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Monthly premium
Your premium is the amount you pay for your health insurance each month. |
Deductible
The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs. |
Out-of-pocket maximum
A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year. |
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|---|---|---|---|
| Employee | $516.08 | $6,450 | $8,700 |
| Employee & Spouse | $1,032.16 | $12,900 | $17,400 |
| Employee & Child(ren) | $996.03 | $12,900 | $17,400 |
| Family | $1,450.18 | $12,900 | $17,400 |
| Applies to All |
Generic drugs
A generic drug is a medication created to be the same as an existing approved brand-name drug. A fixed dollar amount you pay for specific services. |
Specialist visit
A visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist. A fixed dollar amount you pay for specific services. |
Primary doctor visit
A health care provider who provides primary, routine care services. A fixed dollar amount you pay for specific services. |
Your plan options
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Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Aggregate)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $522.54 $7,050 $7,050 Employee & Spouse $1,033.98 $14,100 $14,100 Employee & Child(ren) $997.79 $14,100 $14,100 Family $1,452.74 $14,100 $14,100 Applies to All Generic drugs $0A generic drug is a medication created to be the same as an existing approved brand-name drug.
Specialist visit $0A visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
Primary doctor visit $0A health care provider who provides primary, routine care services.
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Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Stacked)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $523.08 $8,700 $8,700 Employee & Spouse $1,046.16 $17,400 $17,400 Employee & Child(ren) $1,009.54 $17,400 $17,400 Family $1,469.85 $17,400 $17,400 Applies to All Generic drugs $0A generic drug is a medication created to be the same as an existing approved brand-name drug.
Specialist visit $0A visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
Primary doctor visit $0A health care provider who provides primary, routine care services.
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Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Aggregate)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $530.38 $5,700 $7,050 Employee & Spouse $1,060.76 $11,400 $14,100 Employee & Child(ren) $1,023.63 $11,400 $14,100 Family $1,490.37 $11,400 $14,100 Applies to All Generic drugs $12 co-payA generic drug is a medication created to be the same as an existing approved brand-name drug.
A fixed dollar amount you pay for specific services.
Specialist visit 50% co-insuranceA visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
The share of a medical cost you are responsible to pay after your deductible has been met.
Primary doctor visit 50% co-insuranceA health care provider who provides primary, routine care services.
The share of a medical cost you are responsible to pay after your deductible has been met.
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Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Aggregate)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $552.54 $8,700 $8,700 Employee & Spouse $1,045.08 $17,400 $17,400 Employee & Child(ren) $1,008.50 $17,400 $17,400 Family $1,468.34 $17,400 $17,400 Applies to All Generic drugs $0A generic drug is a medication created to be the same as an existing approved brand-name drug.
Specialist visit $0A visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
Primary doctor visit $0A health care provider who provides primary, routine care services.
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Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Aggregate)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $590.43 $3,000 $8,150 Employee & Spouse $1,180.86 $6,000 $16,300 Employee & Child(ren) $1,139.53 $6,000 $16,300 Family $1,659.11 $6,000 $16,300 Applies to All Generic drugs $5 co-payA generic drug is a medication created to be the same as an existing approved brand-name drug.
A fixed dollar amount you pay for specific services.
Specialist visit $50 co-payA visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
A fixed dollar amount you pay for specific services.
Primary doctor visit $30 co-payA health care provider who provides primary, routine care services.
A fixed dollar amount you pay for specific services.
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Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Aggregate)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $603.66 $4,600 $4,600 Employee & Spouse $1,207.32 $9,200 $9,200 Employee & Child(ren) $1,165.03 $9,200 $9,200 Family $1,696.28 $9,200 $9,200 Applies to All Generic drugs $0A generic drug is a medication created to be the same as an existing approved brand-name drug.
Specialist visit $0A visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
Primary doctor visit $0A health care provider who provides primary, routine care services.
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Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Stacked)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $611.47 $3,400 $8,550 Employee & Spouse $1,222.94 $6,800 $17,100 Employee & Child(ren) $1,180.14 $6,800 $17,100 Family $1,718.23 $6,800 $17,100 Applies to All Generic drugs $15 co-payA generic drug is a medication created to be the same as an existing approved brand-name drug.
A fixed dollar amount you pay for specific services.
Specialist visit $80 co-payA visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
A fixed dollar amount you pay for specific services.
Primary doctor visit $35 co-payA health care provider who provides primary, routine care services.
A fixed dollar amount you pay for specific services.
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Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Aggregate)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $637.08 $1,850 $6,900 Employee & Spouse $1,274.10 $3,700 $13,800 Employee & Child(ren) $1,229.51 $3,700 $13,800 Family $1,790.11 $3,700 $13,800 Applies to All Generic drugs $10 co-payA generic drug is a medication created to be the same as an existing approved brand-name drug.
A fixed dollar amount you pay for specific services.
Specialist visit 30% co-insuranceA visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
The share of a medical cost you are responsible to pay after your deductible has been met.
Primary doctor visit 10% co-insuranceA health care provider who provides primary, routine care services.
The share of a medical cost you are responsible to pay after your deductible has been met.
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Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Aggregate)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $686.61 $1,550 $5,150 Employee & Spouse $1,373.22 $3,100 $10,300 Employee & Child(ren) $1,325.16 $3,100 $10,300 Family $1,929.37 $3,100 $10,300 Applies to All Generic drugs $5 co-payA generic drug is a medication created to be the same as an existing approved brand-name drug.
A fixed dollar amount you pay for specific services.
Specialist visit $40 co-payA visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
A fixed dollar amount you pay for specific services.
Primary doctor visit $20 co-payA health care provider who provides primary, routine care services.
A fixed dollar amount you pay for specific services.
-
Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Aggregate)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $723.92 $2,550 $2,550 Employee & Spouse $1,447.84 $5,100 $5,100 Employee & Child(ren) $1,397.17 $5,100 $5,100 Family $2,034.22 $5,100 $5,100 Applies to All Generic drugs $0A generic drug is a medication created to be the same as an existing approved brand-name drug.
Specialist visit $0A visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
Primary doctor visit $0A health care provider who provides primary, routine care services.
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Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Stacked)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $741.08 $1,200 $5,400 Employee & Spouse $1,482.16 $2,400 $10,800 Employee & Child(ren) $1,430.28 $2,400 $10,800 Family $2,082.43 $2,400 $10,800 Applies to All Generic drugs $12 co-payA generic drug is a medication created to be the same as an existing approved brand-name drug.
A fixed dollar amount you pay for specific services.
Specialist visit $50 co-payA visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
A fixed dollar amount you pay for specific services.
Primary doctor visit $20 co-payA health care provider who provides primary, routine care services.
A fixed dollar amount you pay for specific services.
-
Monthly premium Your premium is the amount you pay for your health insurance each month.
Deductible (Stacked)The dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of costs.
Out-of-pocket maximum A limit on the amount you will pay for covered services (medical or prescriptions) in a calendar year. Once you meet this limit, we will pay for 100% of covered health care costs for the rest of the calendar year.
Employee $882.05 $400 $1,400 Employee & Spouse $1,764.10 $800 $2,800 Employee & Child(ren) $1,702.36 $800 $2,800 Family $2,478.56 $800 $2,800 Applies to All Generic drugs $10 co-payA generic drug is a medication created to be the same as an existing approved brand-name drug.
A fixed dollar amount you pay for specific services.
Specialist visit $40 co-payA visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
A fixed dollar amount you pay for specific services.
Primary doctor visit $15 co-insuranceA health care provider who provides primary, routine care services.
The share of a medical cost you are responsible to pay after your deductible has been met.