Your Plan Options

Care for Health

As you make your healthcare selections, ask yourself these 3 questions:

  1. Is your primary provider in the network? Use the search features on each carrier’s website – see the Your Carriers
  2. How do you like to manage your costs? Choose between options like a lower copay or less out of your paycheck.
  3. What are your medical needs? Think how often you visit the doctor, any major health care needs in the next year, or any changes like growing a family or surgery.

 

  Platinum Plan Gold Plan Silver Plan Bronze Plan
HSA Eligible? No Yes
Annual Deductible
Individual/Family $250 / $500 $800 / $1,600 $1,650 / $3,300* $2,450 / $4,900*
Total Out-of-Pocket Max
Individual/Family $2,300 / $4,600 $3,600 / $7,200 $3,800 / $7,600* $3,900 / $7,800*
Covered Services
Doctor’s office visits

PCP $25

Specialist $40

PCP $25

Specialist $40

25% after deductible 25% after deductible
Preventive care Covered at 100% Covered at 100% Covered at 100% Covered at 100%
Coinsurance 15% 25% 25% 25%
Emergency room 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Outpatient hospital services 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Inpatient hospital services 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Labs and x-rays Covered at 100% as part of preventive visit; otherwise 15% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible
Prescription Drug Plan
Retail Pharmacy (30-day supply)
Tier 1 drug $8 $10 $8 (Tier 1) / $30 (Tier 2) / $50 (Tier 3) for certain preventive medications (deductible does not apply). All other drugs are 25% after deductible.
Tier 2 drug $30 $40
Tier 3 drug $50 $60
Mail Order (90-day supply)
Tier 1 drug $20 $25 $20 (Tier 1) / $75 (Tier 2) / $125 (Tier 3) for certain preventive medications (deductible does not apply). All other drugs are 25% after deductible.
Tier 2 drug $75 $100
Tier 3 drug $125 $150

Premiums can be found on Canvas.

This is not a comprehensive list. Please visit Canvas for more information.

*True family deductibles and out-of-pocket maximums apply, meaning for those in family coverage, the full family amount must be paid.

 

 

  Platinum Plan Gold Plan Silver Plan Bronze Plan
HSA Eligible? No Yes
Annual Deductible
Individual/Family $250 / $500 $800 / $1,600 $1,650 / $3,300* $2,450 / $4,900*
Total Out-of-Pocket Max
Individual/Family $2,300 / $4,600 $3,600 / $7,200 $3,800 / $7,600* $3,900 / $7,800*
Covered Services
Doctor’s office visits

PCP $25

Specialist $40

PCP $25

Specialist $40

25% after deductible 25% after deductible
Preventive care Covered at 100% Covered at 100% Covered at 100% Covered at 100%
Coinsurance 15% 25% 25% 25%
Emergency room 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Outpatient hospital services 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Inpatient hospital services 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Labs and x-rays Covered at 100% as part of preventive visit; otherwise 15% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible
Prescription Drug Plan
Retail Pharmacy (30-day supply)
Tier 1 drug $8 $10 $8 (Tier 1) / $30 (Tier 2) / $50 (Tier 3) for certain preventive medications (deductible does not apply). All other drugs are 25% after deductible.
Tier 2 drug $30 $40
Tier 3 drug $50 $60
Mail Order (90-day supply)
Tier 1 drug $20 $25 $20 (Tier 1) / $75 (Tier 2) / $125 (Tier 3) for certain preventive medications (deductible does not apply). All other drugs are 25% after deductible.
Tier 2 drug $75 $100
Tier 3 drug $125 $150

Premiums can be found on Canvas.

This is not a comprehensive list. Please visit Canvas for more information.

*True family deductibles and out-of-pocket maximums apply, meaning for those in family coverage, the full family amount must be paid.

 

 

  Platinum Plan Gold Plan Silver Plan Bronze Plan
HSA Eligible? No Yes
Annual Deductible
Individual/Family $250 / $500 $800 / $1,600 $1,650 / $3,300* $2,450 / $4,900*
Total Out-of-Pocket Max
Individual/Family $2,300 / $4,600 $3,600 / $7,200 $3,800 / $7,600* $3,900 / $7,800*
Covered Services
Doctor’s office visits

PCP $25

Specialist $40

PCP $25

Specialist $40

25% after deductible 25% after deductible
Preventive care Covered at 100% Covered at 100% Covered at 100% Covered at 100%
Coinsurance 15% 25% 25% 25%
Emergency room 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Outpatient hospital services 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Inpatient hospital services 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Labs and x-rays Covered at 100% as part of preventive visit; otherwise 15% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible
Prescription Drug Plan
Retail Pharmacy (30-day supply)
Tier 1 drug $8 $10 $8 (Tier 1) / $30 (Tier 2) / $50 (Tier 3) for certain preventive medications (deductible does not apply). All other drugs are 25% after deductible.
Tier 2 drug $30 $40
Tier 3 drug $50 $60
Mail Order (90-day supply)
Tier 1 drug $20 $25 $20 (Tier 1) / $75 (Tier 2) / $125 (Tier 3) for certain preventive medications (deductible does not apply). All other drugs are 25% after deductible.
Tier 2 drug $75 $100
Tier 3 drug $125 $150

Premiums can be found on Canvas.

This is not a comprehensive list. Please visit Canvas for more information.

*True family deductibles and out-of-pocket maximums apply, meaning for those in family coverage, the full family amount must be paid.

 

 

  Platinum Plan Gold Plan Silver Plan Bronze Plan
HSA Eligible? No Yes
Annual Deductible
Individual/Family $250 / $500* $800 / $1,600* $1,600 / $3,200* $2,450 / $4,900*
Total Out-of-Pocket Max
Individual/Family $2,300 / $4,600* $3,600 / $7,200* $3,800 / $7,600* $3,900 / $7,800*
Covered Services
Doctor’s office visits

PCP $25

Specialist $40

PCP $25

Specialist $40

25% after deductible 25% after deductible
Preventive care Covered at 100% Covered at 100% Covered at 100% Covered at 100%
Coinsurance 15% 25% 25% 25%
Emergency room 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Outpatient hospital services 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Inpatient hospital services 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Labs and x-rays Covered at 100% as part of preventive visit; otherwise 15% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible
Prescription Drug Plan
Retail Pharmacy (30-day supply)
Tier 1 drug $8 $10 $8 (Tier 1) / $30 (Tier 2) / $50 (Tier 3) for certain preventive medications (deductible does not apply). All other drugs are 25% after deductible.
Tier 2 drug $30 $40
Tier 3 drug $50 $60
Mail Order (90-day supply)
Tier 1 drug $20 $25 $20 (Tier 1) / $75 (Tier 2) / $125 (Tier 3) for certain preventive medications (deductible does not apply). All other drugs are 25% after deductible.
Tier 2 drug $75 $100
Tier 3 drug $125 $150

Premiums can be found on Canvas.

This is not a comprehensive list. Please visit Canvas for more information.

*True family deductibles and out-of-pocket maximums apply, meaning for those in family coverage, the full family amount must be paid.

 

 

  Platinum Plan Gold Plan Silver Plan Bronze Plan
HSA Eligible? No Yes
Annual Deductible
Individual/Family $250 / $500* $800 / $1,600* $1,600 / $3,200* $2,450 / $4,900*
Total Out-of-Pocket Max
Individual/Family $2,300 / $4,600* $3,600 / $7,200* $3,800 / $7,600* $3,900 / $7,800*
Covered Services
Doctor’s office visits

PCP $25

Specialist $40

PCP $25

Specialist $40

25% after deductible 25% after deductible
Preventive care Covered at 100% Covered at 100% Covered at 100% Covered at 100%
Coinsurance 15% 25% 25% 25%
Emergency room 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Outpatient hospital services 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Inpatient hospital services 15% after deductible 25% after deductible 25% after deductible 25% after deductible
Labs and x-rays Covered at 100% as part of preventive visit; otherwise 15% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible Covered at 100% as part of preventive visit; otherwise 25% after deductible
Prescription Drug Plan
Retail Pharmacy (30-day supply)
Tier 1 drug $8 $10 $8 (Tier 1) / $30 (Tier 2) / $50 (Tier 3) for certain preventive medications (deductible does not apply). All other drugs are 25% after deductible.
Tier 2 drug $30 $40
Tier 3 drug $50 $60
Mail Order (90-day supply)
Tier 1 drug $20 $25 $20 (Tier 1) / $75 (Tier 2) / $125 (Tier 3) for certain preventive medications (deductible does not apply). All other drugs are 25% after deductible.
Tier 2 drug $75 $100
Tier 3 drug $125 $150

Premiums can be found on Canvas.

This is not a comprehensive list. Please visit Canvas for more information.

*True family deductibles and out-of-pocket maximums apply, meaning for those in family coverage, the full family amount must be paid.

 

Medical (California only)

Plan Features Platinum Plan Gold Plan Silver Plan
HSA Eligible Plan? No Yes
Annual Deductible
Individual/Family $250 / $500 $750 / $1,500 $1,650 / $3,300*
Total Out-of-Pocket Max
Individual/Family $2,300 / $4,600 $3,000 / $6,000 $4,000 / $8,000*
Covered Services
Doctor’s office visits PCP $25
Specialist $40
PCP $20
Specialist $30
25% after deductible
Preventive care Covered at 100% Covered at 100% Covered at 100%
Coinsurance 15% 20% 25%
Emergency room 15% after deductible 20% after deductible 25% after deductible
Outpatient hospital services 15% after deductible 20% after deductible 25% after deductible
Inpatient hospital services 15% after deductible 20% after deductible 25% after deductible
Labs and x-rays $10 $10 Covered at 100% as part of preventive visit; otherwise, 25% after deductible
Prescription Drug Plan
Retail Pharmacy (30-day supply)
Generic $10 $10 25% after deductible
($50 max)
Brand $30 $30 25% after deductible
($100 max)
Specialty 10% up to $250 20% up to $250 25% after deductible
($250 max)
Mail Order (90-day supply)
Generic $20 $20 25% after deductible
($50 max)
Brand $60 $60 25% after deductible
($100 max)
Specialty 10% up to $250 20% up to $250 25% after deductible
($250 max)

Premiums can be found on Canvas.

This is not a comprehensive list. Please visit Canvas for more information.

*True family deductibles and out-of-pocket maximums apply, meaning for those in family coverage, the full family amount must be paid.