Employers with 2 to 50 employees
2020 Gold plans
Gold plans cover more services and have a higher monthly premium. The employee will pay less out of pocket for medical services. The benefits below apply to each employee.
Group Health Coverage - Metallic plans [pdf]: Additional benefits available for individuals and families for these Small Group Plans.
Gold 1000 ELITE
| Benefits | Gold 1000 ELITE |
|---|---|
| Deductible | $1,000 |
| Coinsurance | 20% |
| Out-of-Pocket Costs | $5,500 |
| Primary Care Physician Office Visit | $5 copay |
| Specialist Office Visit | $55 copay |
| 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 |
| Deductible Type | Fulfillment |
Gold 1000 ESSENTIAL
| Benefits | Gold 1000 ESSENTIAL |
|---|---|
| Deductible | $1,000 |
| Coinsurance | 20% |
| Out-of-Pocket Costs | $7,000 |
| Primary Care Physician Office Visit | $5 copay |
| Specialist Office Visit | $55 copay |
| Prescription Drugs | $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 Type | Fulfillment |
Gold 1500 ELITE
| Benefits | Gold 1500 ELITE |
|---|---|
| Deductible | $1,500 |
| Coinsurance | 20% |
| Out-of-Pocket Costs | $3,750 |
| Primary Care Physician Office Visit | $5 copay |
| Specialist Office Visit | $55 copay |
| 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 |
| Deductible Type | Fulfillment |
Gold 1500 ESSENTIAL
| Benefits | Gold 1500 ESSENTIAL |
|---|---|
| Deductible | $1,500 |
| Coinsurance | 20% |
| Out-of-Pocket Costs | $7,000 |
| Primary Care Physician Office Visit | $5 copay |
| Specialist Office Visit | $55 copay |
| Prescription Drugs | $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 Type | Fulfillment |
Gold 2000 ELITE
| Benefits | Gold 2000 ELITE |
|---|---|
| Deductible | $2,000 |
| Coinsurance | 20% |
| Out-of-Pocket Costs | $5,750 |
| Primary Care Physician Office Visit | $5 copay |
| Specialist Office Visit | $55 copay |
| 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 |
| Deductible Type | Fulfillment |
Gold 2100 HSA
| Benefits | Gold 2100 HSA |
|---|---|
| Deductible | $2,100 |
| Coinsurance | 0% |
| Out-of-Pocket Costs | $2,100 |
| Primary Care Physician Office Visit | N/A |
| Specialist Office Visit | N/A |
| Prescription Drugs | N/A |
| Deductible Type | True Family |
Gold 2800 HSA
| Benefits | Gold 2800 HSA |
|---|---|
| Deductible | $2,800 |
| Coinsurance | 0% |
| Out-of-Pocket Costs | $2,800 |
| Primary Care Physician Office Visit | N/A |
| Specialist Office Visit | N/A |
| Prescription Drugs | N/A |
| Deductible Type | Embedded |