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Employers with 2 to 50 employees

2018 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 - Metallics and Dual Option [pdf]: Additional benefits available for individuals and families for these Small Group Plans.

Gold 500-1

BenefitsGold 500-1
Deductible$500
Coinsurance80%
Out-of-Pocket Costs$5,500
Primary Care Physician Office Visit$35 copay
Specialist Office Visit$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
Deductible TypeFulfillment

Gold 1000-1

BenefitsGold 1000-1
Deductible$1,000
Coinsurance80%
Out-of-Pocket Costs$3,500
Primary Care Physician Office Visit$35 copay
Specialist Office Visit$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
Deductible TypeFulfillment

Gold 1000-2

BenefitsGold 1000-2
Deductible$1,000
Coinsurance80%
Out-of-Pocket Costs$5,000
Primary Care Physician Office Visit$35 copay
Specialist Office Visit$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
Deductible TypeFulfillment

Gold 1500-1

BenefitsGold 1500-1
Deductible$1,500
Coinsurance80%
Out-of-Pocket Costs$3,000
Primary Care Physician Office Visit$35 copay
Specialist Office Visit$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
Deductible TypeFulfillment

Gold 1500-3

BenefitsGold 1500-3
Deductible$1,500
Coinsurance80%
Out-of-Pocket Costs$5,000
Primary Care Physician Office Visit$35 copay
Specialist Office Visit$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
Deductible TypeFulfillment

Gold 2000 HSA

BenefitsGold 2000 HSA
Deductible$2,000
Coinsurance100%
Out-of-Pocket Costs$2,000
Primary Care Physician Office VisitN/A
Specialist Office VisitN/A
Prescription DrugsN/A
Deductible TypeTrue Family

Gold 2000-1

BenefitsGold 2000-1
Deductible$2,000
Coinsurance80%
Out-of-Pocket Costs$4,250
Primary Care Physician Office Visit$35 copay
Specialist Office Visit$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
Deductible TypeFulfillment

*Copayments apply only to in-network providers.