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Information about COVID-19 and your insurance coverage

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Employers

2020 Dual option plans

Dual options provide your employees the chance to choose a plan that best fits their lifestyles and budgets.

Platinum 500 ELITE and Gold 1500 ESSENTIAL

BenefitsPlatinum 500 ELITEGold 1500 ESSENTIAL
Deductible$500$1,500
Coinsurance20%20%
Out-of-Pocket Costs$1,500$7,000
Primary Care Physician Office Visit$5 copay$5 copay
Specialist Office Visit$55 copay$55 copay
Prescription Drugs
  • $5 copay for generics
  • $30 copay for preferred brand-name
  • $50 copay for non-preferred brand-name
  • $100 copay for preferred specialty
  • $200 copay for specialty
  • $5 copay for generics
  • $45 copay for preferred brand-name
  • $75 copay for non-preferred brand-name
  • copay for preferred specialty
  • copay for specialty
Deductible TypeFulfillmentFulfillment

Gold 1000 ELITE and Silver 3000 ELITE

BenefitsGold 1000 ELITESilver 3000 ELITE
Deductible$1,000$3,000
Coinsurance20%20%
Out-of-Pocket Costs$5,500$8,150
Primary Care Physician Office Visit$5 copay$25
Specialist Office Visit$55 copay$65
Prescription Drugs
  • $5 copay for generics
  • $35 copay for preferred brand-name
  • $60 copay for non-preferred brand-name
  • $120 copay for preferred specialty
  • $240 copay for specialty
  • $20 copay for generics
  • $60 copay for preferred brand-name
  • $100 copay for non-preferred brand-name
  • copay for preferred specialty
  • copay for specialty
Deductible TypeFulfillmentFulfillment

Platinum 250 ELITE and Gold 2100 HSA

BenefitsPlatinum 250 ELITEGold 2100 HSA
Deductible$250$2,100
Coinsurance20%0%
Out-of-Pocket Costs$1,250$2,100
Primary Care Physician Office Visit$5 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs
  • $5 copay for generics
  • $30 copay for preferred brand-name
  • $50 copay for non-preferred brand-name
  • $100 copay for preferred specialty
  • $200 copay for specialty
N/A
Deductible TypeFulfillmentTrue Family

Platinum 500 ELITE and Gold 2100 HSA

BenefitsPlatinum 500 ELITEGold 2100 HSA
Deductible$500$2,100
Coinsurance20%0%
Out-of-Pocket Costs$1,500$2,100
Primary Care Physician Office Visit$5 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs
  • $5 copay for generics
  • $30 copay for preferred brand-name
  • $50 copay for non-preferred brand-name
  • $100 copay for preferred specialty
  • $200 copay for specialty
N/A
Deductible TypeFulfillmentTrue Family

Platinum 750 ELITE and Gold 2800 HSA

BenefitsPlatinum 750 ELITEGold 2800 HSA
Deductible$750$2,800
Coinsurance20%0%
Out-of-Pocket Costs$1,750$2,800
Primary Care Physician Office Visit$5 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs
  • $5 copay for generics
  • $30 copay for preferred brand-name
  • $50 copay for non-preferred brand-name
  • $100 copay for preferred specialty
  • $200 copay for specialty
N/A
Deductible TypeFulfillmentEmbedded

Platinum 1000 ELITE and Gold 2800 HSA

BenefitsPlatinum 1000 ELITEGold 2800 HSA
Deductible$1,000$2,800
Coinsurance20%0%
Out-of-Pocket Costs$2,000$2,800
Primary Care Physician Office Visit$5 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs
  • $5 copay for generics
  • $30 copay for preferred brand-name
  • $50 copay for non-preferred brand-name
  • $100 copay for preferred specialty
  • $200 copay for specialty
N/A
Deductible TypeFulfillmentEmbedded

Gold 1000 ELITE and Silver 4100 HSA

BenefitsGold 1000 ELITESilver 4100 HSA
Deductible$1,000$4,100
Coinsurance20%0%
Out-of-Pocket Costs$5,500$4,100
Primary Care Physician Office Visit$5 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs
  • $5 copay for generics
  • $35 copay for preferred brand-name
  • $60 copay for non-preferred brand-name
  • $120 copay for preferred specialty
  • $240 copay for specialty
N/A
Deductible TypeFulfillmentEmbedded

Gold 1500 ELITE and Silver 4100 HSA

BenefitsGold 1500 ELITESilver 4100 HSA
Deductible$1,500$4,100
Coinsurance20%0%
Out-of-Pocket Costs$3,750$4,100
Primary Care Physician Office Visit$5 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs
  • $5 copay for generics
  • $35 copay for preferred brand-name
  • $60 copay for non-preferred brand-name
  • $120 copay for preferred specialty
  • $240 copay for specialty
N/A
Deductible TypeFulfillmentEmbedded

Gold 1000 ELITE and Bronze 5500 ELITE**

BenefitsGold 1000 ELITEBronze 5500 ELITE
Deductible$1,000$5,500
Coinsurance20%50%
Out-of-Pocket Costs$5,500$8,150
Primary Care Physician Office Visit$5 copay$25 copay
Specialist Office Visit$55 copayN/A
Prescription Drugs
  • $5 copay for generics
  • $35 copay for preferred brand-name
  • $60 copay for non-preferred brand-name
  • $120 copay for preferred specialty
  • $240 copay for specialty
  • $25 copay for generics
  • N/A copay for preferred brand-name
  • N/A copay for non-preferred brand-name
  • N/A copay for preferred specialty
  • N/A copay for specialty
Deductible TypeFulfillmentEmbedded

Silver 2000 ELITE and Bronze 5500 ELITE**

BenefitsSilver 2000 ELITEBronze 5500 ELITE
Deductible$2,000$5,500
Coinsurance20%50%
Out-of-Pocket Costs$5,750$8,150
Primary Care Physician Office Visit$5 copay$25 copay
Specialist Office Visit$55 copayN/A
Prescription Drugs
  • $5 copay for generics
  • $45 copay for preferred brand-name
  • $75 copay for non-preferred brand-name
  • $150 copay for preferred specialty
  • $300 copay for specialty
  • $25 copay for generics
  • N/A copay for preferred brand-name
  • N/A copay for non-preferred brand-name
  • N/A copay for preferred specialty
  • N/A copay for specialty
Deductible TypeFulfillmentEmbedded

Gold 2000 ELITE and Bronze 6750 HSA**

BenefitsSilver 2000 ELITEBronze 6750 HSA
Deductible$2,000$6,750
Coinsurance20%0%
Out-of-Pocket Costs$5,750$6,750
Primary Care Physician Office Visit$5 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs
  • $5 copay for generics
  • $45 copay for preferred brand-name
  • $75 copay for non-preferred brand-name
  • $150 copay for preferred specialty
  • $300 copay for specialty
N/A
Deductible TypeFulfillmentEmbedded

Silver 2500 ELITE and Bronze 6750 HSA**

BenefitsSilver 2500 ELITEBronze 6750 HSA
Deductible$2,500$6,750
Coinsurance20%0%
Out-of-Pocket Costs$7,800$6,750
Primary Care Physician Office VisitN/AN/A
Specialist Office VisitN/AN/A
Prescription Drugs
  • $5 copay for generics
  • $60 copay for preferred brand-name
  • $100 copay for non-preferred brand-name
  • $200 copay for preferred specialty
  • $400 copay for specialty
N/A
Deductible TypeFulfillmentEmbedded

**Expanded Bronze

Notices

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