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Employers with 2 to 50 employees

2020 Dual option plans

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

Group Health Coverage - Dual Option plans [pdf]: Additional benefits available for individuals and families for these Small Group Plans.

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
Coinsurance for preferred specialty
Coinsurance 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
Coinsurance for preferred specialty
Coinsurance 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 for preferred brand-name
N/A for non-preferred brand-name
N/A for preferred specialty
N/A 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 for preferred brand-name
N/A for non-preferred brand-name
N/A for preferred specialty
N/A 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