then 20% of the covered amount.
Referral Required: No
Urgent Care Copay: 80
Employee Contribution: TBD by Group
Employer Contribution: TBD by Group
Inpatient Hospital Stay: You pay the full cost until your deductible is met, then 20% of the covered amount.
Habilitation - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Included no cost services: 0% Copay Telemedicine, Virtual Primary Care, Advocay Services
Prescription Drug Deductible: You just pay low copays for medications right away—no deductible needs to be met.
Habilitation - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Home heslth care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Hospice services - In Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialist Copay - In Network: 60
Emergency Medical Transporation: You pay the full cost until your deductible is met, then 20% of the covered amount.
Primary Care Copay - In Network: 30
Your Rights to Continue Coverage: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievance or appeal. For more information about your rights, look at the explaination of benefits you will receivefor that medical claim. Your plan documents also provide complete information to submit a claim, appeal, or a grievance for any reason to your plan.For more information about your rights, this notice, or assistance, contact: Acuity at 1-866-872-6356 or Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform.
Deductible (Family) - In Network: 5000
Home heslth care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Hospice services - Out of Network: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is :Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Skilled nursing care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Specialist Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Your Grievance and Appeals Rights: Yes.
If you don't have Minimum Essential Coverage for a month, you'll have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month.
Specialty Drugs - Network Provider: 50% coinsurance
Primary Care Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Chiropractic Care Copay - In Network: 20
Deductible (Family) - Out of Network: 10000
Deductible (Individual) - In Netwok: 2500
Pregnancy office visits - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Skilled nursing care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Durable medical equipment - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Chiropractic Care Copay - Out of Network: NA
Deductible (individual) - Out of Netwok: 5000
Pregnancy office visits - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialty Drugs - Out of Network Provider: Not covered
Durable medical equipment - Out of Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out of Pocket Maximum (Family) - In Network: 14700
Routine Preventive Services (Non-Diagnostic): No Member Cost Sharing - Deductible Waived
Out of Pocket Maximum (family) - Out of Network: 29400
Does this plan meet the Minimum Value Standards?: None
Out of Pockert Maximum (Individual) - In Network: 7350
Cildbirth/delivery facility services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - In Network: 80% / 20%%
Does This Plan provide Minimum Essential Coverage?: For more information about limitations and exceptions, see the plan or policy document at https://www.acuity-grp.com
Out of Pocket Maximum (Individual) - Out of Network: 14700
Blood test to help diagnose a condition - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount.
Cildbirth/delivery facility services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Free Standing Lab & Diagnostic Services (Lab & x-ray): You pay the full cost until your deductible is met, then 0% of the covered amount.
Preventative Care/Screening/Immunization - In Network: 0% Coinsurance
Childbirth/delivery professional services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - Out of Network: 60% / 40%
Blood test to help diagnose a condition - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Preventative Care/Screening/Immunization - Out of Network: Not Covered
Childbirth/delivery professional services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out Patient Services, Surgical Services (Procedure & Anesthesia): You pay the full cost until your deductible is met, then 20% of the covered amount.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Generic medication (30-day supply) from a pharmacy in your plan’s network: $15 copay
Generic medication (31-90-day supply) from a pharmacy in your plan’s network: $45 copayemnt
Inpatient mental/ behavioral health, and substance abuse services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Complex Diagnositc Services (CT, MRI, Ultra Sound, PET, Nuclear Med.) (Network): You pay the full cost until your deductible is met, then 20% of the covered amount.
Outpatient mental/ behavioral health, and substance abuse services - In Network: $30 copay
Inpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Outpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Brand-name medication that’s on your plan’s preferred list (30-day supply from an in-network pharmacy): $45 copay
Brand-name medication that’s on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $90 copayemnt
Brand-name medication that’s not on your plan’s preferred list (30-day supply) from an in-network pharmacy): $85 copay
Brand-name medication that’s not on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $150 copayemnt

96
rag/cigna_3500_classic.txt
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PLAN: Cigna 3500 Classic
UID: Cigna 3500 Classic
Category: Major Medical
Type: PPO
Marketing Name: Cigna- 3,500 Plan
Average Price: $1046.52
Short Description: A cost-conscious PPO plan offering solid coverage and access to care with lower monthly premiums.
Long Description: .The Cigna 3500 Plan is a budget-friendly PPO that still gives you access to great care. Primary care visits are just $45, specialists are $90, and preventive care is free. It’s a smart choice if you’re healthy but want solid protection just in case.
PRICING:
Coverage 4: $1591.96
Coverage 3: $968.61
Coverage 2: $1072.50
Coverage 1: $553.04
DETAILS:
COVERAGE:
Notes: Yes.
If your plan doesn't meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Coverage Tier: All
Emergency Room: You pay the full cost until your deductible is met, then 20% of the covered amount.
Monthly Premium: None
Lifetime Maximum: No Maximum
Professoinal Fees: You pay the full cost until your deductible is met, then 20% of the covered amount.
Referral Required: No
Urgent Care Copay: 90
Employee Contribution: TBD by Group
Employer Contribution: TBD by Group
Inpatient Hospital Stay: You pay the full cost until your deductible is met, then 20% of the covered amount.
Habilitation - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Included no cost services: 0% Copay Telemedicine, Virtual Primary Care, Advocay Services
Prescription Drug Deductible: You just pay low copays for medications right away—no deductible needs to be met.
Habilitation - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Home heslth care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Hospice services - In Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialist Copay - In Network: 90
Emergency Medical Transporation: You pay the full cost until your deductible is met, then 20% of the covered amount.
Primary Care Copay - In Network: 45
Your Rights to Continue Coverage: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievance or appeal. For more information about your rights, look at the explaination of benefits you will receivefor that medical claim. Your plan documents also provide complete information to submit a claim, appeal, or a grievance for any reason to your plan.For more information about your rights, this notice, or assistance, contact: Acuity at 1-866-872-6356 or Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform.
Deductible (Family) - In Network: 7000
Home heslth care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Hospice services - Out of Network: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is :Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Skilled nursing care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Specialist Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Your Grievance and Appeals Rights: Yes.
If you don't have Minimum Essential Coverage for a month, you'll have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month.
Specialty Drugs - Network Provider: 50% coinsurance
Primary Care Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Chiropractic Care Copay - In Network: 20
Deductible (Family) - Out of Network: 14000
Deductible (Individual) - In Netwok: 3500
Pregnancy office visits - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Skilled nursing care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Durable medical equipment - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Chiropractic Care Copay - Out of Network: NA
Deductible (individual) - Out of Netwok: 7000
Pregnancy office visits - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialty Drugs - Out of Network Provider: Not covered
Durable medical equipment - Out of Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out of Pocket Maximum (Family) - In Network: 14700
Routine Preventive Services (Non-Diagnostic): No Member Cost Sharing - Deductible Waived
Out of Pocket Maximum (family) - Out of Network: 29400
Does this plan meet the Minimum Value Standards?: None
Out of Pockert Maximum (Individual) - In Network: 7350
Cildbirth/delivery facility services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - In Network: 80% / 20%%
Does This Plan provide Minimum Essential Coverage?: For more information about limitations and exceptions, see the plan or policy document at https://www.acuity-grp.com
Out of Pocket Maximum (Individual) - Out of Network: 14700
Blood test to help diagnose a condition - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount.
Cildbirth/delivery facility services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Free Standing Lab & Diagnostic Services (Lab & x-ray): You pay the full cost until your deductible is met, then 0% of the covered amount.
Preventative Care/Screening/Immunization - In Network: 0% Coinsurance
Childbirth/delivery professional services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - Out of Network: 60% / 40%
Blood test to help diagnose a condition - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Preventative Care/Screening/Immunization - Out of Network: Not Covered
Childbirth/delivery professional services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out Patient Services, Surgical Services (Procedure & Anesthesia): You pay the full cost until your deductible is met, then 20% of the covered amount.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Generic medication (30-day supply) from a pharmacy in your plan’s network: $15 copay
Generic medication (31-90-day supply) from a pharmacy in your plan’s network: $45 copayemnt
Inpatient mental/ behavioral health, and substance abuse services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Complex Diagnositc Services (CT, MRI, Ultra Sound, PET, Nuclear Med.) (Network): You pay the full cost until your deductible is met, then 20% of the covered amount.
Outpatient mental/ behavioral health, and substance abuse services - In Network: $45 copay
Inpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Outpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Brand-name medication that’s on your plan’s preferred list (30-day supply from an in-network pharmacy): $65 copay
Brand-name medication that’s on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $90 copayemnt
Brand-name medication that’s not on your plan’s preferred list (30-day supply) from an in-network pharmacy): $100 copay
Brand-name medication that’s not on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $150 copayemnt

96
rag/cigna_3500_hsa.txt
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PLAN: Cigna 3500 HSA
UID: Cigna 3500 HSA
Category: Major Medical
Type: PPO
Marketing Name: Cigna - 3,500 HSA Plan
Average Price: $933.13
Short Description: An HSA-compatible PPO that helps you save on taxes while offering flexible access to care.
Long Description: The Cigna 3500 HSA Plan lets you save money in a Health Savings Account while staying protected. You’ll pay 20% after your deductible, and preventive care is 100% covered. If you want to take control of your health spending and save on taxes, this plan is a great fit
PRICING:
Coverage 4: $1418.62
Coverage 3: $863.78
Coverage 2: $956.25
Coverage 1: $493.90
DETAILS:
COVERAGE:
Notes: Yes.
If your plan doesn't meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Coverage Tier: All
Emergency Room: You pay the full cost until your deductible is met, then 20% of the covered amount.
Monthly Premium: None
Lifetime Maximum: No Maximum
Professoinal Fees: You pay the full cost until your deductible is met, then 20% of the covered amount.
Referral Required: No
Urgent Care Copay: You pay the full cost until your deductible is met, then 20% of the covered amount.
Employee Contribution: TBD by Group
Employer Contribution: TBD by Group
Inpatient Hospital Stay: You pay the full cost until your deductible is met, then 20% of the covered amount.
Habilitation - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Included no cost services: 0% Copay Telemedicine, Virtual Primary Care, Advocay Services
Prescription Drug Deductible: You pay full price for prescriptions until your medical deductible is met.
Habilitation - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Home heslth care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Hospice services - In Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialist Copay - In Network: 20% after deductable met
Emergency Medical Transporation: You pay the full cost until your deductible is met, then 20% of the covered amount.
Primary Care Copay - In Network: 20% after deductable met
Your Rights to Continue Coverage: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievance or appeal. For more information about your rights, look at the explaination of benefits you will receivefor that medical claim. Your plan documents also provide complete information to submit a claim, appeal, or a grievance for any reason to your plan.For more information about your rights, this notice, or assistance, contact: Acuity at 1-866-872-6356 or Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform.
Deductible (Family) - In Network: 7000
Home heslth care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Hospice services - Out of Network: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is :Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Skilled nursing care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Specialist Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Your Grievance and Appeals Rights: Yes.
If you don't have Minimum Essential Coverage for a month, you'll have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month.
Specialty Drugs - Network Provider: 50% coinsurance after deductable met
Primary Care Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Chiropractic Care Copay - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount.
Deductible (Family) - Out of Network: 14000
Deductible (Individual) - In Netwok: 3500
Pregnancy office visits - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Skilled nursing care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Durable medical equipment - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Chiropractic Care Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Deductible (individual) - Out of Netwok: 7000
Pregnancy office visits - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialty Drugs - Out of Network Provider: Not covered
Durable medical equipment - Out of Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out of Pocket Maximum (Family) - In Network: 13100
Routine Preventive Services (Non-Diagnostic): No Member Cost Sharing - Deductible Waived
Out of Pocket Maximum (family) - Out of Network: 26200
Does this plan meet the Minimum Value Standards?: None
Out of Pockert Maximum (Individual) - In Network: 6650
Cildbirth/delivery facility services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - In Network: 80% / 20%%
Does This Plan provide Minimum Essential Coverage?: For more information about limitations and exceptions, see the plan or policy document at https://www.acuity-grp.com
Out of Pocket Maximum (Individual) - Out of Network: 13100
Blood test to help diagnose a condition - In Network: You pay the full cost until of facility and professional service fees until your deductible is met, then 20% of the covered amount.
Cildbirth/delivery facility services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Free Standing Lab & Diagnostic Services (Lab & x-ray): You pay the full cost until your deductible is met, then 0% of the covered amount.
Preventative Care/Screening/Immunization - In Network: 0% Coinsurance
Childbirth/delivery professional services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - Out of Network: 60% / 40%
Blood test to help diagnose a condition - Out of Network: You pay the full cost facility and professional service fees until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Preventative Care/Screening/Immunization - Out of Network: Not Covered
Childbirth/delivery professional services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - In Network: You pay the full cost until of facility and professional service fees until your deductible is met, then 20% of the covered amount.
Out Patient Services, Surgical Services (Procedure & Anesthesia): You pay the full cost until your deductible is met, then 20% of the covered amount.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - Out of Network: You pay the full cost facility and professional service fees until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Generic medication (30-day supply) from a pharmacy in your plan’s network: $15 copay
Generic medication (31-90-day supply) from a pharmacy in your plan’s network: $45 copayemnt
Inpatient mental/ behavioral health, and substance abuse services - In Network: You pay the full cost until of facility and professional service fees until your deductible is met, then 20% of the covered amount.
Complex Diagnositc Services (CT, MRI, Ultra Sound, PET, Nuclear Med.) (Network): You pay the full cost until your deductible is met, then 20% of the covered amount.
Outpatient mental/ behavioral health, and substance abuse services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Inpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost facility and professional service fees until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Outpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Brand-name medication that’s on your plan’s preferred list (30-day supply from an in-network pharmacy): $65 copay
Brand-name medication that’s on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $90 copayemnt
Brand-name medication that’s not on your plan’s preferred list (30-day supply) from an in-network pharmacy): $100 copay
Brand-name medication that’s not on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $150 copayemnt

96
rag/cigna_5000_classic.txt
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PLAN: Cigna 5000 Classic
UID: Cigna 5000 Classic
Category: Major Medical
Type: PPO
Marketing Name: Cigna - 5000 Plan
Average Price: $979.04
Short Description: A high-deductible PPO plan with clear cost-sharing and strong coverage for major medical needs.
Long Description: With a $5,000 deductible and copays starting at $45, the Cigna 5000 Plan gives you strong protection at a lower monthly cost. It’s perfect if you’re looking for a PPO that covers the big stuff but doesn’t overcharge for the basics.
PRICING:
Coverage 4: $1488.80
Coverage 3: $906.22
Coverage 2: $1003.32
Coverage 1: $517.85
DETAILS:
COVERAGE:
Notes: Yes.
If your plan doesn't meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Coverage Tier: All
Emergency Room: You pay the full cost until your deductible is met, then 20% of the covered amount.
Monthly Premium: None
Lifetime Maximum: No Maximum
Professoinal Fees: You pay the full cost until your deductible is met, then 20% of the covered amount.
Referral Required: No
Urgent Care Copay: 90
Employee Contribution: TBD by Group
Employer Contribution: TBD by Group
Inpatient Hospital Stay: You pay the full cost until your deductible is met, then 20% of the covered amount.
Habilitation - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Included no cost services: 0% Copay Telemedicine, Virtual Primary Care, Advocay Services
Prescription Drug Deductible: You just pay low copays for medications right away—no deductible needs to be met.
Habilitation - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Home heslth care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Hospice services - In Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialist Copay - In Network: 20% after deductable met
Emergency Medical Transporation: You pay the full cost until your deductible is met, then 20% of the covered amount.
Primary Care Copay - In Network: 45
Your Rights to Continue Coverage: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievance or appeal. For more information about your rights, look at the explaination of benefits you will receivefor that medical claim. Your plan documents also provide complete information to submit a claim, appeal, or a grievance for any reason to your plan.For more information about your rights, this notice, or assistance, contact: Acuity at 1-866-872-6356 or Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform.
Deductible (Family) - In Network: 10000
Home heslth care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Hospice services - Out of Network: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is :Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Skilled nursing care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Specialist Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Your Grievance and Appeals Rights: Yes.
If you don't have Minimum Essential Coverage for a month, you'll have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month.
Specialty Drugs - Network Provider: 50% coinsurance
Primary Care Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Chiropractic Care Copay - In Network: 20
Deductible (Family) - Out of Network: 14000
Deductible (Individual) - In Netwok: 5000
Pregnancy office visits - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Skilled nursing care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Durable medical equipment - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Chiropractic Care Copay - Out of Network: NA
Deductible (individual) - Out of Netwok: 7000
Pregnancy office visits - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialty Drugs - Out of Network Provider: Not covered
Durable medical equipment - Out of Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out of Pocket Maximum (Family) - In Network: 14700
Routine Preventive Services (Non-Diagnostic): No Member Cost Sharing - Deductible Waived
Out of Pocket Maximum (family) - Out of Network: 29400
Does this plan meet the Minimum Value Standards?: None
Out of Pockert Maximum (Individual) - In Network: 7350
Cildbirth/delivery facility services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - In Network: 80% / 20%%
Does This Plan provide Minimum Essential Coverage?: For more information about limitations and exceptions, see the plan or policy document at https://www.acuity-grp.com
Out of Pocket Maximum (Individual) - Out of Network: 14700
Blood test to help diagnose a condition - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount.
Cildbirth/delivery facility services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Free Standing Lab & Diagnostic Services (Lab & x-ray): You pay the full cost until your deductible is met, then 0% of the covered amount.
Preventative Care/Screening/Immunization - In Network: 0% Coinsurance
Childbirth/delivery professional services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - Out of Network: 60% / 40%
Blood test to help diagnose a condition - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Preventative Care/Screening/Immunization - Out of Network: Not Covered
Childbirth/delivery professional services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out Patient Services, Surgical Services (Procedure & Anesthesia): You pay the full cost until your deductible is met, then 20% of the covered amount.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Generic medication (30-day supply) from a pharmacy in your plan’s network: $15 copay
Generic medication (31-90-day supply) from a pharmacy in your plan’s network: $45 copayemnt
Inpatient mental/ behavioral health, and substance abuse services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Complex Diagnositc Services (CT, MRI, Ultra Sound, PET, Nuclear Med.) (Network): You pay the full cost until your deductible is met, then 20% of the covered amount.
Outpatient mental/ behavioral health, and substance abuse services - In Network: $45 copay
Inpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Outpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Brand-name medication that’s on your plan’s preferred list (30-day supply from an in-network pharmacy): $65 copay
Brand-name medication that’s on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $90 copayemnt
Brand-name medication that’s not on your plan’s preferred list (30-day supply) from an in-network pharmacy): $100 copay
Brand-name medication that’s not on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $150 copayemnt

96
rag/cigna_5000_hsa.txt
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PLAN: Cigna 5000 HSA
UID: Cigna 5000 HSA
Category: Major Medical
Type: PPO
Marketing Name: Cigna- 5000 HSA Plan
Average Price: $889.41
Short Description: An HSA-qualified plan with maximum flexibility and tax-saving benefits for healthcare expenses.
Long Description: The Cigna 5000 HSA Plan is all about flexibility and smart saving. It pairs a $5,000 deductible with access to a Health Savings Account, where you can use pre-tax dollars to cover your care. Ideal for folks who like to plan ahead and take control of their health budget.
PRICING:
Coverage 4: $1351.78
Coverage 3: $823.36
Coverage 2: $911.43
Coverage 1: $471.10
DETAILS:
COVERAGE:
Notes: Yes.
If your plan doesn't meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Coverage Tier: All
Emergency Room: You pay the full cost until your deductible is met, then 20% of the covered amount.
Monthly Premium: None
Lifetime Maximum: No Maximum
Professoinal Fees: You pay the full cost until your deductible is met, then 20% of the covered amount.
Referral Required: No
Urgent Care Copay: You pay the full cost until your deductible is met, then 20% of the covered amount.
Employee Contribution: TBD by Group
Employer Contribution: TBD by Group
Inpatient Hospital Stay: You pay the full cost until your deductible is met, then 20% of the covered amount.
Habilitation - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Included no cost services: 0% Copay Telemedicine, Virtual Primary Care, Advocay Services
Prescription Drug Deductible: You pay full price for prescriptions until your medical deductible is met.
Habilitation - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Home heslth care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Hospice services - In Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialist Copay - In Network: 20% after deductable met
Emergency Medical Transporation: You pay the full cost until your deductible is met, then 20% of the covered amount.
Primary Care Copay - In Network: 20% after deductable met
Your Rights to Continue Coverage: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievance or appeal. For more information about your rights, look at the explaination of benefits you will receivefor that medical claim. Your plan documents also provide complete information to submit a claim, appeal, or a grievance for any reason to your plan.For more information about your rights, this notice, or assistance, contact: Acuity at 1-866-872-6356 or Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform.
Deductible (Family) - In Network: None
Home heslth care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Hospice services - Out of Network: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is :Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Skilled nursing care - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Specialist Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Your Grievance and Appeals Rights: Yes.
If you don't have Minimum Essential Coverage for a month, you'll have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month.
Specialty Drugs - Network Provider: You pay full price for prescriptions until your medical deductible is met.
Primary Care Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount.
Chiropractic Care Copay - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount.
Deductible (Family) - Out of Network: 20000
Deductible (Individual) - In Netwok: 5000
Pregnancy office visits - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Skilled nursing care - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Durable medical equipment - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Chiropractic Care Copay - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Deductible (individual) - Out of Netwok: 10000
Pregnancy office visits - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Specialty Drugs - Out of Network Provider: Not covered
Durable medical equipment - Out of Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Out of Pocket Maximum (Family) - In Network: 14700
Routine Preventive Services (Non-Diagnostic): No Member Cost Sharing - Deductible Waived
Out of Pocket Maximum (family) - Out of Network: 29400
Does this plan meet the Minimum Value Standards?: None
Out of Pockert Maximum (Individual) - In Network: 7350
Cildbirth/delivery facility services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - In Network: 80% / 20%%
Does This Plan provide Minimum Essential Coverage?: For more information about limitations and exceptions, see the plan or policy document at https://www.acuity-grp.com
Out of Pocket Maximum (Individual) - Out of Network: 14700
Blood test to help diagnose a condition - In Network: You pay the full cost until of facility and professional service fees until your deductible is met, then 20% of the covered amount.
Cildbirth/delivery facility services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Free Standing Lab & Diagnostic Services (Lab & x-ray): You pay the full cost until your deductible is met, then 0% of the covered amount.
Preventative Care/Screening/Immunization - In Network: 0% Coinsurance
Childbirth/delivery professional services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - Out of Network: 60% / 40%
Blood test to help diagnose a condition - Out of Network: You pay the full cost facility and professional service fees until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Preventative Care/Screening/Immunization - Out of Network: Not Covered
Childbirth/delivery professional services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - In Network: You pay the full cost until of facility and professional service fees until your deductible is met, then 20% of the covered amount.
Out Patient Services, Surgical Services (Procedure & Anesthesia): You pay the full cost until your deductible is met, then 20% of the covered amount.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - Out of Network: You pay the full cost facility and professional service fees until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Generic medication (30-day supply) from a pharmacy in your plan’s network: $15 copay
Generic medication (31-90-day supply) from a pharmacy in your plan’s network: $30 copayemnt
Inpatient mental/ behavioral health, and substance abuse services - In Network: You pay the full cost until of facility and professional service fees until your deductible is met, then 20% of the covered amount.
Complex Diagnositc Services (CT, MRI, Ultra Sound, PET, Nuclear Med.) (Network): You pay the full cost until your deductible is met, then 20% of the covered amount.
Outpatient mental/ behavioral health, and substance abuse services - In Network: You pay the full cost until your deductible is met, then 20% of the covered amount subject to plan's allowable fee.
Inpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost facility and professional service fees until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Outpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 40% of the covered amount subject to plan's allowable fee.
Brand-name medication that’s on your plan’s preferred list (30-day supply from an in-network pharmacy): $65 copay
Brand-name medication that’s on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $130 copayemnt
Brand-name medication that’s not on your plan’s preferred list (30-day supply) from an in-network pharmacy): $100 copay
Brand-name medication that’s not on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $200 copayemnt

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PLAN: Cigna 7350 Value
UID: Cigna 7350 Value
Category: Major Medical
Type: PPO
Marketing Name: Cigna - 7350 Value Plan
Average Price: $847.77
Short Description: Our lowest-cost PPO plan, ideal for healthy individuals who want essential protection and peace of mind.
Long Description: The Cigna 7350 Value Plan offers the lowest premium of all. It comes with a $7,350 deductible and matching out-of-pocket max, plus $50 copays for doctors and $100 for specialists. Preventive care is free. It’s a great fit for those who don’t go to the doctor often but want peace of mind just in case.
PRICING:
Coverage 4: $1288.12
Coverage 3: $784.87
Coverage 2: $868.74
Coverage 1: $449.38
DETAILS:
COVERAGE:
Notes: Yes.
If your plan doesn't meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Coverage Tier: All
Emergency Room: You pay the full cost until your deductible is met, then 0% of the covered amount.
Monthly Premium: None
Lifetime Maximum: No Maximum
Professoinal Fees: You pay the full cost until your deductible is met, then 0% of the covered amount.
Referral Required: No
Urgent Care Copay: 100
Employee Contribution: TBD by Group
Employer Contribution: TBD by Group
Inpatient Hospital Stay: You pay the full cost until your deductible is met, then 0% of the covered amount.
Habilitation - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Included no cost services: 0% Copay Telemedicine, Virtual Primary Care, Advocay Services
Prescription Drug Deductible: You just pay low copays for medications right away—no deductible needs to be met.
Habilitation - Out of Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Home heslth care - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Hospice services - In Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Specialist Copay - In Network: 100
Emergency Medical Transporation: You pay the full cost until your deductible is met, then 0% of the covered amount.
Primary Care Copay - In Network: 50
Your Rights to Continue Coverage: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievance or appeal. For more information about your rights, look at the explaination of benefits you will receivefor that medical claim. Your plan documents also provide complete information to submit a claim, appeal, or a grievance for any reason to your plan.For more information about your rights, this notice, or assistance, contact: Acuity at 1-866-872-6356 or Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform.
Deductible (Family) - In Network: 14700
Home heslth care - Out of Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Hospice services - Out of Network: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is :Department of Labor's Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Skilled nursing care - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Specialist Copay - Out of Network: You pay the full cost until your deductible is met, then 50% of the covered amount.
Your Grievance and Appeals Rights: Yes.
If you don't have Minimum Essential Coverage for a month, you'll have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month.
Specialty Drugs - Network Provider: 50% coinsurance
Primary Care Copay - Out of Network: You pay the full cost until your deductible is met, then 0% of the covered amount.
Chiropractic Care Copay - In Network: 20
Deductible (Family) - Out of Network: 29400
Deductible (Individual) - In Netwok: 7350
Pregnancy office visits - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Rehabilitation Services - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Skilled nursing care - Out of Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Durable medical equipment - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Chiropractic Care Copay - Out of Network: NA
Deductible (individual) - Out of Netwok: 14700
Pregnancy office visits - Out of Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Rehabilitation Services - Out of Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Specialty Drugs - Out of Network Provider: Not Covered
Durable medical equipment - Out of Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Out of Pocket Maximum (Family) - In Network: 14700
Routine Preventive Services (Non-Diagnostic): No Member Cost Sharing - Deductible Waived
Out of Pocket Maximum (family) - Out of Network: 29400
Does this plan meet the Minimum Value Standards?: None
Out of Pockert Maximum (Individual) - In Network: 7350
Cildbirth/delivery facility services - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - In Network: Plan pays 100%
Does This Plan provide Minimum Essential Coverage?: For more information about limitations and exceptions, see the plan or policy document at https://www.acuity-grp.com
Out of Pocket Maximum (Individual) - Out of Network: 14700
Blood test to help diagnose a condition - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount.
Cildbirth/delivery facility services - Out of Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Free Standing Lab & Diagnostic Services (Lab & x-ray): You pay the full cost until your deductible is met, then 0% of the covered amount.
Preventative Care/Screening/Immunization - In Network: 0% Coinsurance
Childbirth/delivery professional services - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Coinsurance % (Plan pays/Member Pays) - Out of Network: 50%/50%
Blood test to help diagnose a condition - Out of Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Preventative Care/Screening/Immunization - Out of Network: Not Covered
Childbirth/delivery professional services - Out of Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - In Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Out Patient Services, Surgical Services (Procedure & Anesthesia): You pay the full cost until your deductible is met, then 0% of the covered amount.
Imaging tests like X-Rays, CT/PET Scans, or MRI's - Out of Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Generic medication (30-day supply) from a pharmacy in your plan’s network: $15 copay
Generic medication (31-90-day supply) from a pharmacy in your plan’s network: $45 copayemnt
Inpatient mental/ behavioral health, and substance abuse services - In Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Complex Diagnositc Services (CT, MRI, Ultra Sound, PET, Nuclear Med.) (Network): You pay the full cost until your deductible is met, then 0% of the covered amount.
Outpatient mental/ behavioral health, and substance abuse services - In Network: $50 copay
Inpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay in full until deductible met ; after that, the plan covers 100% subject to plan's allowable fee.
Outpatient mental/ behavioral health, and substance abuse services - Out of Network: You pay the full cost until your deductible is met, then 0% of the covered amount subject to plan's allowable fee.
Brand-name medication that’s on your plan’s preferred list (30-day supply from an in-network pharmacy): $65 copay
Brand-name medication that’s on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $90 copayemnt
Brand-name medication that’s not on your plan’s preferred list (30-day supply) from an in-network pharmacy): $100 copay
Brand-name medication that’s not on your plan’s preferred list (31-90-day supply) from an in-network pharmacy): $150 copayemnt

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PLAN: Equitable Accident Insurance Plan
UID: Equitable Accident Plan
Category: Accident
Type: None
Marketing Name: Equitable Accedent lan
Average Price: $43.02
Short Description: This accident plan provides cash benefits for a wide range of injuries — from fractures and dislocations to hospital stays and emergency care — helping cover out-of-pocket costs for both minor and major accidents.
Long Description: The Equitable Accident Insurance Plan offers financial protection for unexpected injuries by paying cash benefits directly to you. Coverage includes a broad range of injuries such as fractures, dislocations, burns, lacerations, and even paralysis. Benefits also cover medical treatments like X-rays, physical therapy, and hospital stays. The money can be used however you need — whether for medical bills, daily expenses, or lost income — giving you peace of mind after an accident.
PRICING:
Coverage 4: $63.74
Coverage 3: $46.37
Coverage 2: $39.69
Coverage 1: $22.28
DETAILS:
BURNS:
Skin graft - Child: Pays 50% of the full burn benefit.
Skin graft - Spouse: Pays 50% of the full burn benefit.
Skin graft - Employee: Pays 50% of the full burn benefit.
21–40 sq. cm third degree - Child: 1000
41–65 sq. cm third degree - Child: 2000
21–40 sq. cm second degree - Child: 400
21–40 sq. cm third degree - Spouse: 1000
41–65 sq. cm second degree - Child: 800
41–65 sq. cm third degree - Spouse: 2000
66–160 sq. cm third degree - Child: 6000
161–225 sq. cm third degree - Child: 14000
21–40 sq. cm second degree - Spouse: 400
41–65 sq. cm second degree - Spouse: 800
66–160 sq. cm second degree - Child: 1200
66–160 sq. cm third degree - Spouse: 6000
161–225 sq. cm second degree - Child: 1600
161–225 sq. cm third degree - Spouse: 14000
21–40 sq. cm third degree - Employee: 1000
41–65 sq. cm third degree - Employee: 2000
66–160 sq. cm second degree - Spouse: 1200
161–225 sq. cm second degree - Spouse: 1600
21–40 sq. cm second degree - Employee: 400
41–65 sq. cm second degree - Employee: 800
66–160 sq. cm third degree - Employee: 6000
161–225 sq. cm third degree - Employee: 14000
66–160 sq. cm second degree - Employee: 1200
161–225 sq. cm second degree - Employee: 1600
More than 225 sq. cm third degree - Child: 20000
More than 225 sq. cm second degree - Child: 2000
More than 225 sq. cm third degree - Spouse: 20000
More than 225 sq. cm second degree - Spouse: 2000
More than 225 sq. cm third degree - Employee: 20000
More than 225 sq. cm second degree - Employee: 2000
SURGERY:
Open surgery - Child: 3000
Open surgery - Spouse: 3000
Open surgery - Employee: 3000
Torn knee cartilage - Child: 1500
Torn knee cartilage - Spouse: 1500
Torn knee cartilage - Employee: 1500
Ruptured/herniated disc - Child: 1500
Ruptured/herniated disc - Spouse: 1500
Ruptured/herniated disc - Employee: 1500
Tendon/Ligament/Rotator cuff tear - Child: 1500
Exploratory surgery or debridement - Child: 800
Tendon/Ligament/Rotator cuff tear - Spouse: 1500
Exploratory surgery or debridement - Spouse: 800
Tendon/Ligament/Rotator cuff tear - Employee: 1500
Exploratory surgery or debridement - Employee: 800
Laparoscopic surgery or hernia repair - Child: 1000
Laparoscopic surgery or hernia repair - Spouse: 1000
Laparoscopic surgery or hernia repair - Employee: 1000
Miscellaneous surgery requiring general anesthesia not otherwise listed (once per 24-hour period, even though multiple surgical procedures may be performed) - Child: 1000
Miscellaneous surgery requiring general anesthesia not otherwise listed (once per 24-hour period, even though multiple surgical procedures may be performed) - Spouse: 1000
Miscellaneous surgery requiring general anesthesia not otherwise listed (once per 24-hour period, even though multiple surgical procedures may be performed) - Employee: 1000
HOSPITAL:
Ambulance (Air) - Child: 2000
Ambulance (Air) - Spouse: 2000
Ambulance (Air) - Employee: 2000
Ambulance (Ground) - Child: 400
Ambulance (Ground) - Spouse: 400
Ambulance (Ground) - Employee: 400
ER admission or urgent care facility - Child: 200
ER admission or urgent care facility - Spouse: 200
ER admission or urgent care facility - Employee: 200
Hospital admission (once per benefit year) - Child: 2000
Hospital admission (once per benefit year) - Spouse: 2000
Hospital admission (once per benefit year) - Employee: 2000
Rehabilitation unit (per day, up to 30 days per covered accident) - Child: 100
Hospital confinement (per day up to 365 days per covered accident) - Child: 400
Rehabilitation unit (per day, up to 30 days per covered accident) - Spouse: 100
Hospital confinement (per day up to 365 days per covered accident) - Spouse: 400
Rehabilitation unit (per day, up to 30 days per covered accident) - Employee: 100
Hospital confinement (per day up to 365 days per covered accident) - Employee: 400
Transportation (100 or more miles up to three times per covered accident) - Child: 500
Transportation (100 or more miles up to three times per covered accident) - Spouse: 500
Transportation (100 or more miles up to three times per covered accident) - Employee: 500
Family Lodging Maximum Lodging night stays: one benefit per day, 30 days per benefit year - Child: 100
Family Lodging Maximum Lodging night stays: one benefit per day, 30 days per benefit year - Spouse: 100
Family Lodging Maximum Lodging night stays: one benefit per day, 30 days per benefit year - Employee: 100
Intensive care unit confinement (per day up to 15 days; payable in addition to any hospital confinement benefit) - Child: 500
Intensive care unit confinement (per day up to 15 days; payable in addition to any hospital confinement benefit) - Spouse: 500
Intensive care unit confinement (per day up to 15 days; payable in addition to any hospital confinement benefit) - Employee: 500
Intensive care unit admission (once per benefit year; payable instead of hospital admission benefit if confined immediately to ICU) - Child: 400
Intensive care unit admission (once per benefit year; payable instead of hospital admission benefit if confined immediately to ICU) - Spouse: 3000
Intensive care unit admission (once per benefit year; payable instead of hospital admission benefit if confined immediately to ICU) - Employee: 3000
FRACTURES:
Foot - Child: $1,500 / $750
Hand - Child: $1,500 / $750
Heel - Child: $1,500 / $750
Ankle - Child: $1,500 / $750
Elbow - Child: $1,500 / $750
Foot - Spouse: $1,500 / $750
Hand - Spouse: $1,500 / $750
Heel - Spouse: $1,500 / $750
Wrist - Child: $1,500 / $750
Ankle - Spouse: $1,500 / $750
Elbow - Spouse: $1,500 / $750
Wrist - Spouse: $1,500 / $750
Foot - Employee: $1,500 / $750
Forearm - Child: $1,500 / $750
Hand - Employee: $1,500 / $750
Heel - Employee: $1,500 / $750
Ankle - Employee: $1,500 / $750
Elbow - Employee: $1,500 / $750
Forearm - Spouse: $1,500 / $750
Knee cap - Child: $1,500 / $750
Shoulder - Child: $1,500 / $750
Wrist - Employee: $1,500 / $750
Knee cap - Spouse: $1,500 / $750
Lower jaw - Child: $1,500 / $750
Shoulder - Spouse: $1,500 / $750
Collarbone - Child: $1,500 / $750
Forearm - Employee: $1,500 / $750
Lower jaw - Spouse: $1,500 / $750
Collarbone - Spouse: $1,500 / $750
Knee cap - Employee: $1,500 / $750
Shoulder - Employee: $1,500 / $750
Lower jaw - Employee: $1,500 / $750
Collarbone - Employee: $1,500 / $750
Hip or thigh - Child: $10,000 / $5,000
Hip or thigh - Spouse: $10,000 / $5,000
Multiple ribs - Child: $2,000 / $1,000
Multiple ribs - Spouse: $2,000 / $1,000
Skull (simple) - Child: $7,000 / $3,500
Hip or thigh - Employee: $10,000 / $5,000
Skull (simple) - Spouse: $7,000 / $3,500
Multiple ribs - Employee: $2,000 / $1,000
Skull (depressed) - Child: $12,000 / $6,000
Skull (simple) - Employee: $7,000 / $3,500
Vertebral process - Child: $2,000 / $1,000
Skull (depressed) - Spouse: $12,000 / $6,000
Vertebral process - Spouse: $2,000 / $1,000
Skull (depressed) - Employee: $12,000 / $6,000
Vertebral process - Employee: $2,000 / $1,000
Bones of face or nose - Child: $2,000 / $1,000
Leg (tibia or fibula) - Child: $6,000 / $3,000
Bones of face or nose - Spouse: $2,000 / $1,000
Leg (tibia or fibula) - Spouse: $6,000 / $3,000
Upper jaw or upper arm - Child: $2,000 / $1,000
Upper jaw or upper arm - Spouse: $2,000 / $1,000
Bones of face or nose - Employee: $2,000 / $1,000
Leg (tibia or fibula) - Employee: $6,000 / $3,000
Pelvis (excluding coccyx) - Child: $8,000 / $4,000
Upper jaw or upper arm - Employee: $2,000 / $1,000
Pelvis (excluding coccyx) - Spouse: $8,000 / $4,000
Rib, finger, toe or coccyx - Child: $1,500 / $750
Rib, finger, toe or coccyx - Spouse: $1,500 / $750
Pelvis (excluding coccyx) - Employee: $8,000 / $4,000
Rib, finger, toe or coccyx - Employee: $1,500 / $750
Vertebrae (body of) or sternum - Child: $5,000 / $2,500
Vertebrae (body of) or sternum - Spouse: $5,000 / $2,500
Vertebrae (body of) or sternum - Employee: $5,000 / $2,500
Chip fractures and other fractures not reduced (not treated by a doctor) - Child: Pays 25% of the full amount if the bone is treated, with or without surgery.
Chip fractures and other fractures not reduced (not treated by a doctor) - Spouse: Pays 25% of the full amount if the bone is treated, with or without surgery.
Chip fractures and other fractures not reduced (not treated by a doctor) - Employee: Pays 25% of the full amount if the bone is treated, with or without surgery.
LACERATIONS:
Single laceration under 5 cm with suture - Child: 65
Single laceration under 5 cm with suture - Spouse: 65
Single laceration under 5 cm with suture - Employee: 65
Laceration(s) with no sutures and treated by a physician - Child: 35
Laceration(s) with no sutures and treated by a physician - Spouse: 35
Laceration(s) with no sutures and treated by a physician - Employee: 35
Lacerations 5–15 cm with sutures (total of all lacerations) - Child: 250
Lacerations 5–15 cm with sutures (total of all lacerations) - Spouse: 250
Lacerations 5–15 cm with sutures (total of all lacerations) - Employee: 250
Lacerations greater than 15 cm with sutures (total of all lacerations) - Child: 500
Lacerations greater than 15 cm with sutures (total of all lacerations) - Spouse: 500
Lacerations greater than 15 cm with sutures (total of all lacerations) - Employee: 500
DISLOCATIONS:
Shoulder - Child: $3,000 / $1,500
Lower jaw - Child: $1,500 / $750
Shoulder - Spouse: $3,000 / $1,500
Lower jaw - Spouse: $1,500 / $750
Shoulder - Employee: $3,000 / $1,500
Lower jaw - Employee: $1,500 / $750
Elbow or wrist - Child: $1,500 / $700
Elbow or wrist - Spouse: $1,500 / $700
Elbow or wrist - Employee: $1,500 / $700
Finger(s) or toe(s) - Child: $1,000 / $500
Finger(s) or toe(s) - Spouse: $1,000 / $500
Finger(s) or toe(s) - Employee: $1,000 / $500
Incomplete dislocation - Child: 25% of the applicable non -surgical procedure
Incomplete dislocation - Spouse: 25% of the applicable non -surgical procedure
Incomplete dislocation - Employee: 25% of the applicable non -surgical procedure
Collarbone or bones of the hand - Child: $4,000 / $2,000
Collarbone or bones of the hand - Spouse: $4,000 / $2,000
Knee, ankle or bones of the foot - Child: $5,000 / $2,500
Knee, ankle or bones of the foot - Spouse: $5,000 / $2,500
Collarbone or bones of the hand - Employee: $4,000 / $2,000
Knee, ankle or bones of the foot - Employee: $5,000 / $2,500
Hip (surgery required /no surgery required) - Child: $10,000 / $5,000
Hip (surgery required /no surgery required) - Spouse: $10,000 / $5,000
Hip (surgery required /no surgery required) - Employee: $10,000 / $5,000
EMERGENCYDENTAL:
Emergency dental crown - Child: 200
Emergency dental crown - Spouse: 200
Emergency dental crown - Employee: 200
Emergency dental extraction) - Child: 65
Emergency dental extraction) - Spouse: 65
Emergency dental extraction) - Employee: 65
Wellness screening benefit (once per benefit year) - Child: 50
Wellness screening benefit (once per benefit year) - Spouse: 50
Wellness screening benefit (once per benefit year) - Employee: 50
MEDICALSERVICES:
Anesthesia - Child: 100
Anesthesia - Spouse: 100
Anesthesia - Employee: 100
Medical devices - Child: 500
Medical devices - Spouse: 500
Prosthesis (one) - Child: 750
Prosthesis (two) - Child: 1500
Prescription drug - Child: 50
Prosthesis (one) - Spouse: 750
Prosthesis (two) - Spouse: 1500
Medical devices - Employee: 500
Prescription drug - Spouse: 50
Prosthesis (one) - Employee: 750
Prosthesis (two) - Employee: 1500
Prescription drug - Employee: 50
Blood, plasma or platelet transfusion - Child: 200
Blood, plasma or platelet transfusion - Spouse: 200
Blood, plasma or platelet transfusion - Employee: 200
Epidural pain management (up to 2 times per covered accident) - Child: 100
Epidural pain management (up to 2 times per covered accident) - Spouse: 100
Epidural pain management (up to 2 times per covered accident) - Employee: 100
Diagnostic exam (one-time per benefit year): X-ray (once per covered accident) - Child: 100
Diagnostic exam (one-time per benefit year): X-ray (once per covered accident) - Spouse: 100
Diagnostic exam (one-time per benefit year): X-ray (once per covered accident) - Employee: 100
Physical and occupational therapy (per visit, up to 10 times per covered accident) - Child: 100
Physical and occupational therapy (per visit, up to 10 times per covered accident) - Spouse: 100
Physical and occupational therapy (per visit, up to 10 times per covered accident) - Employee: 100
Diagnostic exam (one-time per benefit year): Arteriogram, angiogram, CT, CAT, EKG, EEG or MRI - Child: 200
Diagnostic exam (one-time per benefit year): Arteriogram, angiogram, CT, CAT, EKG, EEG or MRI - Spouse: 200
Physician’s follow-up treatment office visit (per visit, up to 10 times per covered accident) - Child: 75
Diagnostic exam (one-time per benefit year): Arteriogram, angiogram, CT, CAT, EKG, EEG or MRI - Employee: 200
Physician’s follow-up treatment office visit (per visit, up to 10 times per covered accident) - Spouse: 75
Accident emergency treatment (non-ER or non-urgent care facility) (one time per covered accident) - Child: 150
Accident emergency treatment (non-ER or non-urgent care facility) (one time per covered accident) - Spouse: 150
Physician’s follow-up treatment office visit (per visit, up to 10 times per covered accident) - Employee: 75
Accident emergency treatment (non-ER or non-urgent care facility) (one time per covered accident) - Employee: 150
WELLNESSBENEFIT:
ACCIDENTALDISMEMBERMENT:
Loss of sight or loss of an eye — one eye - Child: 5000
Loss of sight or loss of an eye — one eye - Spouse: 10000
Loss of hearing or loss of an ear — one ear - Child: 5000
Loss of hearing or loss of an ear — one ear - Spouse: 10000
Loss of sight or loss of an eye — one eye - Employee: 10000
Loss of hearing or loss of an ear — one ear - Employee: 10000
Loss of a finger or loss of a toe — one finger or one toe - Child: 500
Loss of a finger or loss of a toe — one finger or one toe - Spouse: 1000
Loss of a finger or loss of a toe — one finger or one toe - Employee: 1000
Loss of a finger or loss of a toe — two or more fingers or toes - Child: 1500
Loss of a finger or loss of a toe — two or more fingers or toes - Spouse: 3000
Loss of a finger or loss of a toe — two or more fingers or toes - Employee: 3000
Loss of hand — one hand, Loss of foot — one foot, Loss of leg — one leg or loss of arm — one arm - Child: 10000
Loss of hand — one hand, Loss of foot — one foot, Loss of leg — one leg or loss of arm — one arm - Spouse: 10000
Loss of hand — one hand, Loss of foot — one foot, Loss of leg — one leg or loss of arm — one arm - Employee: 10000
LIFEANDDISMEMBERMENTLOSSES:
Accidental Death - Child: 25000
Accidental Death - Spouse: 50000
Accidental Death - Employee: 50000
Accidental Death Common Carrier (If a person wo is covered dies in an accident while riding a commercial vehicle, like a plane, train, bus, ferry, or subway, the insurance pays a larger benefit than a standard accidental death) - Child: 100000
Accidental Death Common Carrier (If a person wo is covered dies in an accident while riding a commercial vehicle, like a plane, train, bus, ferry, or subway, the insurance pays a larger benefit than a standard accidental death) -Spouse: 200000
Accidental Death Common Carrier (If a person wo is covered dies in an accident while riding a commercial vehicle, like a plane, train, bus, ferry, or subway, the insurance pays a larger benefit than a standard accidental death) - Employee: 200000
Catastrophic loss: loss of arm or loss of hand — both arms or both hands, loss of leg or loss of foot — both legs or both feet, loss of hand and loss of foot or loss of arm and loss of leg — one hand and one foot or one arm and one leg, loss of an ear — both ears, irrecoverable loss of hearing — both ears, loss of an eye — both eyes, irrecoverable loss of sight — both eyes, irrecoverable loss of speech or ability to speak, or any combination equaling two or more losses from: loss of arm, loss of hand, loss of leg, loss of foot, loss of an ear or loss of an eye - Child: 25000
Catastrophic loss: loss of arm or loss of hand — both arms or both hands, loss of leg or loss of foot — both legs or both feet, loss of hand and loss of foot or loss of arm and loss of leg — one hand and one foot or one arm and one leg, loss of an ear — both ears, irrecoverable loss of hearing — both ears, loss of an eye — both eyes, irrecoverable loss of sight — both eyes, irrecoverable loss of speech or ability to speak, or any combination equaling two or more losses from: loss of arm, loss of hand, loss of leg, loss of foot, loss of an ear or loss of an eye - Spouse: 25000
Catastrophic loss: loss of arm or loss of hand — both arms or both hands, loss of leg or loss of foot — both legs or both feet, loss of hand and loss of foot or loss of arm and loss of leg — one hand and one foot or one arm and one leg, loss of an ear — both ears, irrecoverable loss of hearing — both ears, loss of an eye — both eyes, irrecoverable loss of sight — both eyes, irrecoverable loss of speech or ability to speak, or any combination equaling two or more losses from: loss of arm, loss of hand, loss of leg, loss of foot, loss of an ear or loss of an eye - Employee: 25000

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rag/equitable_critical_illness_insurance_plan.txt
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PLAN: Equitable Critical Illness Insurance Plan
UID: Equitable Critical Illness Plan
Category: Critical Illness
Type: None
Marketing Name: Equitable Critical Illness Plan
Average Price: $43.02
Short Description: This plan pays a lump sum cash benefit if you're diagnosed with a covered critical illness, like cancer, heart attack, or stroke — helping you handle medical bills, lost income, or everyday expenses.
Long Description: The Equitable Critical Illness plan provides a one-time cash payment when you’re diagnosed with a serious condition such as cancer, heart attack, stroke, or organ failure. Benefits range from $10,000 to $40,000 for employees and their families and are paid directly to you — not to doctors or hospitals — so you can use them however you need: for medical bills, rent, groceries, or recovery time. The plan also includes recurrence benefits for repeat diagnoses and a wellness screening benefit that pays $50 annually when you complete eligible health screenings.
PRICING:
Coverage 4: $63.74
Coverage 3: $46.37
Coverage 2: $39.69
Coverage 1: $22.28
DETAILS:
BENEFITS:
Benefit Amount - Child: $5,000 minimum in $5,000 increments to a maximum of $20,000 Not to exceed 50% of the Employee Benefit
Benefit Amount - Spouse: $10,000 minimum in $10,000 increments to a maximum of $40,000 Not to exceed 100% of the Employee Benefit
Benefit Amount - Employee: $10,000 minimum to a maximum of $40,000 in $10,000 increments
COVERAGE:
Coma - Benefit Percentages: 100%
Stroke - Benefit Percentages: 100%
Blindness - Benefit Percentages: 100%
Paralysis - Benefit Percentages: 100%
Angioplasty - Benefit Percentages: 5%
Skin Cancer - Benefit Percentages: 5%
Severe Burns - Benefit Percentages: 100%
Hearrt Attack - Benefit Percentages: 100%
Cancer in Situ - Benefit Percentages: 25%
Loss of Speech - Benefit Percentages: 100%
Coma - Recurrence Benefit Percentages: 100%
Invasive Cancer - Benefit Percentages: 100%
Stroke - Recurrence Benefit Percentages: 100%
Benign Brain Tumor - Benefit Percentages: 100%
Major organ failure - Benefit Percentages: 100%
Blindness - Recurrence Benefit Percentages: N/A
Paralysis - Recurrence Benefit Percentages: 100%
Angioplasty - Recurrence Benefit Percentages: 5%
Coronary Artery Bypass - Benefit Percentages: 25%
Skin Cancer - Recurrence Benefit Percentages: 5%
End-stage heart failure - Benefit Percentages: 100%
Heart Attack - Recurrence Benefit Percentages: 100%
Severe Burns - Recurrence Benefit Percentages: 100%
Complete Loss of Hearing - Benefit Percentages: 100%
End-stage kidney disease - Benefit Percentages: 100%
Cancer in Situ - Recurrence Benefit Percentages: 25%
Loss of Speech - Recurrence Benefit Percentages: N/A
Invasive Cancer - Recurrence Benefit Percentages: 100%
Advanced Alzheimer's Disease- Benefit Percentages: 100%
Advanced Parkinson's Disease - Benefit Percentages: 100%
Benign Brain Tumor- Recurrence Benefit Percentages: 100%
Major organ failure - Recurrence Benefit Percentages: 100%
Occupational infectious disease - Benefit Percentages: 100%
Coronary Artery Bypass - Recurrence Benefit Percentages: 25%
End-stage heart failure - Recurrence Benefit Percentages: 100%
Advanced ALS/Lou Gehrig’s Disease - Benefit Percentages: 100%
Complete Loss of Hearing - Recurrence Benefit Percentages: N/A
End-stage kidney disease - Recurrence Benefit Percentages: 100%
Advanced Alzheimer's Disease - Recurrence Benefit Percentages: N/A
Advanced Parkinson's Disease - Recurrence Benefit Percentages: N/A
Occupational infectious disease - Recurrence Benefit Percentages: N/A
Advanced ALS/Lou Gehrig’s Disease - Recurrence Benefit Percentages: N/A
CHILDHOODSPECIFICDISEASES:
Lower jaw - Child: $1,500 / $750
Lower jaw - Spouse: $1,500 / $750
Lower jaw - Employee: $1,500 / $750
Finger(s) or toe(s) - Child: $1,000 / $500
Finger(s) or toe(s) - Spouse: $1,000 / $500
Incomplete dislocation - Child: 25% of the applicable non -surgical procedure
Incomplete dislocation - Spouse: 25% of the applicable non -surgical procedure
Incomplete dislocation - Employee: 25% of the applicable non -surgical procedure
Spina Bifida - Benefit Percentages: 100%
Down Syndrome - Benefit Percentages: 100%
Cerebral Palsy - Benefit Percentages: 100%
Cystic Fibrosis - Benefit Percentages: 100%
Cleft Lip/Palate - Benefit Percentages: 100%
Muscular Dystrophy - Benefit Percentages: 100%
Spina Bifida - Recurrence Benefit Percentages: N/A
Down Syndrome - Recurrence Benefit Percentages: N/A
Type 1 Diabetes Mellitus - Benefit Percentages: 100%
Cerebral Palsy - Recurrence Benefit Percentages: N/A
Cystic Fibrosis - Recurrence Benefit Percentages: N/A
Cleft Lip/Palate - Recurrence Benefit Percentages: N/A
Muscular Dystrophy - Recurrence Benefit Percentages: N/A
Complex Congenital Heart Disease - Benefit Percentages: 100%
Type 1 Diabetes Mellitus - Recurrence Benefit Percentages: N/A
Complex Congenital Heart Disease - Recurrence Benefit Percentages: N/A

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rag/equitable_dental_plan.txt
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PLAN: Equitable Dental Plan
UID: Equitable Dental Plan
Category: Dental
Type: None
Marketing Name: Equitable Dental
Average Price: $65.64
Short Description: A flexible PPO dental plan with coverage for preventive, basic, and major services, plus child orthodontia in higher tiers. Choose any dentist, with the best savings in-network.
Long Description: The Equitable Dental PPO Plan offers comprehensive dental coverage with access to both in-network and out-of-network providers. Preventive care is covered at 100% across all tiers, while basic and major services are covered at varying coinsurance levels depending on the plan tier (Low, Mid, or High). Annual benefit maximums range from $1,000 to $3,000, and child orthodontia is included in the Mid and High plans. In-network providers offer significant savings through discounted contracted rates, giving members flexibility and value.
PRICING:
Coverage 4: $103.18
Coverage 3: $75.62
Coverage 2: $55.68
Coverage 1: $28.11
DETAILS:
COVERAGE:
Coinsurance - In Network: 100% – Preventive care (like cleanings, exams, and X-rays).80% – Basic care (like fillings and simple extractions).50% – Major care (like crowns, dentures, and root canals).
Coinsurance - Out of Network: 100% – Preventive care (like cleanings, exams, and X-rays).80% – Basic care (like fillings and simple extractions).50% – Major care (like crowns, dentures, and root canals).
Missing Tooth Clause - In Network: Pre-existing missing teeth not covered
Missing Tooth Clause - Out ofNetwork: Pre-existing missing teeth not covered
Annual Individual Maxium Benefit - In Network: 1000
Annual Individual Maxium Benefit - Out of Network: 1000
Annual Individual / Family Deductible - In Network: $50 deductible per person For a family, you only have to pay it for 3 people max (so $150 total), even if more are covered and preventive services are free.
Annual Individual / Family Deductible - Out of Network: $50 deductible per person For a family, you only have to pay it for 3 people max (so $150 total), even if more are covered and preventive services are free.
Reimbursement (how much the insurance company pays thef or care) - In Network: Agreed Rate
Reimbursement (how much the insurance company pays thef or care) - Out of Network: Fixed Coverage Amount
Alternative Benefit (If two treatments would fix the problem, the plan pays for the less expensive one) - In Network: Included
Alternative Benefit (If two treatments would fix the problem, the plan pays for the less expensive one) - Out of Network: Included
BASICSERVICES:
Simple Extractions - In Network: 80%
Simple Extractions - Out of Network: 80%
Periodontal Maintenance - In Network: 80%
Periodontal Maintenance - Out of Network: 80%
Emergency Palliative Treatment - In Network: 80%
Complete Series/ Panoramic X-Rays - In Network: 80%
Emergency Palliative Treatment - Out of Network: 80%
Complete Series/ Panoramic X-Rays - Out of Network: 80%
Basic Restorative Services (amalgam, composite resin, acrylic, synthetic or plastic fillings) - In Network: 80%
Basic Restorative Services (amalgam, composite resin, acrylic, synthetic or plastic fillings) - Out of Network: 80%
MAJORSERVICES:
Bridges - In Network: 50%
Bridges - Out of Network: 50%
Oral Surgery - In Network: 50%
Bitewing X-Rays - In Network: 50%
Oral Surgery - Out of Network: 50%
Bitewing X-Rays - Out of Network: 50%
Periodontal Surgery - In Network: 50%
Inlays/Onlays/Crowns - In Network: 50%
Surgical Endodontics - In Network: 50%
Periodontal Surgery - Out of Network: 50%
Inlays/Onlays/Crowns - Out of Network: 50%
Non-Surgical Endodontics - In Network: 50%
Non-Surgical Periodontal - In Network: 50%
Surgical Endodontics - Out of Network: 50%
Non-Surgical Endodontics - Out of Network: 50%
Non-Surgical Periodontal - Out of Network: 50%
Surgical Extractions and Removal of Impacted Teeth - In Network: 80%
Surgical Extractions and Removal of Impacted Teeth - Out of Network: 50%
Dentures – complete, partial, overdenture (upper and lower) - In Network: 50%
Dentures – complete, partial, overdenture (upper and lower) - Out of Network: 50%
PREVENTIVESERVICES:
Periodic Oral Evaluation - In Network: 100%
Periodic Oral Evaluation - Out of Network: 100%
Comprehensive Oral Evaluation - In Network: 100%
Comprehensive Oral Evaluation - Out of Network: 100%
Limited Oral Evaluation (problem focused) - In Network: 100%
Limited Oral Evaluation (problem focused) - Out of Network: 100%

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rag/equitable_dental_plan_class_1.txt
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PLAN: Equitable Dental Plan - Class 1
UID: Equitable Dental Plan - Class 1
Category: Dental
Type: None
Marketing Name: Equitable Dental - Class 1
Average Price: $65.64
Short Description: Essential dental coverage for preventive care including exams, cleanings, and X-rays. Great for maintaining a healthy smile on a budget.
Long Description: The Class I dental plan offers essential preventive coverage designed to help you maintain good oral health. This includes 100% coverage (in-network) for routine exams, cleanings, and bitewing X-rays twice per year, with no deductible. It’s an affordable way to stay proactive with your dental care and avoid unexpected issues.
PRICING:
Coverage 1: $28.11
Coverage 2: $55.68
Coverage 3: $75.62
Coverage 4: $103.18
DETAILS:
COVERAGE:
Coinsurance - In Network: 100% – Preventive care (like cleanings, exams, and X-rays).80% – Basic care (like fillings and simple extractions).50% – Major care (like crowns, dentures, and root canals).
Coinsurance - Out of Network: 100% – Preventive care (like cleanings, exams, and X-rays). 80% – Basic care (like fillings and simple extractions). 50% – Major care (like crowns, dentures, and root canals).
Missing Tooth Clause - In Network: Pre-existing missing teeth not covered
Missing Tooth Clause - Out ofNetwork: Pre-existing missing teeth not covered
Annual Individual Maxium Benefit - In Network: 1000
Annual Individual Maxium Benefit - Out of Network: 1000
Annual Individual / Family Deductible - In Network: $50 deductible per person For a family, you only have to pay it for 3 people max (so $150 total), even if more are covered and preventive services are free.
Annual Individual / Family Deductible - Out of Network: $50 deductible per person For a family, you only have to pay it for 3 people max (so $150 total), even if more are covered and preventive services are free.
Reimbursement (how much the insurance company pays thef or care) - In Network: Agreed Rate
Reimbursement (how much the insurance company pays thef or care) - Out of Network: Fixed Coverage Amount
Alternative Benefit (If two treatments would fix the problem, the plan pays for the less expensive one) - In Network: Included
Alternative Benefit (If two treatments would fix the problem, the plan pays for the less expensive one) - Out of Network: Included
BASICSERVICES:
Simple Extractions - In Network: 80%
Simple Extractions - Out of Network: 80%
Periodontal Maintenance - In Network: 80%
Periodontal Maintenance - Out of Network: 80%
Emergency Palliative Treatment - In Network: 80%
Complete Series/ Panoramic X-Rays - In Network: 80%
Emergency Palliative Treatment - Out of Network: 80%
Complete Series/ Panoramic X-Rays - Out of Network: 80%
Basic Restorative Services (amalgam, composite resin, acrylic, synthetic or plastic fillings) - In Network: 80%
Basic Restorative Services (amalgam, composite resin, acrylic, synthetic or plastic fillings) - Out of Network: 80%
MAJORSERVICES:
Bridges - In Network: 50%
Bridges - Out of Network: 50%
Oral Surgery - In Network: 50%
Bitewing X-Rays - In Network: 50%
Oral Surgery - Out of Network: 50%
Bitewing X-Rays - Out of Network: 50%
Periodontal Surgery - In Network: 50%
Inlays/Onlays/Crowns - In Network: 50%
Surgical Endodontics - In Network: 50%
Periodontal Surgery - Out of Network: 50%
Inlays/Onlays/Crowns - Out of Network: 50%
Non-Surgical Endodontics - In Network: 50%
Non-Surgical Periodontal - In Network: 50%
Surgical Endodontics - Out of Network: 50%
Non-Surgical Endodontics - Out of Network: 50%
Non-Surgical Periodontal - Out of Network: 50%
Surgical Extractions and Removal of Impacted Teeth - In Network: 80%
Surgical Extractions and Removal of Impacted Teeth - Out of Network: 50%
Dentures – complete, partial, overdenture (upper and lower) - In Network: 50%
Dentures – complete, partial, overdenture (upper and lower) - Out of Network: 50%
PREVENTIVESERVICES:
Periodic Oral Evaluation - In Network: 100%
Periodic Oral Evaluation - Out of Network: 100%
Comprehensive Oral Evaluation - In Network: 100%
Comprehensive Oral Evaluation - Out of Network: 100%
Limited Oral Evaluation (problem focused) - In Network: 100%
Limited Oral Evaluation (problem focused) - Out of Network: 100%

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rag/equitable_dental_plan_class_2.txt
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PLAN: Equitable Dental Plan - Class 2
UID: Equitable Dental Plan - Class 2
Category: Dental
Type: None
Marketing Name: Equitable Dental - Class2
Average Price: $77.90
Short Description: Expanded dental coverage including preventive and basic restorative services like fillings and extractions.
Long Description: The Class II dental plan builds on the preventive care of Class I and adds basic restorative services such as fillings, simple extractions, and emergency treatment for pain relief. Preventive services are covered at 100% in-network, and basic services are covered at 80% after a $50 annual deductible. This plan is ideal if you want broader protection and help managing more than just routine dental care.
PRICING:
Coverage 1: $32.87
Coverage 2: $65.12
Coverage 3: $90.68
Coverage 4: $122.93
DETAILS:
COVERAGE:
Coinsurance - In Network: 100% – Preventive care (like cleanings, exams, and X-rays).80% – Basic care (like fillings and simple extractions).50% – Major care (like crowns, dentures, and root canals).
Coinsurance - Out of Network: 100% – Preventive care (like cleanings, exams, and X-rays). 80% – Basic care (like fillings and simple extractions). 50% – Major care (like crowns, dentures, and root canals).
Missing Tooth Clause - In Network: Pre-existing missing teeth not covered
Missing Tooth Clause - Out ofNetwork: Pre-existing missing teeth not covered
Annual Individual Maxium Benefit - In Network: 2000
Annual Individual Maxium Benefit - Out of Network: 2000
Annual Individual / Family Deductible - In Network: $50 deductible per person For a family, you only have to pay it for 3 people max (so $150 total), even if more are covered and preventive services are free.
Annual Individual / Family Deductible - Out of Network: $50 deductible per person For a family, you only have to pay it for 3 people max (so $150 total), even if more are covered and preventive services are free.
Reimbursement (how much the insurance company pays thef or care) - In Network: Agreed Rate
Reimbursement (how much the insurance company pays thef or care) - Out of Network: Fixed Coverage Amount
Alternative Benefit (If two treatments would fix the problem, the plan pays for the less expensive one) - In Network: Included
Alternative Benefit (If two treatments would fix the problem, the plan pays for the less expensive one) - Out of Network: Included
BASICSERVICES:
Simple Extractions - In Network: 80%
Simple Extractions - Out of Network: 80%
Periodontal Maintenance - In Network: 80%
Periodontal Maintenance - Out of Network: 80%
Emergency Palliative Treatment - In Network: 80%
Complete Series/ Panoramic X-Rays - In Network: 80%
Emergency Palliative Treatment - Out of Network: 80%
Complete Series/ Panoramic X-Rays - Out of Network: 80%
Basic Restorative Services (amalgam, composite resin, acrylic, synthetic or plastic fillings) - In Network: 80%
Basic Restorative Services (amalgam, composite resin, acrylic, synthetic or plastic fillings) - Out of Network: 80%
MAJORSERVICES:
Bridges - In Network: 50%
Bridges - Out of Network: 50%
Oral Surgery - In Network: 50%
Bitewing X-Rays - In Network: 50%
Oral Surgery - Out of Network: 50%
Bitewing X-Rays - Out of Network: 50%
Periodontal Surgery - In Network: 50%
Inlays/Onlays/Crowns - In Network: 50%
Surgical Endodontics - In Network: 50%
Periodontal Surgery - Out of Network: 50%
Inlays/Onlays/Crowns - Out of Network: 50%
Non-Surgical Endodontics - In Network: 50%
Non-Surgical Periodontal - In Network: 50%
Surgical Endodontics - Out of Network: 50%
Non-Surgical Endodontics - Out of Network: 50%
Non-Surgical Periodontal - Out of Network: 50%
Surgical Extractions and Removal of Impacted Teeth - In Network: 80%
Surgical Extractions and Removal of Impacted Teeth - Out of Network: 50%
Dentures – complete, partial, overdenture (upper and lower) - In Network: 50%
Dentures – complete, partial, overdenture (upper and lower) - Out of Network: 50%
PREVENTIVESERVICES:
Periodic Oral Evaluation - In Network: 100%
Periodic Oral Evaluation - Out of Network: 100%
Comprehensive Oral Evaluation - In Network: 100%
Comprehensive Oral Evaluation - Out of Network: 100%
Limited Oral Evaluation (problem focused) - In Network: 100%
Limited Oral Evaluation (problem focused) - Out of Network: 100%

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rag/equitable_hospital_indemnity_high_plan.txt
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PLAN: Equitable Hospital Indemnity - High Plan
UID: Equitable Hospital Indemnity - High Plan
Category: Hospital Indemnity
Type: None
Marketing Name: Equitable Hospital Indemnity Benefit - High Plan
Average Price: $87.01
Short Description: Enhanced coverage with higher daily payments and stronger support for ICU stays, emergencies, and family-related travel.
Long Description: The High Hospital Indemnity Plan offers more robust protection for serious medical events. It pays $2,000 for the first day in the hospital, $300 per day for regular stays, and $500 per day in the ICU—plus enhanced benefits for maternity, rehabilitation, wellness screenings, accident-related ER visits, and well-baby nursery care. It also includes increased reimbursements for family lodging, transportation, and caregiving expenses. This plan is ideal for those seeking greater peace of mind when facing potential hospital-related costs.
PRICING:
Coverage 1: $45.65
Coverage 2: $96.54
Coverage 3: $77.48
Coverage 4: $128.37
DETAILS:
BENEFITS:
Daily Lodging - Benefit Amount: $200, up to 5 days per year
Daily Family Care - Benefit Amount: $200, up to 5 days per year
First Day Hospital - Benefit Amount: $2,000, once a per year
Daily Transportation - Benefit Amount: $200, up to 5 days per year
Annual Wellness Screening - Benefit Amount: $50, once per year per insured
Daily Hospital Confinement - Benefit Amount: $300, up to 31 days per year
Daily Hospital ICU Confinement - Benefit Amount: $500, up to 10 days per year
Daily Hospital Rehabilitation Unit - Benefit Amount: $100, up to 60 days per year
Daily Well Baby Nursery Confinement - Benefit Amount: $200, up to 60 days per year
Emergency Room Treatment (accident only) - Benefit Amount: 200
First Day Hospital Intensive Care Unit (ICU) Confinement - Benefit Amount: $4,000, once a per year

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rag/equitable_hospital_indemnity_insurance.txt
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PLAN: Equitable Hospital Indemnity Insurance
UID: Equitable Hospital Indemnity
Category: Hospital Indemnity
Type: None
Marketing Name: Equitable Hospital Indemnity Benefit Plan
Average Price: $46.06
Short Description: This plan pays you cash for hospital stays and related treatments — helping with expenses like deductibles, rent, or groceries while you recover.
Long Description: The Equitable Hospital Indemnity plan provides a fixed cash benefit when you’re admitted to the hospital, ICU, rehab unit, or emergency room. It pays set amounts per day or per event, regardless of what your medical bills cost. You can use the money however you need — for medical bills, housing, transportation, or everyday expenses. The plan also includes wellness screening rewards and coverage for family care, lodging, and travel. It’s a simple way to add financial protection during unexpected hospitalizations.
PRICING:
Coverage 4: $68.69
Coverage 3: $41.62
Coverage 2: $51.51
Coverage 1: $22.44
DETAILS:
BENEFITS:
Daily Lodging - Benefit Amount: $100, up to 5 days per year
Daily Family Care - Benefit Amount: $100, up to 5 days per year
First Day Hospital - Benefit Amount: $1,000, once a per year
Daily Transportation - Benefit Amount: $100, up to 5 days per year
Annual Wellness Screening - Benefit Amount: $50, once per year per insured
Daily Hospital Confinement - Benefit Amount: $200, up to 31 days per year
Daily Hospital ICU Confinement - Benefit Amount: $400, up to 10 days per year
Daily Hospital Rehabilitation Unit - Benefit Amount: $50, up to 60 days per year
Daily Well Baby Nursery Confinement - Benefit Amount: $50, up to 60 days per year
Emergency Room Treatment (accident only) - Benefit Amount: 100
First Day Hospital Intensive Care Unit (ICU) Confinement - Benefit Amount: $2,000, once a per year

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rag/equitable_hospital_indemnity_low_plan.txt
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PLAN: Equitable Hospital Indemnity - Low Plan
UID: Equitable Hospital Indemnity - Low Plan
Category: Hospital Indemnity
Type: None
Marketing Name: Equitable Hospital Indemnity Benefit - Low Plan
Average Price: $46.06
Short Description: Helps cover basic out-of-pocket costs during a hospital stay, including daily payments, wellness screenings, and accident-related ER visits.
Long Description: The Low Hospital Indemnity Plan provides essential financial protection in the event of a hospital stay. It pays you a fixed amount per day you’re hospitalized—including $1,000 for your first hospital day, $200 per day for regular stays, and $400 per day for ICU stays. Additional benefits include wellness screening payouts, emergency accident coverage, and limited support for lodging, transportation, and family care. This plan offers a straightforward safety net for medical-related interruptions without deductibles or networks.
PRICING:
Coverage 1: $22.44
Coverage 2: $51.51
Coverage 3: $41.62
Coverage 4: $68.69
DETAILS:
BENEFITS:
Daily Lodging - Benefit Amount: $100, up to 5 days per year
Daily Family Care - Benefit Amount: $100, up to 5 days per year
First Day Hospital - Benefit Amount: $1,000, once a per year
Daily Transportation - Benefit Amount: $100, up to 5 days per year
Annual Wellness Screening - Benefit Amount: $50, once per year per insured
Daily Hospital Confinement - Benefit Amount: $200, up to 31 days per year
Daily Hospital ICU Confinement - Benefit Amount: $400, up to 10 days per year
Daily Hospital Rehabilitation Unit - Benefit Amount: $50, up to 60 days per year
Daily Well Baby Nursery Confinement - Benefit Amount: $100, up to 60 days per year
Emergency Room Treatment (accident only) - Benefit Amount: 100
First Day Hospital Intensive Care Unit (ICU) Confinement - Benefit Amount: $2,000, once a per year

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rag/guardian_vision_full_feature_insurance_plan.txt
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PLAN: Guardian Vision Full Feature Insurance Plan
UID: Guardian Vision Plan
Category: Vision
Type: None
Marketing Name: Guardian Full Feature Vision Plan
Average Price: $24.30
Short Description: A comprehensive vision plan that covers annual eye exams, glasses or contact lenses, and offers big savings when you visit in-network providers.
Long Description: The Guardian Vision Plan helps keep your eyes healthy and your vision clear with coverage for routine eye exams, prescription lenses, frames, and contacts. You'll save the most when using in-network providers, with fixed copays and generous allowances. Whether you wear glasses or contacts, the plan supports both comfort and affordability — with optional discounts on LASIK and other services.
PRICING:
Coverage 4: $36.83
Coverage 3: $25.35
Coverage 2: $23.50
Coverage 1: $11.53
DETAILS:
COVERAGE:
Exams Copay: 10
Frames - In Network: You pay 80% of the cost of the frames over $150*
Frames - Out of Network: You pay (after your copay) any amount over $46
Lenticular - In Network: 0
Lenticular - Out of Network: You pay (after your copay) any amount over $64
Cosmetic Extras - In Network: You'll save an average of 20-25% off the retail price
Eye Exam Covereage - In Network: 0
Cosmetic Extras - Out of Network: No out of network discounts
Lined Bifocal Lenses - In Network: 0
Lined Trifocal Lenses - In Network: 0
Single Vision Lenses - In Network: 0
Eye Exam Covereage - Out of Network: Amount over $39
Contact Lense (elective) - In Network: You pay (after your copay) any amount over $150
Lined Bifocal Lenses - Out of Network: You pay (after your copay) any amount over $23
Single Vision Lenses - Out of Network: You pay (after your copay) any amount over $39
Lined Trifocal Lenses - Out of Network: You pay (after your copay) any amount over $37
Contact Lenses (elective) - Out of Network: You pay (after your copay) any amount over $100
Materials Copay (waived for contact lenses): 10
Laser Correction Surgery Discount - In Network: You'll save up to 15% off the usual charge or 5% off a promotional price
Contact Lenses (medically necessary) - In Network: 0
Laser Correction Surgery Discount - Out of Network: No out of network discounts
Contact Lenses (evaluation and fitting) - In Network: The plan will pay up to $60
Contact Lenses (medically necessary) - Out of Network: You pay (after your copay) any amount over $210
Contact Lenses (evaluation and fitting) - Out of Network: Not Applicable
Costco, Walmart, and Sam's Club Frame Allowance- In Network: You pay (after your copay) any amount over $80
Glasses (additional pari of frames and lenses) - In Network: You'll save 20% off the retail price**
Glasses (additional pari of frames and lenses) - Out of Network: No out of network discounts
BASICSERVICES:
Simple Extractions - In Network: 80%
Simple Extractions - Out of Network: 80%
Periodontal Maintenance - In Network: 80%
Periodontal Maintenance - Out of Network: 80%
Emergency Palliative Treatment - In Network: 80%
Complete Series/ Panoramic X-Rays - In Network: 80%
Emergency Palliative Treatment - Out of Network: 80%
Complete Series/ Panoramic X-Rays - Out of Network: 80%
Basic Restorative Services (amalgam, composite resin, acrylic, synthetic or plastic fillings) - In Network: 80%
Basic Restorative Services (amalgam, composite resin, acrylic, synthetic or plastic fillings) - Out of Network: 80%
MAJORSERVICES:
Bridges - In Network: 50%
Bridges - Out of Network: 50%
Oral Surgery - In Network: 50%
Bitewing X-Rays - In Network: 50%
Oral Surgery - Out of Network: 50%
Bitewing X-Rays - Out of Network: 50%
Periodontal Surgery - In Network: 50%
Inlays/Onlays/Crowns - In Network: 50%
Surgical Endodontics - In Network: 50%
Periodontal Surgery - Out of Network: 50%
Inlays/Onlays/Crowns - Out of Network: 50%
Non-Surgical Endodontics - In Network: 50%
Non-Surgical Periodontal - In Network: 50%
Surgical Endodontics - Out of Network: 50%
Non-Surgical Endodontics - Out of Network: 50%
Non-Surgical Periodontal - Out of Network: 50%
Surgical Extractions and Removal of Impacted Teeth - In Network: 50%
Surgical Extractions and Removal of Impacted Teeth - Out of Network: 50%
Dentures – complete, partial, overdenture (upper and lower) - In Network: 50%
Dentures – complete, partial, overdenture (upper and lower) - Out of Network: 50%
SERVICEFREQUENCIES:
Exams: Every calendar year
Frames: Every calendar year
Lenses (for glasses or contact lenses)***: Every calendar year
Comprehensive Oral Evaluation - In Network: No limit with 12 months of exam
Comprehensive Oral Evaluation - Out of Network: 100%
Network Discounts (glasses and contact lens professional service): Every calendar year

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# Insurance Plan Processor Cron Setup
This directory contains scripts for running the insurance plan processor as a scheduled task.
## Files
- `run_insurance_processor.sh` - Main script to run the insurance plan processor from within the Docker container
## Setup Instructions
### 1. Test the Script
First, test that the script works correctly:
```bash
./scripts/run_insurance_processor.sh
```
### 2. Set up Cron Job
Add a cron job to run the script at your desired interval. For example, to run it daily at 2 AM:
```bash
# Open crontab for editing
crontab -e
# Add one of these lines depending on your needs:
# Run daily at 2 AM
0 2 * * * /path/to/lolly-ai/scripts/run_insurance_processor.sh
# Run every 6 hours
0 */6 * * * /path/to/lolly-ai/scripts/run_insurance_processor.sh
# Run every hour
0 * * * * /path/to/lolly-ai/scripts/run_insurance_processor.sh
# Run every 30 minutes
*/30 * * * * /path/to/lolly-ai/scripts/run_insurance_processor.sh
```
### 3. Verify Cron Job
Check that your cron job was added correctly:
```bash
crontab -l
```
### 4. Monitor Logs
The script creates logs in the `logs/` directory:
- `logs/insurance_processor.log` - General execution logs
- `logs/insurance_processor_error.log` - Error logs
Monitor these files to ensure the script is running correctly:
```bash
# View recent logs
tail -f logs/insurance_processor.log
# View error logs
tail -f logs/insurance_processor_error.log
```
## Prerequisites
- Docker Compose must be running with the `lolly-ai` service
- The `.env` file must be properly configured with API keys
- The script must have execute permissions (`chmod +x scripts/run_insurance_processor.sh`)
## Troubleshooting
### Common Issues
1. **Docker service not running**: The script checks if the Docker Compose service is running and will log an error if it's not.
2. **Permission denied**: Make sure the script is executable:
```bash
chmod +x scripts/run_insurance_processor.sh
```
3. **Path issues**: Make sure to use the full path to the script in your cron job.
4. **Environment variables**: The script uses the `.env` file from the project directory, so make sure it's properly configured.
### Debugging
To debug cron issues, you can temporarily run the script manually and check the logs:
```bash
# Run manually
./scripts/run_insurance_processor.sh
# Check logs
cat logs/insurance_processor.log
cat logs/insurance_processor_error.log
```
## Cron Schedule Examples
| Schedule | Description |
|----------|-------------|
| `0 2 * * *` | Daily at 2 AM |
| `0 */6 * * *` | Every 6 hours |
| `0 * * * *` | Every hour |
| `*/30 * * * *` | Every 30 minutes |
| `0 2 * * 1` | Every Monday at 2 AM |
| `0 2 1 * *` | First day of each month at 2 AM |

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#!/bin/bash
# Insurance Plan Processor Cron Script
# This script runs the insurance plan processor from within the Docker container
# Set script directory
SCRIPT_DIR="$(cd "$(dirname "${BASH_SOURCE[0]}")" && pwd)"
PROJECT_DIR="$(dirname "$SCRIPT_DIR")"
# Log file for cron output
LOG_FILE="$PROJECT_DIR/logs/insurance_processor.log"
ERROR_LOG_FILE="$PROJECT_DIR/logs/insurance_processor_error.log"
# Create logs directory if it doesn't exist
mkdir -p "$(dirname "$LOG_FILE")"
# Function to log messages
log_message() {
echo "$(date '+%Y-%m-%d %H:%M:%S') - $1" | tee -a "$LOG_FILE"
}
log_error() {
echo "$(date '+%Y-%m-%d %H:%M:%S') - ERROR: $1" | tee -a "$ERROR_LOG_FILE"
}
# Log start of execution
log_message "Starting insurance plan processor..."
# Check if Docker Compose is running
if ! docker compose ps --services --filter "status=running" | grep -q "lolly-api"; then
log_error "Docker Compose service 'lolly-api' is not running"
exit 1
fi
# Change to project directory
cd "$PROJECT_DIR" || {
log_error "Failed to change to project directory: $PROJECT_DIR"
exit 1
}
# Run the insurance plan processor
log_message "Executing insurance plan processor..."
if docker compose exec -T lolly-api uv run python ./src/insurance_plan_processor.py; then
log_message "Insurance plan processor completed successfully"
exit 0
else
log_error "Insurance plan processor failed with exit code $?"
exit 1
fi

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#!/usr/bin/env python3
"""
Insurance Plan Processor
This script fetches insurance plans from the API endpoint and processes them through the RAG system.
Each plan is parsed into a dictionary and sent to the RAG processing endpoint.
"""
import json
import httpx
import time
from typing import Dict, List, Any
import logging
from config import settings
# Configure logging
logging.basicConfig(level=logging.INFO, format='%(asctime)s - %(levelname)s - %(message)s')
logger = logging.getLogger(__name__)
class InsurancePlanProcessor:
def __init__(self, talestorm_api_base: str, api_key: str):
"""
Initialize the processor.
Args:
talestorm_api_base: Base URL of the Talestorm API (e.g., "http://localhost:8000")
api_key: API key for authentication
"""
self.talestorm_api_base = talestorm_api_base.rstrip('/')
self.api_key = api_key
self.client = httpx.Client(
headers={
'X-API-Key': api_key
}
)
def fetch_insurance_plans(self) -> List[Dict[str, Any]]:
"""
Fetch insurance plans from the API endpoint.
Returns:
List of insurance plan dictionaries
"""
url = "https://api-virgil.liambo.ai/insurance/plans/full"
try:
logger.info("Fetching insurance plans from API...")
response = self.client.get(url)
response.raise_for_status()
plans = response.json()
logger.info(f"Successfully fetched {len(plans)} insurance plans")
return plans
except httpx.RequestError as e:
logger.error(f"Error fetching insurance plans: {e}")
raise
def process_plan_to_rag(self, plan: Dict[str, Any]) -> bool:
"""
Process a single insurance plan through the RAG endpoint.
Args:
plan: Insurance plan dictionary
Returns:
True if successful, False otherwise
"""
try:
# Convert plan to JSON string
plan_json = json.dumps(plan, indent=2)
plan_name = f"insurance_plan_{plan.get('name', 'unnamed').replace(' ', '_')}"
# Create a file-like object for the upload
import io
file_data = io.BytesIO(plan_json.encode('utf-8'))
# Prepare the multipart form data with proper file format
files = {
'file': (f'{plan_name}.txt', file_data, 'text/plain')
}
# Ensure file pointer is at the beginning
file_data.seek(0)
# Add the plan name as a parameter
data = {
'name': plan_name
}
# Send to RAG processing endpoint
url = f"{self.talestorm_api_base}/rag/process?name={plan_name}"
logger.info(f"Processing plan: {plan_name}")
# Send multipart form data
response = self.client.post(
url,
files=files,
timeout=60.0
)
if response.status_code == 200:
result = response.json()
logger.info(f"Successfully processed plan {plan.get('name', 'Unknown')} - Document name: {result.get('name', 'Unknown')} - {result.get('chunks_count', 0)} chunks created")
return True
else:
logger.error(f"Failed to process plan {plan.get('name', 'Unknown')}: {response.status_code} - {response.text}")
return False
except Exception as e:
logger.error(f"Error processing plan {plan.get('name', 'Unknown')}: {e}")
return False
finally:
# Reset file pointer for potential reuse
file_data.seek(0)
def process_all_plans(self, delay_between_requests: float = 1.0) -> Dict[str, int]:
"""
Process all insurance plans through the RAG system.
Args:
delay_between_requests: Delay in seconds between processing requests
Returns:
Dictionary with processing statistics
"""
try:
# Fetch all plans
plans = self.fetch_insurance_plans()
if not plans:
logger.warning("No insurance plans found")
return {'total': 0, 'successful': 0, 'failed': 0}
successful = 0
failed = 0
logger.info(f"Starting to process {len(plans)} insurance plans...")
for i, plan in enumerate(plans, 1):
logger.info(f"Processing plan {i}/{len(plans)}: {plan.get('name', 'Unknown')}")
if self.process_plan_to_rag(plan):
successful += 1
else:
failed += 1
# Add delay between requests to avoid overwhelming the server
if i < len(plans): # Don't delay after the last request
time.sleep(delay_between_requests)
stats = {
'total': len(plans),
'successful': successful,
'failed': failed
}
logger.info(f"Processing complete! {successful} successful, {failed} failed out of {len(plans)} total plans")
return stats
except Exception as e:
logger.error(f"Error in process_all_plans: {e}")
raise
finally:
# Close the client
self.client.close()
def main():
"""
Main function to run the insurance plan processor.
"""
import sys
# Configuration from config.py
TALESTORM_API_BASE = settings.TALESTORM_API_BASE_URL
API_KEY = settings.TALESTORM_API_KEY
DELAY_BETWEEN_REQUESTS = float(getattr(settings, 'DELAY_BETWEEN_REQUESTS', '1.0'))
try:
# Create processor instance
processor = InsurancePlanProcessor(TALESTORM_API_BASE, API_KEY)
# Process all plans
stats = processor.process_all_plans(delay_between_requests=DELAY_BETWEEN_REQUESTS)
# Print final statistics
print("\n" + "="*50)
print("PROCESSING SUMMARY")
print("="*50)
print(f"Total plans processed: {stats['total']}")
print(f"Successful: {stats['successful']}")
print(f"Failed: {stats['failed']}")
print(f"Success rate: {(stats['successful']/stats['total']*100):.1f}%" if stats['total'] > 0 else "No plans processed")
print("="*50)
if stats['failed'] > 0:
sys.exit(1)
except Exception as e:
logger.error(f"Script failed: {e}")
sys.exit(1)
if __name__ == "__main__":
main()