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

$1,500 HSA Plan

In-Network

Out-Of-Network

Plan Year Deductible-Non-Embedded

Employee Only

Family

 

$1,500

$3,000

 

$4,000

$8,000

Coinsurance

10%

30%

Out-Of-Pocket Maximum

Employee Only

Family

 

$2,500

$5,000

 

$8,000

$16,000

Preventive Care

100% covered

30%*

Physician Services

10%*

30%*

Hospital Services- Inpatient & Outpatient Care

10%*

30%*

Emergency Services

Covered as In-Network during true emergency

10%*

 

30%*

 

Urgent Care Services

10%*

30%*

Chiropractic Services

10%*

30%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

10%*

10%*

 

30%*

30%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 copay*

$35 copay*

$60 copay*

$60 copay*

 

$25 copay*

$87 copay*

$150 copay*

$60 copay*

NOTE: *After Deductible

 

 

$2,000 HSA Plan

In-Network

Out-Of-Network

Plan Year Deductible- Non- Embedded

Employee Only

Family

 

$2,000

$4,000

 

$4,000

$8,000

Coinsurance

10%

30%

Out-Of-Pocket Maximum

Employee Only

Family

 

$3,000

$6,000

 

$8,000

$16,000

Preventive Care

100% covered

30%*

Physician Services

10%*

30%*

Hospital Services- Inpatient & Outpatient Care

10%*

30%*

Emergency Services

Covered as In-Network during true emergency

10%*

 

30%*

 

Urgent Care Services

10%*

30%*

Chiropractic Services

10%*

30%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

10%*

10%*

 

30%*

30%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

$10 copay*

$35 copay*

$60 copay*

$60 copay*

 

$25 copay*

$87 copay*

$150 copay*

$60 copay*

NOTE: *After Deductible

 

 

$2,700 HSA Plan

In-Network

Out-Of-Network

Play Year Deductible- Embedded

Employee Only

Family

 

$2,700

$5,200

 

$4,000

$8,000

Coinsurance

10%

30%

Out-Of-Pocket Maximum

Employee Only

Family

 

$3,600

$7,200

 

$8,000

$16,000

Preventive Care

100% Covered

30%*

Physician Services

10%*

30%*

Hospital Services Inpatients & Outpatient Care

10%*

30%*

Emergency Services

Covered as In-Network during true emergency

10%*

 

30%*

 

Urgent Care Services

10%*

30%*

Chiropractic Services

10%*

30%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

10%*

10%*

 

30%*

30%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 copay*

$35 copay*

$60 copay*

$60 copay

 

$25 copay

$87 copay*

$150 copay*

Not Available

NOTE: *After Deductible

 

 

Contact your HR rep to choose your plan.

If you prefer talking with a HealthEZ representative, call 855-520-4324