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2017 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.


Benefits Gold 1000-1 Gold 1000-2 Gold 1000-3
Deductible $1,000 $1,000 $1,000
Coinsurance 80% 80% 80%
Out-of-Pocket Costs $3,500 $4,000 $6,500
Primary Care Physician Office Visit $30 copay $20 copay $30 copay
Specialist Office Visit N/A $40 copay $50 copay
Prescription Drugs $10 copay for generics
$30 copay for preferred brand-name
$50 copay for non-preferred brand-name
$50 for specialty
$10 copay for generics
$30 copay for preferred brand-name
$50 copay for non-preferred brand-name
$100 for specialty
$10 copay for generics
$30 copay for preferred brand-name
$50 copay for non-preferred brand-name
$100 for specialty
Deductible Type Fulfillment Fulfillment Fulfillment

Benefits Gold 1000-4 Gold 1000-5 Gold 1000-6
Deductible $1,000 $1,000 $1,000
Coinsurance 80% 80% 80%
Out-of-Pocket Costs $4,500 $4,000 $7,150
Primary Care Physician Office Visit $30 copay $20 copay $30 copay
Specialist Office Visit N/A $40 copay $50 copay
Prescription Drugs $10 copay for generics
$40 copay for preferred brand-name
$60 copay for non-preferred brand-name
$120 for specialty
$10 copay for generics
$40 copay for preferred brand-name
$60 copay for non-preferred brand-name
$120 for specialty
$10 copay for generics
$30 copay for preferred brand-name
$50 copay for non-preferred brand-name
$100 for specialty
Deductible Type Fulfillment Fulfillment Fulfillment

Benefits Gold 1500-1 Gold 1500-2 Gold 1500-3
Deductible $1,500 $1,500 $1,500
Coinsurance 80% 80% 80%
Out-of-Pocket Costs $3,000 $3,500 $3,500
Primary Care Physician Office Visit N/A $20 copay $30 copay
Specialist Office Visit N/A $40 copay $50 copay
Prescription Drugs N/A $10 copay for generics
$30 copay for preferred brand-name
$50 copay for non-preferred brand-name
$50 for specialty
$10 copay for generics
$30 copay for preferred brand-name
$50 copay for non-preferred brand-name
$50 for specialty
Deductible Type Fulfillment Fulfillment Fulfillment

Benefits Gold 2500 HSA
Deductible $2,500
Coinsurance 100%
Out-of-Pocket Costs $2,500
Primary Care Physician Office Visit N/A
Specialist Office Visit N/A
Prescription Drugs N/A
Deductible Type True Family

*Copayments apply only to in-network providers.

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