Medical Plans Comparison

In-Network Benefits

Plan Features
$750 PPO
Preferred-Care Blue
$2,800 HDHP
Preferred-Care Blue
$4,000 HDHP
Preferred-Care Blue
$4,000 HDHP
BlueSelect Plus + Spira Care
Deductible
(Calendar year)
$750 individual /
$1,500 family
$2,800 individual /
$5,600 family
$4,000 individual /
$8,000 family
$4,000 individual /
$8,000 family
Out-of-Pocket Maximum
(Calendar year)
$3,000 individual /
$6,000 family
$2,800 individual /
$5,600 family
$5,000 individual /
$10,000 family
$5,000 individual /
$10,000 family
Coinsurance
(Plan pays/You pay)
80% / 20%100% / 0%90% / 10%90% / 10%
Primary Care Physician Office Visits$25 copayDeductible, then 0% coinsuranceDeductible, then 10% coinsuranceDeductible, then 10% coinsurance
Specialist Office Visits$50 copayDeductible, then 0% coinsuranceDeductible, then 10% coinsuranceDeductible, then 10% coinsurance
Preventive Care100%100%100%100%
Urgent Care$50 copayDeductible, then 0% coinsuranceDeductible, then 10% coinsuranceDeductible, then 10% coinsurance
Emergency Room$300 Copay, then deductible, then 20% coinsuranceIn-Network deductible, then 0% coinsuranceIn-Network deductible, then 10% coinsuranceIn-Network deductible, then 10% coinsurance
Inpatient ServicesDeductible, then 20% coinsuranceDeductible, then 0% coinsuranceDeductible, then 10% coinsuranceDeductible, then 10% coinsurance
Outpatient ServicesDeductible, then 20% coinsuranceDeductible, then 0% coinsuranceDeductible, then 10% coinsuranceDeductible, then 10% coinsurance
Retail Prescription Drug Coverage
(up to 34-day supply)
Tier 1: $10 copay
Tier 2: $35 copay
Tier 3: $60 copay
Deductible, then 0% coinsuranceDeductible, then
Tier 1: $10 copay
Tier 2: $35 copay
Tier 3: $60 copay
Deductible, then
Tier 1: $10 copay
Tier 2: $35 copay
Tier 3: $60 copay
Mail Order
(up to 102-day supply)
Tier 1: $25 copay
Tier 2: $87.50 copay
Tier 3: $150 copay
Deductible, then 0% coinsuranceDeductible, then
Tier 1: $25 copay
Tier 2: $87.50 copay
Tier 3: $150 copay
Deductible, then
Tier 1: $25 copay
Tier 2: $87.50 copay
Tier 3: $150 copay
Monthly Premium
$750 PPO
Preferred-Care Blue
$2,800 HDHP
Preferred-Care Blue
$4,000 HDHP
Preferred-Care Blue
$4,000 HDHP
BlueSelect Plus + Spira Care
    Employee only
$142.24$118.77$23.49$0.00
    Employee + Spouse
$558.43$509.16$309.05$233.59
    Employee + Child(ren)
$505.24$460.67$279.62$211.34
    Family
$771.17$703.16$426.81$322.58

Out-Of-Network Benefits

Plan Features
$750 PPO
Preferred-Care Blue
$2,800 HDHP
Preferred-Care Blue
$4,000 HDHP
Preferred-Care Blue
$4,000 HDHP
BlueSelect Plus + Spira Care
Deductible
(Calendar year)
$1,500 individual /
$3,000 family
$2,800 individual /
$5,600 family
$1,500 individual /
$3,000 family
$8,000 individual /
$16,000 family
Out-of-Pocket Maximum
(Calendar year)
$6,000 individual /
$12,000 family
$5,600 individual /
$11,200 family
$6,000 individual /
$12,000 family
$25,000 individual /
$50,000 family
Coinsurance
(Plan pays/You pay)
60% / 40%80% / 20%60% / 40%60% / 40%
Primary Care Physician Office VisitsDeductible, then 40% coinsuranceDeductible, then 20% coinsuranceDeductible, then 30% coinsuranceDeductible, then 40% coinsurance
Specialist Office VisitsDeductible, then 40% coinsuranceDeductible, then 20% coinsuranceDeductible, then 30% coinsuranceDeductible, then 40% coinsurance
Preventive CareDeductible, then 40% coinsuranceDeductible, then 20% coinsuranceDeductible, then 30% coinsuranceDeductible, then 40% coinsurance
Urgent CareDeductible, then 40% coinsuranceDeductible, then 20% coinsuranceDeductible, then 30% coinsuranceDeductible, then 40% coinsurance
Emergency Room$300 copay, then deductible, then 20% coinsurance $300 copay, then deductible, then 20% coinsurance $300 copay, then deductible, then 20% coinsurance $300 copay, then deductible, then 20% coinsurance
Inpatient ServicesDeductible, then 40% coinsuranceDeductible, then 20% coinsuranceDeductible, then 30% coinsuranceDeductible, then 40% coinsurance
Outpatient ServicesDeductible, then 40% coinsuranceDeductible, then 20% coinsuranceDeductible, then 30% coinsuranceDeductible, then 40% coinsurance
Retail Prescription Drug Coverage
(up to 34-day supply)
Copay + 50% coinsuranceDeductible, then 50% coinsuranceDeductible, then 50% coinsuranceDeductible, then 50% coinsurance
Mail Order
(up to 102-day supply)
Copay + 50% coinsuranceDeductible, then 50% coinsuranceDeductible, then 50% coinsuranceDeductible, then 50% coinsurance