Basic Plan Information

Type of Plan: There are several types of plans available; PPO, EPO and HMO. The primary differences are upon enrollment with a HMO you select a Personal Care Physician (PCP) who directs your care and access to specialists. The benefit structure revolves around copayments versus coinsurance or share, and there is no coverage outside of the "Network" except in the case of an emergency. With a PPO or EPO, there is no PCP so coverage is accessed as needed and coverage involves a deductible and coinsurance or share. The difference between an EPO and a PPO is with an EPO there is no out-of-network coverage, similar to an HMO.

Coverage Tiers: There are four tiers of coverage available; Bronze, Silver, Gold and Platinum. With the Bronze plan typically you will find a lower premium but high deductible, high copayments and a high yearly maximum out of pocket. On the other end of the scale, a Platinum plan will normally have a higher premium, low or no deductible, low copayments and a lower yearly maximum out of pocket.

Pricing Choices: Low premium will generally come with high deductibles, high copayments and high yearly out-of-pocket maximums. Higher premium will generally come with low or no deductibles, low or no copayments and lower yearly out-of-pocket maximums.