HMO Plans
| Health Plan Name |
Office Visit Copay |
Hospital Copay |
Outpatient Copay |
| Basic HMO | $40 |
$500/day, max $2000 |
$300 |
| Standard HMO | $25 | $250/day, max $1000 | $150 |
| 500/80 | $35 | Deductible & Coinsurance | Ded. & Coins. |
| 1000/70 | $45 | Deductible & Coinsurance | Ded. & Coins. |
| 1500/75 | $45 | Deductible & Coinsurance | Ded. & Coins. |
| 2000/70 | $45 | Deductible & Coinsurance | Ded. & Coins. |
PPO Plans
| Plan Name |
Office Visit Copay |
Deductible |
Coinsurance |
| $40 |
$4000 |
30% to $8,000 max |
|
| $25 |
$1500 |
20% to $3,500 max |
|
$35 |
$500 |
20% to $3000 |
|
$45 |
$1000 |
30% to $3,500 |
|
$45 |
$1500 |
25% to $3,500 |
|
$45 |
$2000 |
30% to $4,000 |
|
$45 |
$3000 |
35% to $2,000 |
|
Not covered |
$1,500 |
25% to $3,500 |
|
$35 |
$500 |
30% to $3,000 |
|
$35 |
$1,000 |
30% to $2,000 |
|
$35 |
$1,500 |
30% to $3,000 |
HSA Plans
Plan Name |
Deductible |
Coinsurance |
Max Out-of-Pocket |
| $2650/$4000 |
0% |
$2650/$4000 |
|
| $3250/$6000 |
0% |
$3250/$6000 |
|
$5000/$10,000 |
0% |
$5000/$10,000 |