Consumer Choice PPO Plan

 

The Consumer Choice PPO Plan is a qualified high deductible health plan (HDHP) 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 PPO plan has a $2,700 deductible for employee coverage or $5,450 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 PPO 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 $2,700 for employee only coverage and $5,450 for all other tier levels (employee + spouse, employee + child(ren) or family). Out-of-network annual out-of-pocket maximum is $5,400 for employee only and $10,900 for all other tier levels.
  
  
• Office Visit Charges: Under the Consumer Choice PPO plan, office visits are subject to your deductible. Copays do not apply for the Consumer Choice PPO 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 PPO plan, prescription drugs are subject to your deductible. Copays do not apply for the Consumer Choice PPO plan. You are responsible for payment of 100% of the cost of prescription drugs until you have satisfied the deductible.

Cost of Consumer Choice PPO Plan

Full-Time Monthly Medical Plan Rates (Employees Working 32+ Hours)
Coverage Tiers	You Pay	HSA Employer Contribution
Employee Only	$0	$30
Employee + Spouse/Domestic Partner	$0	$22
Employee + Child(ren)	$0	$23
Family	$0	$14

 

What medical plan is right for you?  Use the customized Health Plan Cost Estimator Tool.

 

Deductibles for Consumer Choice PPO Plan

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

Coverage for an Individual

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

Coverage for an Individual 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  covered individual before the plan begins to pay benefits.