The health plan that gives your employees more.

Before you choose a health plan:
Call us at 1-800-453-1910 or email us to have a RedShirt® contact you.

Motivating employees to stay healthy with FitWorks® Rewards.

FitWorks® Rewards is an easy online program that keeps employees motivated with monthly rewards.
Learn more »

Offering employees the chance to earn $1,000* back on fresh produce.

Our nutrition benefit rewards your employees for eating healthy.
Learn more »

The better we all collaborate, the better your employees' care.

We're making it easier for physicians to deliver better care to your employees.
Learn more »

Community partnerships to help your employees stay active.

We offer several activities and programs to encourage healthy lifestyles.
Learn more »

*Money back is in the form of store credit for future purchases. Available on select Independent Health plans. Excludes Medicare Advantage plans. Benefits vary by plan.

The plans shown below represent our 2019 Q1 Small Group plans. Download a printable version here.

To view our 2018 Q4 plans and rates, click here.

Show Plans By Metal Tier:

FlexFit Platinum

2019 Q1

Employee Rate
$638.83
Employee and Child(ren) Rate
$1,086.01
Employee and Spouse Rate
$1,277.66
Family Rate
$1,820.67
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$0
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$10/$40
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
$40
Inpatient Hospital Services
(per admission)

$500 copay per stay
Emergency Room Services
$150
Pharmacy*
$5/$30/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums


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iShare Platinum

2019 Q1New

Employee Rate
$606.21
Employee and Child(ren) Rate
$1,030.56
Employee and Spouse Rate
$1,212.42
Family Rate
$1,727.70
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$0
In-Network Coinsurance
20%
Primary Care/Specialist Office Visit
20%/20%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
20%
Inpatient Hospital Services
(per admission)

20%
Emergency Room Services
20%
Pharmacy*
$5/20%/20%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums


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Choice Plus Platinum**

2019 Q1

Employee Rate
$592.71
Employee and Child(ren) Rate
$1,007.61
Employee and Spouse Rate
$1,185.42
Family Rate
$1,689.22
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

A: $0/$0
B: $1,500/$3,000
In-Network Coinsurance
A: 0%
B: 50%
Primary Care/Specialist Office Visit
A: $10/$40
B: Deductible then 50%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
$40
Inpatient Hospital Services
(per admission)

A: $500 copay per stay
B: Deductible then 50%
Emergency Room Services
A: $150
B: $150
Pharmacy*
$5/$30/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums
**Offered in Erie and Niagara counties only

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Passport Plan Platinum

2019 Q1

Employee Rate
$1,003.40
Employee and Child(ren) Rate
$1,705.78
Employee and Spouse Rate
$2,006.80
Family Rate
$2,859.69
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$0
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$30/$50
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
$50
Inpatient Hospital Services
(per admission)

$500 copay per stay
Emergency Room Services
$150
Pharmacy*
$10/$30/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums


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Healthy New York***

2019 Q1

Employee Rate
$472.63
Employee and Child(ren) Rate
$803.47
Employee and Spouse Rate
$945.26
Family Rate
$1,347.00
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$600/$1,200
In-Network Coinsurance
N/A
Primary Care/Specialist Office Visit
Deductible then $25/$40
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
Deductible then $40
Inpatient Hospital Services
(per admission)

Deductible then $1,000 copay per stay
Emergency Room Services
Deductible then $150
Pharmacy*
$10/$35/$70
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums
***Specific qualifications must be met

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iShare Gold

2019 Q1 New

Employee Rate
$529.92
Employee and Child(ren) Rate
$900.86
Employee and Spouse Rate
$1,059.84
Family Rate
$1,510.27
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$0
In-Network Coinsurance
40%
Primary Care/Specialist Office Visit
40%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
40%
Inpatient Hospital Services
(per admission)

40%
Emergency Room Services
40%
Pharmacy*
$15/40%/40%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

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iDirect Gold Copay

2019 Q1

Employee Rate
$563.80
Employee and Child(ren) Rate
$958.46
Employee and Spouse Rate
$1,127.60
Family Rate
$1,606.83
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$1,250/$2,500
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$20/$50
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
$50
Inpatient Hospital Services
(per admission)

Deductible then $1,000 copay per stay
Emergency Room Services
$150
Pharmacy*
$10/$30/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

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iDirect Gold Copay HSAQ

2019 Q1

Employee Rate
$531.31
Employee and Child(ren) Rate
$903.23
Employee and Spouse Rate
$1,062.62
Family Rate
$1,514.23
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$1,500/$3,000
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $15/$40
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then $40
Inpatient Hospital Services
(per admission)

Deductible then $500 copay per stay
Emergency Room Services
Deductible then $100
Pharmacy*
Deductible then $4/$30/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

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Max Gold

2019 Q1

Employee Rate
$543.10
Employee and Child(ren) Rate
$923.27
Employee and Spouse Rate
$1,086.20
Family Rate
$1,547.84
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$1,250/$2,500
In-Network Coinsurance
20%
Primary Care/Specialist Office Visit
$15/Deductible then $40
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
Deductible then $40
Inpatient Hospital Services
(per admission)

Deductible then $750 copay per stay
Emergency Room Services
Deductible then 20%
Pharmacy*
Tier 1: $10 (not subject to deductible)
Tier 2: Deductible then $45
Tier 3: Deductible then 50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums


Show Benefits +

iDirect Gold Coinsurance HSAQ

2019 Q1 New

Employee Rate
$516.22
Employee and Child(ren) Rate
$877.57
Employee and Spouse Rate
$1,032.44
Family Rate
$1,471.23
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$1,500/$3,000
In-Network Coinsurance
20%
Primary Care/Specialist Office Visit
Deductible then 20%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then 20%
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy*
Deductible then 20% on all tiers
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums


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Choice Plus Gold**

2019 Q1

Employee Rate
$525.40
Employee and Child(ren) Rate
$893.18
Employee and Spouse Rate
$1,050.80
Family Rate
$1,497.39
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

A: $1,350/$2,700
B: $2,250/$4,500
In-Network Coinsurance
A: 0%
B: 50%
Primary Care/Specialist Office Visit
A: $20/$50
B: Deductible then 50%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
$50
Inpatient Hospital Services
(per admission)

Deductible then
A: $1,000 copay per stay
B: 50%
Emergency Room Services
A: $150
B: $150
Pharmacy*
$10/$30/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums
**Offered in Erie and Niagara counties only

Show Benefits +

NY PA Gold

2019 Q1

Employee Rate
$537.97
Employee and Child(ren) Rate
$914.55
Employee and Spouse Rate
$1,075.94
Family Rate
$1,533.21
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$2,000/$4,000
In-Network Coinsurance
20%
Primary Care/Specialist Office Visit
20%/Deductible then 20%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
Deductible then 20%
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy*
$10/$50/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums


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Passport Plan Gold

2019 Q1

Employee Rate
$779.83
Employee and Child(ren) Rate
$1,325.71
Employee and Spouse Rate
$1,559.66
Family Rate
$2,222.52
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$2,000/$4,000
In-Network Coinsurance
20%
Primary Care/Specialist Office Visit
20%/Deductible then 20%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
Deductible then 20%
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy*
$10/$50/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums


Show Benefits +

Standard Silver

2019 Q1

Employee Rate
$511.91
Employee and Child(ren) Rate
$870.25
Employee and Spouse Rate
$1,023.82
Family Rate
$1,458.94
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$1,700/$3,400
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $30/$50
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
Deductible then $50
Inpatient Hospital Services
(per admission)

Deductible then $1,500 copay per stay
Emergency Room Services
Deductible then $250
Pharmacy*
$10/$35/$70
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums


Show Benefits +

iDirect Silver Copay

2019 Q1

Employee Rate
$486.54
Employee and Child(ren) Rate
$827.12
Employee and Spouse Rate
$973.08
Family Rate
$1,386.64
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$2,250/$4,500
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $35/$60
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
Deductible then $60
Inpatient Hospital Services
(per admission)

Deductible then $1,000 copay per stay
Emergency Room Services
Deductible then $250
Pharmacy*
$10/$50/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums


Show Benefits +

iDirect Silver Copay HSAQ

2019 Q1

Employee Rate
$470.78
Employee and Child(ren) Rate
$800.33
Employee and Spouse Rate
$941.56
Family Rate
$1,341.72
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$2,250/$4,500
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $35/$60
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then $60
Inpatient Hospital Services
(per admission)

Deductible then $1,000 copay per stay
Emergency Room Services
Deductible then $250
Pharmacy*
Deductible then $15/$50/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums


Show Benefits +

iDirect Silver Coinsurance HSAQ

2019 Q1

Employee Rate
$451.12
Employee and Child(ren) Rate
$766.90
Employee and Spouse Rate
$902.24
Family Rate
$1,285.69
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$3,000/$6,000
In-Network Coinsurance
20%
Primary Care/Specialist Office Visit
Deductible then 20%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then 20%
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy*
Deductible then $15/$50/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

Show Benefits +

Max Silver

2019 Q1

Employee Rate
$471.69
Employee and Child(ren) Rate
$801.87
Employee and Spouse Rate
$943.38
Family Rate
$1,344.32
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$2,800/$5,600
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$35/Deductible then $50
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
Deductible then $50
Inpatient Hospital Services
(per admission)

Deductible then $1,000 copay per stay
Emergency Room Services
Deductible then $225
Pharmacy*
Tier 1: $10 (not subject to deductible)
Tier 2: Deductible then $50
Tier 3: Deductible then 50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

Show Benefits +

iDirect Silver Blended

2019 Q1 New

Employee Rate
$436.83
Employee and Child(ren) Rate
$742.61
Employee and Spouse Rate
$873.66
Family Rate
$1,244.97
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$3,325/$6,650
In-Network Coinsurance
25%
Primary Care/Specialist Office Visit
Deductible then $35/$50
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
Deductible then $50
Inpatient Hospital Services
(per admission)

Deductible then 25%
Emergency Room Services
Deductible then 25%
Pharmacy*
Deductible then 25% on all tiers
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

Show Benefits +

Choice Plus Silver HSAQ**

2019 Q1

Employee Rate
$435.01
Employee and Child(ren) Rate
$739.52
Employee and Spouse Rate
$870.02
Family Rate
$1,239.78
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

A: $2,600/$5,200
B: $3,750/$7,500
In-Network Coinsurance
A: $0
B: 50%
Primary Care/Specialist Office Visit
Deductible then
A: $35/$60
B: 50%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then $60
Inpatient Hospital Services
(per admission)

Deductible then
A: 30%
B: 50%
Emergency Room Services
Deductible then
A: $250
B: $250
Pharmacy*
Deductible then $15/$50/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums
**Offered in Erie and Niagara counties only

Show Benefits +

NY PA Silver HSAQ

2019 Q1

Employee Rate
$471.54
Employee and Child(ren) Rate
$801.62
Employee and Spouse Rate
$943.08
Family Rate
$1,343.89
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$3,000/$6,000
In-Network Coinsurance
20%
Primary Care/Specialist Office Visit
Deductible then 20%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then 20%
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy*
Deductible then $15/$50/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

Show Benefits +

Passport Plan Silver HSAQ

2019 Q1

Employee Rate
$688.93
Employee and Child(ren) Rate
$1,171.18
Employee and Spouse Rate
$1,377.86
Family Rate
$1,963.45
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$3,000/$6,000
In-Network Coinsurance
20%
Primary Care/Specialist Office Visit
Deductible then 20%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then 20%
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy*
Deductible then $15/$50/50%
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

Show Benefits +

Standard Bronze

2019 Q1

Employee Rate
$414.09
Employee and Child(ren) Rate
$703.95
Employee and Spouse Rate
$828.18
Family Rate
$1,180.16
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$4,000/$8,000
In-Network Coinsurance
50%
Primary Care/Specialist Office Visit
Deductible then 50%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

$0
New! Telemedicine Dermatology
Deductible then 50%
Inpatient Hospital Services
(per admission)

Deductible then 50%
Emergency Room Services
Deductible then 50%
Pharmacy*
Deductible then $10/$35/$70
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

Show Benefits +

iDirect Bronze Enhanced HSAQ

2019 Q1

Employee Rate
$430.65
Employee and Child(ren) Rate
$732.11
Employee and Spouse Rate
$861.30
Family Rate
$1,227.35
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$3,500/$7,000
In-Network Coinsurance
30%
Primary Care/Specialist Office Visit
Deductible then 30%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then 30%
Inpatient Hospital Services
(per admission)

Deductible then 30%
Emergency Room Services
Deductible then 30%
Pharmacy*
Deductible then 30% on all tiers
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

Show Benefits +

iDirect Bronze HSAQ

2019 Q1

Employee Rate
$413.73
Employee and Child(ren) Rate
$703.34
Employee and Spouse Rate
$827.46
Family Rate
$1,179.13
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$5,150/$10,300
In-Network Coinsurance
50%
Primary Care/Specialist Office Visit
Deductible then 50%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then 50%
Inpatient Hospital Services
(per admission)

Deductible then 50%
Emergency Room Services
Deductible then 50%
Pharmacy*
Deductible then 50% on all tiers
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

Show Benefits +

iDirect Bronze MV HSAQ

2019 Q1

Employee Rate
$410.78
Employee and Child(ren) Rate
$698.33
Employee and Spouse Rate
$821.56
Family Rate
$1,170.72
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$6,650/$13,300
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $0
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then $0 copay per stay
Emergency Room Services
Deductible then $0
Pharmacy*
Deductible then $0 on all tiers
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

Show Benefits +

Passport Plan Bronze HSAQ

2019 Q1

Employee Rate
$628.15
Employee and Child(ren) Rate
$1,067.86
Employee and Spouse Rate
$1,256.30
Family Rate
$1,790.23
In-Network Deductible
(All plans accumulate as a true family deductible except standard plans.)

$5,150/$10,300
In-Network Coinsurance
50%
Primary Care/Specialist Office Visit
Deductible then 50%
Enhanced! Telemedicine including Mental Health, Behavioral Health and Substance Use Disorder
(participating Teledoc® providers only)

Deductible then $0
New! Telemedicine Dermatology
Deductible then 50%
Inpatient Hospital Services
(per admission)

Deductible then 50%
Emergency Room Services
Deductible then 50%
Pharmacy*
Deductible then 50% on all tiers
OON coverage only applies to non-participating providers outside the 8 counties of WNY
*All pharmacy copays/coinsurance accumulate to out-of-pocket maximums

Show Benefits +