Individuals & Families

Gold Copay

Short Summary

Gold level plan offers the lowest deductible and out of pocket expenses with first dollar copays for many benefits.

Key Benefits

• Primary Care Office Visits- $25 copay/visit ded waived
• Specialist Office Visits- $40 copay/visit ded waived
• Urgent Care- $65 copay/visit ded waived
• Standard Plan Coinsurance- 15%

Deductible

$1,500/$3,000

Out-of-Pocket Maximum

$7,000/$14,000

Silver Copay

Short Summary

Silver level plan offers a mid level deductible and out of pocket maximum with first dollar copays for many benefits

Key Benefits

• Primary Care Office Visits- $30 copay/visit ded waived
• Specialist Office Visits- $70 copay/visit ded waived
• Urgent Care- $75 copay/visit ded waived
• Standard Plan Coinsurance- 40%

Deductible

$4,500/$9,000

Out-of-Pocket Maximum

$7,350/$14,700

Silver Copay (Off)

Short Summary

LSilver level plan offers a mid level deductible and out of pocket maximum with first dollar copays for many benefits

Key Benefits

• Primary Care Office Visits- $30 copay/visit ded waived
• Specialist Office Visits- $75 copay/visit ded waived
• Urgent Care- $75 copay/visit ded waived
• Standard Plan Coinsurance- 50%

Deductible

$4,000/$8,000

Out-of-Pocket Maximum

$7,350/$14,700

Bronze 3 Copay

Short Summary

Bronze level plan offers a high deductible and out of pocket maximum, but low premium. Many benefits are subject to the deductible being met first. This plan does have 3 office visits before meeting the deductible.

Key Benefits

• Primary Care Office Visits- $45 copay/ first 3 visits then 50% after ded
• Specialist Office Visits- 50% coinsurance after ded
• Urgent Care- 50% coinsurance after ded
• Standard Plan Coinsurance- 50%

Deductible

$6,550/$13,100

Out-of-Pocket Maximum

$7,350/$14,700

Bronze HSA

Short Summary

Bronze level plan offers a high deductible and out of pocket maximum, but low premium. All benefits are subject to the deductible being met first other than preventive. This plan is a qualified high deductible health plan.

Key Benefits

• Primary Care Office Visits- 0% coinsurance after ded
• Specialist Office Visits- 0% coinsurance after ded
• Urgent Care- 0% coinsurance after ded
• Standard Plan Coinsurance- 0%

Deductible

$6,650/$13,300

Out-of-Pocket Maximum

$6,500/$13,300