Medical Plans
PPO Plan Comparison
Monthly Premiums |
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| Coverage Type | Premium PPO |
Standard PPO |
Consumer Choice PPO |
Employee |
Employee |
Employee |
|
| Employee | $120 |
$40 |
|
| Employee + Spouse/DP* | $294 |
$127 |
|
| Employee + Child(ren) | $270 |
$115 |
|
| Family | $446 |
$203 |
|
Annual Deductibles |
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Premium PPO |
Standard PPO |
Consumer Choice PPO |
|
| Employee | $450 |
$1,000 |
$2,700 |
| Employee + Spouse/DP* | $900 |
$2,000 |
|
| Employee + Child(ren) | $900 |
$2,000 |
|
| Family | $900 |
$2,000 |
|
Annual Out-of-Pocket Maximums Using PPO Network Providers |
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Premium PPO |
Standard PPO |
Consumer Choice PPO |
|
| Employee | $1,800 |
$3,000 |
$2,700 |
| Employee + Spouse/DP* | $3,600 |
$6,000 |
|
| Employee + Child(ren) | $3,600 |
$6,000 |
|
| Family | $3,600 |
$6,000 |
|
Annual Out-of-Pocket Maximums Out-of-Network Providers |
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Premium PPO |
Standard PPO |
Consumer Choice PPO |
|
| Employee | $2,200 |
$4,000 |
$5,450 |
| Employee + Spouse/DP* | $4,400 |
$8,000 |
$10,900 |
| Employee + Child(ren) | $4,400 |
$8,000 |
$10,900 |
| Family | $4,400 |
$8,000 |
$10,900 |
*DP = Domestic Partner