Plan Detail Definitions

Deductible

All plans include a deductible where some or all service are subject to the deductible. The deductible under which employees will pay the cost, with the exception of, in-network preventive care and services which charge a copayment.

Co-Pays & Coinsurance

PPO High and Low plans include co-pays for office visit such as PCP visit. Other copays apply after the deductible is met. Co-pays are a flat dollar amount due at the time of service. Coinsurance on all plans is 100% paid by the carrier. Coinsurance is a percentage of the costs split between the carrier and employee.

Out-Of-Pocket Maximum

Each of the plans include an out-of-pocket maximum. This is the most an employee will pay in a plan year between deductible, co-pays and coinsurance.