Compare Plans

Not all coverage is the right coverage.

The healthcare coverage you need is probably very different than the coverage some of your co-workers need. Age, family status, medical conditions, hobbies, lifestyle and a myriad of other factors will help you determine if you need a lot or a very little amount of health coverage. That’s why HealthEZ provides multiple coverage options, so you’re never caught paying too much money, or worse, having too little coverage.

Summary Of Medical Benefits

Gold Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$1,000

$2,000

 

$2,000

$4,000

Coinsurance

20%*

40%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$4,000

$8,000

 

$10,000

$20,000

Preventive Care

100% covered

40%*

Physician Services

$25 copay

40%*

Hospital Services Inpatients & Outpatient Care

20%*

40%*

Emergency Services

Covered as In-Network during true emergency

$250 copay

 

$250 copay

 

Urgent Care Services

$45 copay

40%*

Chiropractic Services

20%*

40%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

20%*

$45 copay

 

40%*

40%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$15 copay

$45 copay

$75 copay

$150 copay

 

$30 copay

$90 copay

$150 copay

Not available

*After Deductible

 

 

Silver Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$2,000

$4,000

 

$4,000

$8,000

Coinsurance

20%*

40%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$7,000

$14,000

 

$14,000

$28,000

Preventive Care

100% covered

40%*

Physician Services

$25 copay

40%*

Hospital Services Inpatients & Outpatient Care

20%*

40%*

Emergency Services

Covered as In-Network during true emergency

$250 copay

 

40%*

 

Urgent Care Services

$45 copay

40%*

Chiropractic Services

20%*

40%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

20%*

$45 copay

 

40%*

40%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

$15 copay

$45 copay

$75 copay

$150 copay

 

$30 copay

$90 copay

$150 copay

Not available

*After Deductible

 

 

$2,500 HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Employee w/Family Coverage

Family

 

$2,500

$2,700

$5,000

 

$5,000

$5,000

$10,000

Coinsurance

20%*

40%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$5,000

$10,000

 

$10,000

$20,000

Preventive Care

100% covered

40%*

Physician Services

20%

40%*

Hospital Services Inpatients & Outpatient Care

20%*

40%*

Emergency Services

Covered as In-Network during true emergency

20%*

 

40%*

 

Urgent Care Services

20%*

40%*

Chiropractic Services

20%*

40%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

20%*

20%*

 

40%*

40%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

20%*

20%*

20%*

20%*

 

20%*

20%*

20%*

Not available

*After Deductible

 

 

$5,000 HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$5,000

$10,000

 

$10,000

$20,000

Coinsurance

0%*

40%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$5,000

$10,000

 

$10,000

$20,000

Preventive Care

100% covered

40%*

Physician Services

0%*

40%*

Hospital Services Inpatients & Outpatient Care

0%*

40%*

Emergency Services

Covered as In-Network during true emergency

0%*

 

0%*

 

Urgent Care Services

0%*

40%*

Chiropractic Services

0%*

40%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

0%*

0%*

 

40%*

40%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

0%*

0%*

0%*

0%*

 

0%*

0%*

0%*

Not Available

*After Deductible

 

 

$6,550 HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$6,550

$13,100

 

$13,100

$26,200

Coinsurance

0%*

50%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$6,550

$13,100

 

$20,000

$40,000

Preventive Care

100% covered

50%*

Physician Services

0%*

50%*

Hospital Services Inpatients & Outpatient Care

0%*

50%*

Emergency Services

Covered as In-Network during true emergency

0%*

 

50%*

 

Urgent Care Services

0%*

50%*

Chiropractic Services

0%*

50%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

0%*

0%*

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

0%*

0%*

0%*

0%*

 

0%*

0%*

0%*

Not Available

*After Deductible

 

 

Minimum Essential Coverage Plan

In-Network

Out-Of-Network

Deductibles

Employee Only

Family

 

None

None

 

No Coverage

No Coverage

Out-Of-Pocket Maximum

Employee Only

Family

 

None

None

 

No Coverage

No Coverage

Preventative Care

100% covered

No Coverage

Retail 30 Day Supply

Mail Order 90 day Supply

Preventative Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

100% covered

100% covered

100% covered

100% covered

 

100% covered

100% covered

100% covered

Not Available

Contact your HR rep to choose your plan.

If you prefer talking with a HealthEZ representative, call 1-866-768-9686