It’s never been easier to choose Independent Health
The lowest rates. New and enhanced product options.
And the RedShirt® Treatment.

Since 1980, our mission has been to provide affordable access to quality coverage while enhancing the health and well-being of the communities we serve. We do this by working collaboratively with physicians, hospital systems and other community partners. The trusted relationships we've built over the last 40+ years have helped us bring you the lowest rates for 2022.

Lower Premiums

Lowest rates for 2022

Read More »
Product Options

New and unique plans for 2022.

Read More »
Better Care

Better care and outcomes for employees

Read More »
Locally Owned

Locally owned
health plan

Read More »

Satisfaction across all audiences

Satisfied
Recommended
Preferred

*2021 Annual Employer Stakeholder Study

**2021 Physician and Office Manager Stakeholder Survey

Independent Health has the lowest rates in 2022.

The plans shown below represent our 2022 Q4 Small Group plans. Download a printable version here.

To view our 2022 Q3 plans and rates, click here.

Show Plans By Metal Tier:

FlexFit Platinum

2022 Q4

Employee Rate
$643.36
Employee and Child(ren) Rate
$1,093.71
Employee and Spouse Rate
$1,286.72
Family Rate
$1,833.58
First Dollar Coverage
N/A
In-Network Deductible
$0
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$10/$40
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

$500
Emergency Room Services
$150
Pharmacy1
$5/$30/50%

Show Benefits +

FlexFit Platinum Option 2

2022 Q4 New

Employee Rate
$658.70
Employee and Child(ren) Rate
$1,119.79
Employee and Spouse Rate
$1,317.40
Family Rate
$1,877.30
First Dollar Coverage
N/A
In-Network Deductible
$0
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$5/$25
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

$500
Emergency Room Services
$150
Pharmacy1
$5/$30/$100

Show Benefits +

Choice Plus Platinum2

2022 Q4

Employee Rate
$609.19
Employee and Child(ren) Rate
$1,035.62
Employee and Spouse Rate
$1,218.38
Family Rate
$1,736.19
First Dollar Coverage
N/A
In-Network Deductible
A: $0
B: $1,500/$3,000 (T)
In-Network Coinsurance
A: 0%
B: Deductible then 50%
Primary Care/Specialist Office Visit
A: $10/$40
B: Deductible then 50%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

A: $500
B: Deductible then 50%
Emergency Room Services
A: $150
B: $150
Pharmacy1
$5/$30/50%

Show Benefits +

Passport Plan National Platinum

2022 Q4

Employee Rate
$707.56
Employee and Child(ren) Rate
$1,202.85
Employee and Spouse Rate
$1,415.12
Family Rate
$2,016.55
First Dollar Coverage
N/A
In-Network Deductible
$0
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$10/$40
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

$500
Emergency Room Services
$150
Pharmacy1
$5/$30/50%

Show Benefits +

Passport Plan Local Platinum4

2022 Q4

Employee Rate
$672.93
Employee and Child(ren) Rate
$1,143.98
Employee and Spouse Rate
$1,345.86
Family Rate
$1,917.85
First Dollar Coverage
N/A
In-Network Deductible
$0
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$10/$40
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

$500
Emergency Room Services
$150
Pharmacy1
$5/$30/50%

Show Benefits +

thRed Platinum5

2022 Q4 New

Employee Rate
$586.78
Employee and Child(ren) Rate
$997.53
Employee and Spouse Rate
$1,173.56
Family Rate
$1,672.32
First Dollar Coverage
N/A
In-Network Deductible
$0
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$0/$40
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

$500
Emergency Room Services
$150
Pharmacy1
$5/$30/50%

Show Benefits +

Activate Gold

2022 Q4

Employee Rate
$527.17
Employee and Child(ren) Rate
$896.19
Employee and Spouse Rate
$1,054.34
Family Rate
$1,502.43
First Dollar Coverage
$750/$1,500
In-Network Deductible
$1,500/$3,000 (E)
In-Network Coinsurance
25% Coinsurance after first dollar and deductible
Primary Care/Specialist Office Visit
$20/$50 Copayment after first dollar and deductible
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

25% Coinsurance after first dollar and deductible
Emergency Room Services
25% Coinsurance after first dollar and deductible
Pharmacy1
$10/25%/50% after first dollar and deductible

Show Benefits +

thRed Gold5

2022 Q4

Employee Rate
$500.57
Employee and Child(ren) Rate
$850.97
Employee and Spouse Rate
$1,001.14
Family Rate
$1,426.62
First Dollar Coverage
N/A
In-Network Deductible
$1,500/$3,000 (T)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$0/Deductible then $50
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

Deductible then $1,000
Emergency Room Services
Deductible then $150
Pharmacy1
$10/$40/50%

Show Benefits +

Standard Healthy NY Gold3

2022 Q4

Employee Rate
$491.17
Employee and Child(ren) Rate
$834.99
Employee and Spouse Rate
$982.34
Family Rate
$1,399.83
First Dollar Coverage
N/A
In-Network Deductible
$600/$1,200 (E)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $25/Deductible then $40
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

Deductible then $1,000
Emergency Room Services
Deductible then $150
Pharmacy1
$10/$35/$70

Show Benefits +

iDirect Gold Copay

2022 Q4

Employee Rate
$555.93
Employee and Child(ren) Rate
$945.08
Employee and Spouse Rate
$1,111.86
Family Rate
$1,584.40
First Dollar Coverage
N/A
In-Network Deductible
$1,250/$2,500 (T)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$20/Deductible then $50
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

Deductible then $1,000
Emergency Room Services
$150
Pharmacy1
$10/$40/50%

Show Benefits +

iDirect Gold Copay Option 2

2022 Q4 New

Employee Rate
$560.36
Employee and Child(ren) Rate
$952.61
Employee and Spouse Rate
$1,120.72
Family Rate
$1,597.03
First Dollar Coverage
N/A
In-Network Deductible
$1,250/$2,500 (T)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$20/Deductible then $50
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

Deductible then $750
Emergency Room Services
Deductible then $150
Pharmacy1
$10/$40/$100

Show Benefits +

iDirect Gold Copay HSAQ
HealthEquity

2022 Q4

Employee Rate
$536.20
Employee and Child(ren) Rate
$911.54
Employee and Spouse Rate
$1,072.40
Family Rate
$1,528.17
First Dollar Coverage
N/A
In-Network Deductible
$1,400/$2,800 (T)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $20/Deductible then $50
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then $750
Emergency Room Services
Deductible then $150
Pharmacy1
Deductible then $10/$40/50%

Show Benefits +

iDirect Gold Coinsurance HSAQ
HealthEquity

2022 Q4

Employee Rate
$510.37
Employee and Child(ren) Rate
$867.63
Employee and Spouse Rate
$1,020.74
Family Rate
$1,454.55
First Dollar Coverage
N/A
In-Network Deductible
$1,400/$2,800 (T)
In-Network Coinsurance
Deductible then 20%
Primary Care/Specialist Office Visit
Deductible then 20%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy1
Deductible then 20%/20%/50%

Show Benefits +

Choice Plus Gold2

2022 Q4

Employee Rate
$529.95
Employee and Child(ren) Rate
$900.92
Employee and Spouse Rate
$1,059.90
Family Rate
$1,510.36
First Dollar Coverage
N/A
In-Network Deductible
A: $1,250/$2,500 (T)
B: $2,750/$5,500 (T)
In-Network Coinsurance
A: 0%
B: Deductible then 50%
Primary Care/Specialist Office Visit
A: $20/Deductible then $50
B: Deductible then 50%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

Deductible then
A: $1,000
B: 50%
Emergency Room Services
A: $150
B: $150
Pharmacy1
$10/$40/50%

Show Benefits +

Passport Plan National Gold HSAQ
HealthEquity

2022 Q4

Employee Rate
$560.09
Employee and Child(ren) Rate
$952.15
Employee and Spouse Rate
$1,120.18
Family Rate
$1,596.26
First Dollar Coverage
N/A
In-Network Deductible
$1,400/$2,800 (T)
In-Network Coinsurance
Deductible then 20%
Primary Care/Specialist Office Visit
Deductible then 20%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy1
Deductible then 20%/20%/50%

Show Benefits +

Passport Plan Local Gold HSAQ4
HealthEquity

2022 Q4

Employee Rate
$534.90
Employee and Child(ren) Rate
$909.33
Employee and Spouse Rate
$1,069.80
Family Rate
$1,524.47
First Dollar Coverage
N/A
In-Network Deductible
$1,400/$2,800 (T)
In-Network Coinsurance
Deductible then 20%
Primary Care/Specialist Office Visit
Deductible then 20%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy1
Deductible then 20%/20%/50%

Show Benefits +

Standard Silver

2022 Q4

Employee Rate
$516.07
Employee and Child(ren) Rate
$877.32
Employee and Spouse Rate
$1,032.14
Family Rate
$1,470.80
First Dollar Coverage
N/A
In-Network Deductible
$1,300/$2,600 (E)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $30/Deductible then $50
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

Deductible then $1,500
Emergency Room Services
Deductible then $300
Pharmacy1
$10/$35/$70

Show Benefits +

Activate Silver

2022 Q4

Employee Rate
$460.42
Employee and Child(ren) Rate
$782.71
Employee and Spouse Rate
$920.84
Family Rate
$1,312.20
First Dollar Coverage
$500/$1,000
In-Network Deductible
$3,000/$6,000 (E)
In-Network Coinsurance
40% Coinsurance after first dollar and deductible
Primary Care/Specialist Office Visit
$35/$60 Copayment after first dollar and deductible
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

40% Coinsurance after first dollar and deductible
Emergency Room Services
40% Coinsurance after first dollar and deductible
Pharmacy1
$15/40%/50% after first dollar and deductible

Show Benefits +

thRed Silver5

2022 Q4

Employee Rate
$443.84
Employee and Child(ren) Rate
$754.53
Employee and Spouse Rate
$887.68
Family Rate
$1,264.94
First Dollar Coverage
N/A
In-Network Deductible
$3,500/$7,000 (T)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$0/Deductible then $60
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

Deductible then $1,500
Emergency Room Services
Deductible then $250
Pharmacy1
$15/$50/50%

Show Benefits +

thRed Silver HSAQ5
HealthEquity

2022 Q4

Employee Rate
$405.90
Employee and Child(ren) Rate
$690.03
Employee and Spouse Rate
$811.80
Family Rate
$1,156.82
First Dollar Coverage
N/A
In-Network Deductible
$3,500/$7,000 (T)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $0/Deductible then $60
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then $1,500
Emergency Room Services
Deductible then $250
Pharmacy1
Deductible then $15/$50/50%

Show Benefits +

iDirect Silver Copay

2022 Q4

Employee Rate
$488.37
Employee and Child(ren) Rate
$830.23
Employee and Spouse Rate
$976.74
Family Rate
$1,391.85
First Dollar Coverage
N/A
In-Network Deductible
$2,000/$4,000 (T)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $35/Deductible then $60
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

Deductible then $1,000
Emergency Room Services
Deductible then $250
Pharmacy1
$15/$50/50%

Show Benefits +

iDirect Silver Copay HSAQ
HealthEquity

2022 Q4

Employee Rate
$479.26
Employee and Child(ren) Rate
$814.74
Employee and Spouse Rate
$958.52
Family Rate
$1,365.89
First Dollar Coverage
N/A
In-Network Deductible
$2,000/$4,000 (T)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $35/Deductible then $60
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then $1,000
Emergency Room Services
Deductible then $250
Pharmacy1
Deductible then $15/$50/50%

Show Benefits +

iDirect Silver Coinsurance HSAQ
HealthEquity

2022 Q4

Employee Rate
$447.62
Employee and Child(ren) Rate
$760.95
Employee and Spouse Rate
$895.24
Family Rate
$1,275.72
First Dollar Coverage
N/A
In-Network Deductible
$3,000/$6,000 (T)
In-Network Coinsurance
Deductible then 20%
Primary Care/Specialist Office Visit
Deductible then 20%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy1
Deductible then 20%/20%/50%

Show Benefits +

Max Silver

2022 Q4

Employee Rate
$479.98
Employee and Child(ren) Rate
$815.97
Employee and Spouse Rate
$959.96
Family Rate
$1,367.94
First Dollar Coverage
N/A
In-Network Deductible
$2,800/$5,600 (T)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
$35/Deductible then $60
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

Deductible then $1,000
Emergency Room Services
Deductible then $250
Pharmacy1
$15/Deductible then $50/Deductible then 50%

Show Benefits +

Choice Plus Silver HSAQ2
HealthEquity

2022 Q4

Employee Rate
$457.81
Employee and Child(ren) Rate
$778.28
Employee and Spouse Rate
$915.62
Family Rate
$1,304.76
First Dollar Coverage
N/A
In-Network Deductible
A: $2,000/$4,000 (T)
B: $3,500/$7,000 (T)
In-Network Coinsurance
A: 0%
B: Deductible then 50%
Primary Care/Specialist Office Visit
Deductible then
A: $35/$60
B: 50%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then
A: $1,000
B: 50%
Emergency Room Services
Deductible then
A: $250
B: $250
Pharmacy1
Deductible then
$15/$50/50%

Show Benefits +

Passport Plan National Silver HSAQ
HealthEquity

2022 Q4

Employee Rate
$491.56
Employee and Child(ren) Rate
$835.65
Employee and Spouse Rate
$983.12
Family Rate
$1,400.95
First Dollar Coverage
N/A
In-Network Deductible
$3,000/$6,000 (E)
In-Network Coinsurance
Deductible then 20%
Primary Care/Specialist Office Visit
Deductible then 20%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy1
Deductible then 20%/20%/50%

Show Benefits +

Passport Plan Local Silver HSAQ4
HealthEquity

2022 Q4

Employee Rate
$470.12
Employee and Child(ren) Rate
$799.20
Employee and Spouse Rate
$940.24
Family Rate
$1,339.84
First Dollar Coverage
N/A
In-Network Deductible
$3,000/$6,000 (E)
In-Network Coinsurance
Deductible then 20%
Primary Care/Specialist Office Visit
Deductible then 20%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then 20%
Emergency Room Services
Deductible then 20%
Pharmacy1
Deductible then 20%/20%/50%

Show Benefits +

thRed Bronze5

2022 Q4

Employee Rate
$351.49
Employee and Child(ren) Rate
$597.53
Employee and Spouse Rate
$702.98
Family Rate
$1,001.75
First Dollar Coverage
N/A
In-Network Deductible
$8,550/$17,100 (E)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $0
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

$0
Inpatient Hospital Services
(per admission)

Deductible then $0
Emergency Room Services
Deductible then $0
Pharmacy1
Deductible then $0

Show Benefits +

iDirect Bronze Blended HSAQ
HealthEquity

2022 Q4

Employee Rate
$408.80
Employee and Child(ren) Rate
$694.96
Employee and Spouse Rate
$817.60
Family Rate
$1,165.08
First Dollar Coverage
N/A
In-Network Deductible
$6,000/$12,000 (E)
In-Network Coinsurance
Deductible then 30%
Primary Care/Specialist Office Visit
Deductible then $40/Deductible then $60
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then 30%
Emergency Room Services
Deductible then 30%
Pharmacy1
Deductible then $20/30%/50%

Show Benefits +

iDirect Bronze Coinsurance HSAQ
HealthEquity

2022 Q4

Employee Rate
$408.76
Employee and Child(ren) Rate
$694.89
Employee and Spouse Rate
$817.52
Family Rate
$1,164.97
First Dollar Coverage
N/A
In-Network Deductible
$5,600/$11,200 (E)
In-Network Coinsurance
Deductible then 50%
Primary Care/Specialist Office Visit
Deductible then 50%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then 50%
Emergency Room Services
Deductible then 50%
Pharmacy1
Deductible then 50%

Show Benefits +

iDirect Bronze MV HSAQ
HealthEquity

2022 Q4

Employee Rate
$407.27
Employee and Child(ren) Rate
$692.36
Employee and Spouse Rate
$814.54
Family Rate
$1,160.72
First Dollar Coverage
N/A
In-Network Deductible
$6,950/$13,900 (E)
In-Network Coinsurance
0%
Primary Care/Specialist Office Visit
Deductible then $0
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then $0
Emergency Room Services
Deductible then $0
Pharmacy1
Deductible then $0

Show Benefits +

Passport Plan National Bronze HSAQ
HealthEquity

2022 Q4

Employee Rate
$448.60
Employee and Child(ren) Rate
$762.62
Employee and Spouse Rate
$897.20
Family Rate
$1,278.51
First Dollar Coverage
N/A
In-Network Deductible
$5,600/$11,200 (E)
In-Network Coinsurance
Deductible then 50%
Primary Care/Specialist Office Visit
Deductible then 50%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then 50%
Emergency Room Services
Deductible then 50%
Pharmacy1
Deductible then 50%

Show Benefits +

Passport Plan Local Bronze HSAQ4
HealthEquity

2022 Q4

Employee Rate
$429.43
Employee and Child(ren) Rate
$730.03
Employee and Spouse Rate
$858.86
Family Rate
$1,223.88
First Dollar Coverage
N/A
In-Network Deductible
$5,600/$11,200 (E)
In-Network Coinsurance
Deductible then 50%
Primary Care/Specialist Office Visit
Deductible then 50%
Telemedicine - General Medical and Behavioral Health Services
(participating Teladoc® providers only)
For Dermatology telemedicine, refer to the plan's benefit summary

Deductible then $0
Inpatient Hospital Services
(per admission)

Deductible then 50%
Emergency Room Services
Deductible then 50%
Pharmacy1
Deductible then 50%

Show Benefits +