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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
$3,500 annual deductible for employee coverage or $7,000 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 $3,500 for employee-only coverage and $7,000 for all other tier
levels (employee + spouse, employee + child(ren) or family).
Out-of-network annual out-of-pocket maximum is $7,000 for employee only
and $14,000 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 ...
Employee only: $3,500Family: $7,000
Annual Out-of-Pocket Maximum (Includes deductible)
Employee only $3,500Family $7,000
Employee only $7,000Family$14,000
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
Lab Work/ Professional Services
Subject to Deductible and Coinsurance, then Plan Pays 100%
Emergency Room Visit Copayment
100% of In-Network Eligible Charges
Maximum Lifetime Benefit (Unless noted)
Substance Abuse Treatment
Up to $1,500 After the Deductible is Met Every 3 Years Per Person Covered
Temporomandibular Joint Dysfunction and Related Disorders
and Speech Therapy
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.
The deductibles that apply to you depend on the coverage level you selected.
Coverage for Employee Only
Coverage for Employee and One or More Dependents