Medical Benefits

Section 125
The Villages, Inc. will continue to offer a Section 125 which allows employees to pay their portion of medical, dental, vision and AFLAC payroll deductions on a PRETAX basis. While you will see the total amount deducted from your payroll check, the NET amount of your check should increase as those deductions will be made prior to deducting federal and state taxes. Our plan will consider that all employees with payroll deductions are participating unless they sign a waiver. The plan year is April 1, 2025 to March 31, 2026. You will automatically have payroll deductions taken on a pretax basis unless you request and sign a waiver form.

	In-Network
Deductible (Individual/Family)	$1,500/$3,000
Member Coinsurance	20%
Out-of-Pocket Maximum (Individual/Family)	$5,000/$10,000
Preventive Care	Covered 100%
Primary Care Visit	$35 Copay
Specialist Visit	$70 Copay
Telemedicine	Office Visits: Covered 100% All Other Services: applicable cost-sharing
Urgent Care	$70 Copay (Applicable to provider type - Specialist or Primary Care)
Emergency Room	$250 Copay, then Deductible, then Coinsurance
Inpatient Hospital	Deductible, then Coinsurance
Outpatient Surgery	Deductible, then Coinsurance

Prescription Drugs
Tier 1	$15
Tier 2	$50
Tier 3	$75
Tier 4	$150
Specialty	20% Up to $250
Mail Order Drugs	2.5 x Retail Copay (90 Day Supply)

Rates	Total Monthly Cost	The Villages Monthly Contribution	Employee Monthly Cost
Employee Only	$949.54	$849.54	$100.00
Employee + Spouse	$2,039.74	$1,705.87	$333.87
Employee + Child(ren)	$1,922.47	$1,580.59	$341.88
Employee + Family	$3,012.66	$2,442.60	$570.06