Compare Plans

Not all coverage is the right coverage.

The healthcare coverage you need is probably very different than the coverage some of your co-workers need. Age, family status, medical conditions, hobbies, lifestyle and a myriad of other factors will help you determine if you need a lot or a very little amount of health coverage. That’s why HealthEZ provides multiple coverage options, so you’re never caught paying too much money, or worse, having too little coverage.

Summary Of Medical Benefits

Copay Plan

In-Network

Out-Of-Network

Plan Year Deductible

Employee Only

Family

 

$1,000

$2,000

 

Not Covered

Not Covered

Coinsurance

20%

Not Covered

Out-Of-Pocket Maximum

Employee Only

Family

 

$3,000

$6,000

 

Not Covered

Not Covered

Preventive Care

100% Covered

Not Covered

Physician Services

Specialist Services

$25 Copay

$50 Copay

Not Covered

Not Covered

Hospital Services - Inpatient & Outpatient Care

20%*

Not Covered

Emergency Services

$250 Copay

Not Covered

Urgent Care Services

$50 Copay

Not Covered

Chiropractic Services

Life Clinic Chiropractic Services

$50 Copay

$15 Copay

Not Covered

Not Covered

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

20%*

$50 Copay

 

Not Covered

Not Covered

Retail 30 Day Supply

Mail Order 90 Day Supply

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

 

$15 Copay

$60 Copay

$90 Copay

20%* up to $200

 

$30 Copay

$120 Copay

$180 Copay

Not available

NOTE: *After Deductible

 

 

$2,000 HSA Plan

In-Network

Out-Of-Network

Plan Year Deductible

Employee Only

Employee on Family Plan

Family

 

$2,000

$2,700

$4,000

 

Not Covered

Not Covered

Not Covered

Coinsurance

20%*

Not Covered

Out-Of-Pocket Maximum

Employee Only

Employee on Family Plan

Family

 

$5,000

$5,000

$10,000

 

Not Covered

Not Covered

Not Covered

Preventive Care

100% covered

No coverage

Physician Services

20%*

Not Covered

Hospital Services - Inpatient & Outpatient Care

Outpatient Surgery

20%*

20%*

Not Covered

Not Covered

Emergency Services

20%*

Not Covered

Urgent Care Services

20%*

Not Covered

Chiropractic Services

20%*

Not Covered

Mental health/Chemical Dependency

20%*

Not Covered

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

20%*

20%*

20%*

20%*

 

20%*

20%*

20%*

Not available

*After Deductible

 

 

$5,000 HSA Plan

In-Network

Out-Of-Network

Plan Year Deductible

Employee Only

Family

 

$5,000

$10,000

 

Not Covered

Not Covered

Coinsurance

10%*

Not Covered

Out-Of-Pocket Maximum

Employee Only

Family

 

$6,450

$12,900

 

Not Covered

Not Covered

Preventive Care

100% covered

Not Covered

Physician Services

10%*

Not Covered

Hospital Services - Inpatient & Outpatient Care

Outpatient Surgery

10%*

10%*

Not Covered

Not Covered

Emergency Services

10%*

Not Covered

Urgent Care Services

10%*

Not Covered

Chiropractic Services

10%*

Not Covered

Mental health/Chemical Dependency

10%*

Not Covered

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

10%*

10%*

10%*

10%*

 

10%*

10%*

10%*

Not available

*After Deductible

 

 

Contact your HR rep to choose your plan.

If you prefer talking with a HealthEZ representative, call 1-800-948-3253