Consumer Choice 2

 

​The Consumer Choice 2 is a qualified consumer-driven health plan (CDHP) that when combined with a Health Savings Account (HSA) provides insurance coverage and a tax-advantage way to help save for future health care expenses.

  • Deductibles: The Consumer Choice 2 plan has a $3,450 annual deductible for employee coverage or $6,900 annual deductible for all other tiers. One family member or a combination of family members can satisfy the family deductible and the full family deductible must be met before post-deductible benefits are paid.

  • Coinsurance: Once the deductible is met the Consumer Choice 2 plan will pay 100% of covered expenses from in-network providers or 60% of covered expenses from out-of-network providers.

  • Annual Out-of-Pocket Maximums: Your maximum annual out-of-pocket expenses from in-network providers for the plan year is $3,450 for employee-only coverage and $6,900 for all other tier levels (employee + spouse, employee + child(ren) or family). Out-of-network annual out-of-pocket maximum is $6,900 for employee only and $13,800 for all other tier levels. Once you meet the out-of-pocket maximum, the plan will pay 100% of eligible expenses.

  • Office Visit Charges: Under the Consumer Choice 2 plan, office visits are subject to your deductible. Copays do not apply for the Consumer Choice 2 plan – you are responsible for the entire office visit charge until you have satisfied the deductible.

  • Prescription Drug Coverage (administered by CVS Caremark): Under the Consumer Choice 2 plan, prescription drugs are subject to your deductible. Copays do not apply for the Consumer Choice 2 plan. You are responsible for payment of 100% of the cost of prescription drugs until you have satisfied the deductible. Learn More ...

Coverage at a Glance

Out-of-Pocket Expenses

In-Network

Out-of-Network

Deductible

Employee only: $3,450
Family: $6,900

Annual Out-of-Pocket Maximum
(Includes deductible)

Employee only
$3,450

Family
$6,900

Employee only
$6,900

Family
$ 13,800

Benefits

In-Network

Out-of-Network

Coinsurance Paid After Deductible
(Applies to all professional services except those noted below.)

Plan Pays 100%

You Pay 40%

Office Visit Copays
(Copays do not apply to deductible or out-of-pocket maximum)

Subject to Deductible
and Coinsurance

Lab Work/ Professional Services

Subject to Deductible and Coinsurance,
then Plan Pays 100%

Emergency Room Visit Copayment

Subject to Deductible and Coinsurance,
then Plan Pays 100%

Wellness Benefit

100% of In-Network
Eligible Charges

Benefit Limits

Maximum Lifetime Benefit
(Unless noted)

Unlimited

Substance Abuse Treatment

Subject to Deductible
and Coinsurance

Mental Illness

Subject to Deductible
and Coinsurance

Chiropractic

Subject to Deductible
and Coinsurance

Hearing Aids

Up to $1,500 After the Deductible is Met Every 3 Years Per Person Covered

Temporomandibular Joint Dysfunction and Related Disorders

Subject to Deductible
and Coinsurance

Physical, Occupational
and Speech Therapy

Subject to Deductible
and Coinsurance


What is a Deductible?

The deductible is the amount you must pay for covered medical services each year before the medical plan begins to pay benefits. The deductible starts over each January 1. 

Deductibles for Consumer Choice 2 Plan

The deductibles that apply to you depend on the coverage level you selected.

Coverage for Employee Only

  • If you elect employee only, the individual deductible applies to you. You must pay for covered medical services for yourself until the deductible has been satisfied.
  • The plan will not begin to pay for benefits until you meet the individual deductible.

Coverage for Employee and One or More Dependents

  • If you have family coverage, the entire family deductible must be met before the plan pays benefits for any covered individuals.
  • The family deductible must be met by at least one or a combination of covered individuals before the plan begins to pay benefits.


 More Information