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Employers

2019 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 1000 ELITE

BenefitsGold 1000 ELITE
Deductible$1,000
Coinsurance20%
Out-of-Pocket Costs$4,000
Primary Care Physician Office Visit$20 copay
Specialist Office Visit$40 copay
Prescription Drugs
  • $10 copay for generics
  • $30 copay for preferred brand-name
  • $50 copay for non-preferred brand-name
  • $100 copay for preferred specialty
  • $200 copay for specialty
Deductible TypeFulfillment

Gold 1000 ESSENTIAL

BenefitsGold 1000 ESSENTIAL
Deductible$1,000
Coinsurance20%
Out-of-Pocket Costs$6,500
Primary Care Physician Office Visit$30 copay
Specialist Office Visit$50 copay
Prescription Drugs
  • $10 copay for generics
  • $40 copay for preferred brand-name
  • $70 copay for non-preferred brand-name
  • $140 copay for preferred specialty
  • $280 copay for specialty
Deductible TypeFulfillment

Gold 1000 Value

BenefitsGold 1000 Value
Deductible$1,000
Coinsurance20%
Out-of-Pocket Costs$7,500
Primary Care Physician Office Visit$30 copay
Specialist Office Visit$50 copay
Prescription Drugs
  • $15 copay for generics
  • $40 copay for preferred brand-name
  • $70 copay for non-preferred brand-name
  • $140 copay for preferred specialty
  • $280 copay for specialty
Deductible TypeFulfillment

Gold 1500 ELITE

BenefitsGold 1500 ELITE
Deductible$1,500
Coinsurance20%
Out-of-Pocket Costs$3,600
Primary Care Physician Office Visit$20 copay
Specialist Office Visit$40 copay
Prescription Drugs
  • $10 copay for generics
  • $30 copay for preferred brand-name
  • $50 copay for non-preferred brand-name
  • $100 copay for preferred specialty
  • $200 copay for specialty
Deductible TypeFulfillment

Gold 1500 ESSENTIAL

BenefitsGold 1500 ESSENTIAL
Deductible$1,500
Coinsurance20%
Out-of-Pocket Costs$4,000
Primary Care Physician Office Visit$30 copay
Specialist Office Visit$50 copay
Prescription Drugs
  • $10 copay for generics
  • $40 copay for preferred brand-name
  • $70 copay for non-preferred brand-name
  • $140 copay for preferred specialty
  • $280 copay for specialty
Deductible TypeFulfillment

Gold 2000 ELITE

BenefitsGold 2000 ELITE
Deductible$2,000
Coinsurance20%
Out-of-Pocket Costs$6,000
Primary Care Physician Office Visit$20 copay
Specialist Office Visit$40 copay
Prescription Drugs
  • $10 copay for generics
  • $30 copay for preferred brand-name
  • $50 copay for non-preferred brand-name
  • $100 copay for preferred specialty
  • $200 copay for specialty
Deductible TypeFulfillment

Gold 2000 ESSENTIAL

BenefitsGold 2000 ESSENTIAL
Deductible$2,000
Coinsurance20%
Out-of-Pocket Costs$6,000
Primary Care Physician Office Visit$30 copay
Specialist Office Visit$50 copay
Prescription Drugs
  • $10 copay for generics
  • $40 copay for preferred brand-name
  • $70 copay for non-preferred brand-name
  • $140 copay for preferred specialty
  • $280 copay for specialty
Deductible TypeFulfillment

Gold 2000 HSA

BenefitsGold 2000 HSA
Deductible$2,000
Coinsurance0%
Out-of-Pocket Costs$2,000
Primary Care Physician Office VisitN/A
Specialist Office VisitN/A
Prescription DrugsN/A
Deductible TypeTrue Family

Gold 2700 HSA

BenefitsGold 2700 HSA
Deductible$2,700
Coinsurance0%
Out-of-Pocket Costs$2,700
Primary Care Physician Office VisitN/A
Specialist Office VisitN/A
Prescription DrugsN/A
Deductible TypeEmbedded

*Copayments apply only to in-network providers.