Elevate 2020 Overview

Bronze HDHP
Deductible
$6,550 Individual/$13,100 Family
Out-of-Pocket Max
$6,600 Individual/$13,200 Family
Preventive Care
No charge
Coinsurance
50%
PCP/Specialist
50% Coinsurance after Deductible
Emergency/Urgent Care
50% Coinsurance after Deductible
Silver Standard Rx Copay
Deductible
$3,750 Individual/$7,500 Family
Out-of-Pocket Max
$7,150 Individual/$14,300 Family
Preventive Care
No charge
Coinsurance
30%
PCP/Specialist
30% Coinsurance after Deductible
Emergency/Urgent Care
30% Coinsurance after Deductible
Gold Standard Rx Copay
Deductible
$2,750 Individual/$5,500 Family
Out-of-Pocket Max
$7,000 Individual/$14,000 Family
Preventive Care
No charge
Coinsurance
10%
PCP/Specialist
10% Coinsurance (Deductible does not apply)/10% Coinsurance after Deductible
Emergency/Urgent Care
10% Coinsurance after Deductible