Plan Detail Definitions

Deductible

All plans include a deductible where some or all services are subject to the deductible. The deductible is the amount employees pay for care, except for in-network preventive care and services that charge a copayment.

Co-Pays & Coinsurance

PPO High and Low plans include co-pays for office visits such as PCP visits. Other copays apply after the deductible is met. Co-pays are a flat dollar amount due at the time of service. Coinsurance is a percentage of the costs split between the carrier and employee.

Out-Of-Pocket Maximum

Each plan includes an out-of-pocket maximum — the most an employee will pay in a plan year between deductible, co-pays, and coinsurance.