Low rates for 2023
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Lowest rates for the plans people want.
On average, Independent Health has the lowest rates for plans in the Platinum and Gold tiers for 2023*. That means less money out of the pockets of small business employers and employees, without reducing the benefits employees rely on.
*2023 New York State Department of Financial Services rate adjustments
New plan and unique benefit for 2023
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We've heard you and created a new product and enriched our unique benefits.
iDirect® Gold Copay Option 3
New! Independent Health RedShirt RewardsSM
The new program where members and their family* can receive up to $30 reward dollars per plan year for completing preventive care services and activities that help them get and stay healthy.
*Rewards will be issued when Independent Health receives notification of a claim for each service, which may take up to 90 days for a provider to submit the claim(s). $30.00 limit per eligible member (subscriber, spouse and dependents 18 years of age and older) per plan year.
Better care and outcomes for employees
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We outperform the local competition in HEDIS measures for prevention, including prenatal care, colorectal cancer screening and flu shots, and chronic condition management measures such as diabetes HbA1c<8% and controlling high blood pressure*.
*Independent Health's Commercial HMO/POS Population compared to Local Competitors, 2019. The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of NCQA.
Locally owned
health plan
Western New York has been our home since 1980 and we understand how to keep this community healthy.
We’re dedicated to improving the health and well-being of all Western New Yorkers however we can. Over the last year through our many local initiatives, we’ve impacted nearly 150,000 people in a tangible way. While also creating opportunities to help our community become more educated, aware and involved in the decision making that leads to healthier choices and behaviors.
Satisfaction across all audiences
We are proud to be ranked #1 Member Satisfaction among Commercial Health Plans in New York by J.D. Power, scoring the highest in four of six categories, including customer service, coverage and benefits, information and communication, and provider choice.
For J.D.Power 2020 award information, visit jdpower.com/awards
*2021 Annual Employer Stakeholder Study
**2021 Annual Consumer Stakeholder Study
You Deserve the RedShirt Treatment.® Before you choose a health plan, speak with a RedShirt® at 1-800-453-1910 or email us.
The plans shown below represent our 2023 Q2 Small Group plans. Download a printable version here.
To view our 2023 Q1 plans and rates, click here.
| FlexFit Platinum |
|---|
2023 Q2 |
| Employee Rate $693.96 |
| Employee and Child(ren) Rate $1,179.73 |
| Employee and Spouse Rate $1,387.92 |
| Family Rate $1,977.79 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $707.67 |
| Employee and Child(ren) Rate $1,203.04 |
| Employee and Spouse Rate $1,415.34 |
| Family Rate $2,016.86 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $659.86 |
| Employee and Child(ren) Rate $1,121.76 |
| Employee and Spouse Rate $1,319.72 |
| Family Rate $1,880.60 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $851.53 |
| Employee and Child(ren) Rate $1,447.60 |
| Employee and Spouse Rate $1,703.06 |
| Family Rate $2,426.86 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $707.38 |
| Employee and Child(ren) Rate $1,202.55 |
| Employee and Spouse Rate $1,414.76 |
| Family Rate $2,016.03 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $634.57 |
| Employee and Child(ren) Rate $1,078.77 |
| Employee and Spouse Rate $1,269.14 |
| Family Rate $1,808.52 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $572.62 |
| Employee and Child(ren) Rate $973.45 |
| Employee and Spouse Rate $1,145.24 |
| Family Rate $1,631.97 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $548.91 |
| Employee and Child(ren) Rate $933.15 |
| Employee and Spouse Rate $1,097.82 |
| Family Rate $1,564.39 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $531.74 |
| Employee and Child(ren) Rate $903.96 |
| Employee and Spouse Rate $1,063.48 |
| Family Rate $1,515.46 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $603.62 |
| Employee and Child(ren) Rate $1,026.15 |
| Employee and Spouse Rate $1,207.24 |
| Family Rate $1,720.32 |
| 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 Deductible then $150 |
| Pharmacy1 $10/$40/50% |
Show Benefits + |
| iDirect Gold Copay Option 2 |
|---|
2023 Q2 |
| Employee Rate $610.83 |
| Employee and Child(ren) Rate $1,038.41 |
| Employee and Spouse Rate $1,221.66 |
| Family Rate $1,740.87 |
| 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 Option 3 |
|---|
2023 Q2 New |
| Employee Rate $621.47 |
| Employee and Child(ren) Rate $1,056.50 |
| Employee and Spouse Rate $1,242.94 |
| Family Rate $1,771.19 |
| First Dollar Coverage N/A |
| In-Network Deductible $600/$1,200 (T) |
| 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/$50% |
Show Benefits + |
iDirect Gold Copay HSAQ  |
|---|
2023 Q2 |
| Employee Rate $587.77 |
| Employee and Child(ren) Rate $999.21 |
| Employee and Spouse Rate $1,175.54 |
| Family Rate $1,675.14 |
| First Dollar Coverage N/A |
| In-Network Deductible $1,500/$3,000 (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 + |
|
Passport Plan National Gold HSAQ |
|---|
2023 Q2 |
| Employee Rate $677.35 |
| Employee and Child(ren) Rate $1,151.50 |
| Employee and Spouse Rate $1,354.70 |
| Family Rate $1,930.45 |
| First Dollar Coverage N/A |
| In-Network Deductible $1,500/$3,000 (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 + |
|
Passport Plan Local Gold HSAQ4 |
|---|
2023 Q2 |
| Employee Rate $570.45 |
| Employee and Child(ren) Rate $969.77 |
| Employee and Spouse Rate $1,140.90 |
| Family Rate $1,625.78 |
| First Dollar Coverage N/A |
| In-Network Deductible $1,500/$3,000 (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 + |
| Standard Silver |
|---|
2023 Q2 |
| Employee Rate $553.32 |
| Employee and Child(ren) Rate $940.64 |
| Employee and Spouse Rate $1,106.64 |
| Family Rate $1,576.96 |
| First Dollar Coverage N/A |
| In-Network Deductible $1,750/$3,500 (E) |
| In-Network Coinsurance 0% |
| Primary Care/Specialist Office Visit Deductible then $306/Deductible then $656 |
| 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 $500 |
| Pharmacy1 $15/$40/$75 |
Show Benefits + |
| Activate Silver |
|---|
2023 Q2 |
| Employee Rate $504.84 |
| Employee and Child(ren) Rate $858.23 |
| Employee and Spouse Rate $1,009.68 |
| Family Rate $1,438.79 |
| First Dollar Coverage $500/$1,000 |
| In-Network Deductible $3,100/$6,200 (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 |
|---|
2023 Q2 |
| Employee Rate $482.48 |
| Employee and Child(ren) Rate $820.22 |
| Employee and Spouse Rate $964.96 |
| Family Rate $1,375.07 |
| First Dollar Coverage N/A |
| In-Network Deductible $4,000/$8,000 (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 + |
| iDirect Silver Copay |
|---|
2023 Q2 |
| Employee Rate $541.24 |
| Employee and Child(ren) Rate $920.11 |
| Employee and Spouse Rate $1,082.48 |
| Family Rate $1,542.53 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $533.28 |
| Employee and Child(ren) Rate $906.58 |
| Employee and Spouse Rate $1,066.56 |
| Family Rate $1,519.85 |
| 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 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 |
|---|
2023 Q2 |
| Employee Rate $499.54 |
| Employee and Child(ren) Rate $849.22 |
| Employee and Spouse Rate $999.08 |
| Family Rate $1,423.69 |
| 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 + |
|
Choice Plus Silver HSAQ2 |
|---|
2023 Q2 |
| Employee Rate $508.47 |
| Employee and Child(ren) Rate $864.40 |
| Employee and Spouse Rate $1,016.94 |
| Family Rate $1,449.14 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $603.08 |
| Employee and Child(ren) Rate $1,025.24 |
| Employee and Spouse Rate $1,206.16 |
| Family Rate $1,718.78 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $510.11 |
| Employee and Child(ren) Rate $867.19 |
| Employee and Spouse Rate $1,020.22 |
| Family Rate $1,453.81 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $392.72 |
| Employee and Child(ren) Rate $667.62 |
| Employee and Spouse Rate $785.44 |
| Family Rate $1,119.25 |
| First Dollar Coverage N/A |
| In-Network Deductible $9,100/$18,200 (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 |
|---|
2023 Q2 |
| Employee Rate $460.07 |
| Employee and Child(ren) Rate $782.12 |
| Employee and Spouse Rate $920.14 |
| Family Rate $1,311.20 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $459.88 |
| Employee and Child(ren) Rate $781.80 |
| Employee and Spouse Rate $919.76 |
| Family Rate $1,310.66 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $456.40 |
| Employee and Child(ren) Rate $775.88 |
| Employee and Spouse Rate $912.80 |
| Family Rate $1,300.74 |
| First Dollar Coverage N/A |
| In-Network Deductible $7,100/$14,200 (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 |
|---|
2023 Q2 |
| Employee Rate $553.27 |
| Employee and Child(ren) Rate $940.56 |
| Employee and Spouse Rate $1,106.54 |
| Family Rate $1,576.82 |
| 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 |
|---|
2023 Q2 |
| Employee Rate $469.77 |
| Employee and Child(ren) Rate $798.61 |
| Employee and Spouse Rate $939.54 |
| Family Rate $1,338.84 |
| 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 + |
