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Employers with 2 to 50 employees

2018 Dual option plans

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

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

Platinum 500-1 and Silver 3000-1

BenefitsPlatinum 500-1Silver 3000-1
Deductible$500$3,000
Coinsurance80%80%
Out-of-Pocket Costs$1,000$7,350
Primary Care Physician Office Visit$35 copay$35 copay
Specialist Office Visit$55 copay$55 copay
Prescription Drugs$10 copay for generics
$40 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
$55 copay for preferred brand-name
$85 copay for non-preferred brand-name
$170 copay for preferred specialty
$340 for specialty
Deductible TypeFulfillmentFulfillment

Platinum 1000-1 and Silver 3000-3

BenefitsPlatinum 1000-1Silver 3000-3
Deductible$1,000$3,000
Coinsurance80%80%
Out-of-Pocket Costs$1,250$7,350
Primary Care Physician Office Visit$35 copay$35 copay
Specialist Office Visit$55 copay$55 copay
Prescription Drugs$10 copay for generics
$50 copay for preferred brand-name
$75 copay for non-preferred brand-name
$150 copay for preferred specialty
$300 copay for specialty
$20 copay for generics
$70 copay for preferred brand-name
$100 copay for non-preferred brand-name
$200 copay for preferred specialty
$400 for specialty
Deductible TypeFulfillmentFulfillment

Platinum 1000-1 and Silver 3000-4

BenefitsPlatinum 1000-1Silver 3000-4
Deductible$1,000$3,000
Coinsurance80%75%
Out-of-Pocket Costs$1,250$7,350
Primary Care Physician Office Visit$35 copay$35 copay
Specialist Office Visit$55 copay$55 copay
Prescription Drugs$10 copay for generics
$50 copay for preferred brand-name
$75 copay for non-preferred brand-name
$150 copay for preferred specialty
$300 copay for specialty
$20 copay for generics
$65 copay for preferred brand-name
$100 copay for non-preferred brand-name
$200 copay for preferred specialty
$400 for specialty
Deductible TypeFulfillmentFulfillment

Platinum 1000-1 and Silver 3000 HSA

BenefitsPlatinum 1000-1Silver 3000 HSA
Deductible$1,000$3,000
Coinsurance80%90%
Out-of-Pocket Costs$1,250$6,550
Primary Care Physician Office Visit$35 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs$10 copay for generics
$50 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

Gold 1000-2 and Bronze 4750

BenefitsGold 1000-2Bronze 4750
Deductible$1,000$4,750
Coinsurance80%70%
Out-of-Pocket Costs$5,000$7,150
Primary Care Physician Office Visit$35 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs$10 copay for generics
$50 copay for preferred brand-name
$75 copay for non-preferred brand-name
$120 copay for preferred specialty
$300 copay for specialty
N/A
Deductible TypeFulfillmentEmbedded

Platinum 500-1 and Gold 1500-1

BenefitsPlatinum 500-1Gold 1500-1
Deductible$500$1,500
Coinsurance80%80%
Out-of-Pocket Costs$1,000$3,000
Primary Care Physician Office Visit$35 copay$35 copay
Specialist Office Visit$55 copay$55 copay
Prescription Drugs$10 copay for generics
$40 copay for preferred brand-name
$60 copay for non-preferred brand-name
$120 copay for preferred specialty
$240 copay for specialty
$10 copay for generics
$40 copay for preferred brand-name
$60 copay for non-preferred brand-name
$120 copay for preferred specialty
$240 copay for specialty
Deductible TypeFulfillmentFulfillment

Platinum 500-1 and Gold 1500-3

BenefitsPlatinum 500-1Gold 1500-3
Deductible$500$1,500
Coinsurance80%80%
Out-of-Pocket Costs$1,000$5,000
Primary Care Physician Office Visit$35 copay$35 copay
Specialist Office Visit$55 copay$55 copay
Prescription Drugs$10 copay for generics
$40 copay for preferred brand-name
$60 copay for non-preferred brand-name
$120 copay for preferred specialty
$240 copay for specialty
$10 copay for generics
$50 copay for preferred brand-name
$75 copay for non-preferred brand-name
$150 copay for preferred specialty
$300 copay for specialty
Deductible TypeFulfillmentFulfillment

Platinum 500-1 and Gold 2000 HSA

BenefitsPlatinum 500-1Gold 2000 HSA
Deductible$500$2,000
Coinsurance80%100%
Out-of-Pocket Costs$1,000$2,000
Primary Care Physician Office Visit$35 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs$10 copay for generics
$40 copay for preferred brand-name
$60 copay for non-preferred brand-name
$120 copay for preferred specialty
$240 copay for specialty
N/A
Deductible TypeFulfillmentTrue Family

Platinum 750-1 and Gold 2000 HSA

BenefitsPlatinum 750-1Gold 2000 HSA
Deductible$750$2,000
Coinsurance80%100%
Out-of-Pocket Costs$1,000$2,000
Primary Care Physician Office Visit$35 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs$10 copay for generics
$40 copay for preferred brand-name
$60 copay for non-preferred brand-name
$240 copay for specialty
N/A
Deductible TypeFulfillmentTrue Family

Platinum 1000-1 and Gold 2000 HSA

BenefitsPlatinum 1000-1Gold 2000 HSA
Deductible$1,000$2,000
Coinsurance80%100%
Out-of-Pocket Costs$1,250$2,000
Primary Care Physician Office Visit$35 copayN/A
Specialist Office Visit$55 copayN/A
Prescription Drugs$10 copay for generics
$50 copay for preferred brand-name
$75 copay for non-preferred brand-name
$150 copay for preferred specialty
$300 copay for specialty
N/A
Deductible TypeFulfillmentTrue Family

*Copayments apply only to in-network providers.