Tier 1 — 80/20 Coinsurance · Plan pays 80% after deductible · $2,000 out-of-pocket maximum · then 100%
Platinum
Sickness deductible
$2,500
Coinsurance after deductible
Plan pays 80%
Out-of-pocket maximum
$2,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Gold
Sickness deductible
$3,750
Coinsurance after deductible
Plan pays 80%
Out-of-pocket maximum
$2,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Silver
Sickness deductible
$5,000
Coinsurance after deductible
Plan pays 80%
Out-of-pocket maximum
$2,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Bronze
Sickness deductible
$7,500
Coinsurance after deductible
Plan pays 80%
Out-of-pocket maximum
$2,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Iron
Sickness deductible
$10,000
Coinsurance after deductible
Plan pays 80%
Out-of-pocket maximum
$2,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Tier 2 — 70/30 Coinsurance · Plan pays 70% after deductible · $6,000 out-of-pocket maximum · then 100%
Platinum
Sickness deductible
$2,500
Coinsurance after deductible
Plan pays 70%
Out-of-pocket maximum
$6,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Gold
Sickness deductible
$3,750
Coinsurance after deductible
Plan pays 70%
Out-of-pocket maximum
$6,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Silver
Sickness deductible
$5,000
Coinsurance after deductible
Plan pays 70%
Out-of-pocket maximum
$6,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Bronze
Sickness deductible
$7,500
Coinsurance after deductible
Plan pays 70%
Out-of-pocket maximum
$6,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Iron
Sickness deductible
$10,000
Coinsurance after deductible
Plan pays 70%
Out-of-pocket maximum
$6,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Tier 3 — 60/40 Coinsurance · Plan pays 60% after deductible · $10,000 out-of-pocket maximum · then 100%
Platinum
Sickness deductible
$2,500
Coinsurance after deductible
Plan pays 60%
Out-of-pocket maximum
$10,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Gold
Sickness deductible
$3,750
Coinsurance after deductible
Plan pays 60%
Out-of-pocket maximum
$10,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Silver
Sickness deductible
$5,000
Coinsurance after deductible
Plan pays 60%
Out-of-pocket maximum
$10,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Bronze
Sickness deductible
$7,500
Coinsurance after deductible
Plan pays 60%
Out-of-pocket maximum
$10,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit
Iron
Sickness deductible
$10,000
Coinsurance after deductible
Plan pays 60%
Out-of-pocket maximum
$10,000
Doctor visits
Plan pays $100/visit
5/yr per person · rollover
Generic Rx · Brand Rx
$10 · $50
Annual max $1,000
Urgent care
Plan pays $100/visit