Your Plan Options
Care for Health
As you make your healthcare selections, ask yourself these 3 questions:
- Is your primary provider in the network? Use the search features on each carrier’s website – see Your Carriers
- How do you like to manage your costs? Choose between options like a lower copay or less out of your paycheck.
- 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 | $1,700 / $3,400* | $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 | $1,700 / $3,400* | $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 | $1,700 / $3,400* | $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 | $1,700 / $3,400* |
| 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.