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Employers

2021 Platinum plan

Platinum plans provide the richest benefit offering. Because of this, employees will pay less out of pocket for medical services. The benefits below apply to each employee.

Platinum 250 ELITE

BenefitsPlatinum 250 ELITE
Deductible$250
Coinsurance20%
Out-of-Pocket Costs$1,250
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

Platinum 500 ELITE

BenefitsPlatinum 500 ELITE
Deductible$500
Coinsurance10%
Out-of-Pocket Costs$1,500
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

Platinum 500 ESSENTIAL

BenefitsPlatinum 500 ESSENTIAL
Deductible$500
Coinsurance20%
Out-of-Pocket Costs$2,000
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

Platinum 500 VALUE

BenefitsPlatinum 500 VALUE
Deductible$500
Coinsurance20%
Out-of-Pocket Costs$3,250
Primary Care Physician Office Visit$30 copay
Specialist Office Visit$50 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

Platinum 1000 ELITE

BenefitsPlatinum 1000 ELITE
Deductible$1,000
Coinsurance20%
Out-of-Pocket Costs$2,350
Primary Care Physician Office Visit$30 copay
Specialist Office Visit$50 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

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