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Employers with 2 to 50 employees

2020 Dual option plans

Dual options provide your employees the chance to choose a plan that best fits their lifestyles and budgets.

Group Health Coverage – Metallic Plans [pdf]: Additional benefits available for individuals and families for these Small Group Plans.

Group Health Coverage – Dual Optoin Plans [pdf]: Additional benefits available for individuals and families for these Small Group Plans.

Platinum 250 ELITE and Gold 2100 HSA

BenefitsPlatinum 250 ELITEGold 2100 HSA
Deductible$250$2,100
Coinsurance20%0%
Out-of-Pocket Costs$1,250$2,100
Primary Care Physician Office Visit$20 copayN/A
Specialist Office Visit$40 copayN/A
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
N/A
Deductible TypeFulfillmentTrue Family

Platinum 500 ESSENTIAL and Gold 2100 HSA

BenefitsPlatinum 500 ESSENTIALGold 2000 HSA
Deductible$500$2,100
Coinsurance20%0%
Out-of-Pocket Costs$2,000$2,100
Primary Care Physician Office Visit$20 copayN/A
Specialist Office Visit$40 copayN/A
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
N/A
Deductible TypeFulfillmentTrue Family

Platinum 500 ESSENTIAL and Gold 2800 HSA

BenefitsPlatinum 500 ESSENTIALGold 2800 HSA
Deductible$500$2,800
Coinsurance20%0%
Out-of-Pocket Costs$2,000$2,800
Primary Care Physician Office Visit$20 copayN/A
Specialist Office Visit$40 copayN/A
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
N/A
Deductible TypeFulfillmentEmbedded

Platinum 1000 ELITE and Gold 2800 HSA

BenefitsPlatinum 1000 ELITEGold 2800 HSA
Deductible$1,000$2,800
Coinsurance20%0%
Out-of-Pocket Costs$2,500$2,800
Primary Care Physician Office Visit$30 copayN/A
Specialist Office Visit$50 copayN/A
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
N/A
Deductible TypeFulfillmentEmbedded

Gold 1000 ESSENTIAL and Silver 2000 ESSENTIAL

BenefitsGold 1000 ESSENTIALSilver 2000 ESSENTIAL
Deductible$1,000$2,000
Coinsurance20%30%
Out-of-Pocket Costs$7,000$8,150
Primary Care Physician Office Visit$30 copay$45 copay
Specialist Office Visit$50 copayN/A
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
  • $25 copay for generics
  • $60 copay for preferred brand-name
  • $100 copay for non-preferred brand-name
  • $200 copay for preferred specialty
  • $400 copay for specialty
Deductible TypeFulfillmentFulfillment

Gold 2000 ESSENTIAL and Silver 4000 ELITE

BenefitsGold 2000 ESSENTIALSilver 4000 ELITE
Deductible$2.000$4,000
Coinsurance20%30%
Out-of-Pocket Costs$7,750$8,150
Primary Care Physician Office Visit$30 copay$45 copay
Specialist Office Visit$50 copay$60 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
  • $20 copay for generics
  • $60 copay for preferred brand-name
  • $100 copay for non-preferred brand-name
  • $200 copay for preferred specialty
  • $400 copay for specialty
Deductible TypeFulfillmentFulfillment

Gold 1000 ELITE and Bronze 5500 ELITE**

BenefitsGold 1000 ELITEBronze 5500 ELITE
Deductible$1,000$5,500
Coinsurance20%50%
Out-of-Pocket Costs$5,000$8,150
Primary Care Physician Office Visit$20 copay$25 copay
Specialist Office Visit$40 copayN/A
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
  • $25 copay for generics
  • N/A copay for preferred brand-name
  • N/A copay for non-preferred brand-name
  • N/A copay for preferred specialty
  • N/A copay for specialty
Deductible TypeFulfillmentEmbedded

Gold 2000 ELITE and Bronze 6750 HSA**

BenefitsGold 2000 ELITEBronze 6750 HSA
Deductible$2,000$6,750
Coinsurance20%0%
Out-of-Pocket Costs$6,500$6,750
Primary Care Physician Office Visit$20 copayN/A
Specialist Office Visit$40 copayN/A
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
N/A
Deductible TypeFulfillmentEmbedded

Silver 3000 ELITE and Bronze 6750 HSA**

BenefitsSilver 3000 ELITEBronze 6750 HSA
Deductible$3,000$6,750
Coinsurance30%0%
Out-of-Pocket Costs$8,150$6,750
Primary Care Physician Office VisitN/AN/A
Specialist Office VisitN/AN/A
Prescription Drugs
  • $15 copay for generics
  • $50 copay for preferred brand-name
  • $85 copay for non-preferred brand-name
  • $170 copay for preferred specialty
  • $340 copay for specialty
N/A
Deductible TypeFulfillmentEmbedded

**Expanded Bronze