Employer plans Health Plans for Employers Number of employees: 1-50 51+ Showing plan information for: Plan availability varies by location. Please enter your ZIP code to see plans available in your area. Viewing: Select Type- Any -Chiropractic Dental Medical Orthodontia Pharmacy TMJVision Year: Select Year- Any -202320242025 Multiple counties found: Please choose a county. Select County Select County If members receive services from out-of-network providers, their deductible and out-of-pocket limit will be higher than the amounts listed in the chart below. Platinum 500‡‡ Office Visits Primary care No deductible, $10 Urgent care No deductible, $10 Specialist No deductible, $20 Tier 1 prescription Drug coverage No deductible, $5 In-network Costs Deductible Individual $500 Family $1,000 Out-of-pocket max Individual $4,000 Family $8,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Gold 1000‡‡ Office Visits Primary care No deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $1,000 Family $2,000 Out-of-pocket max Individual $7,000 Family $14,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Gold 2000‡‡ Office Visits Primary care No deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $2,000 Family $4,000 Out-of-pocket max Individual $6,500 Family $13,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Gold 2500‡‡ Office Visits Primary care No deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $2,500 Family $5,000 Out-of-pocket max Individual $6,500 Family $13,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Gold 3500‡‡ Office Visits Primary care No deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $3,500 Family $7,000 Out-of-pocket max Individual $6,500 Family $13,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Silver 3500 Office Visits Primary care No deductible, $50 Urgent care No deductible, $50 Specialist No deductible, $100 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $3,500 Family $7,000 Out-of-pocket max Individual $9,100 Family $18,200 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Silver 4500‡‡ Office Visits Primary care No deductible, $40 Urgent care No deductible, $40 Specialist No deductible, $80 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $4,500 Family $9,000 Out-of-pocket max Individual $9,100 Family $18,200 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Silver 5500‡‡ Office Visits Primary care No deductible, $35 Urgent care No deductible, $35 Specialist No deductible, $70 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $5,500 Family $11,000 Out-of-pocket max Individual $9,100 Family $18,200 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Silver 6500‡‡ Office Visits Primary care No deductible, $30 Urgent care No deductible, $30 Specialist No deductible, $60 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $6,500 Family $13,000 Out-of-pocket max Individual $9,100 Family $18,200 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Bronze 8150 Office Visits Primary care No deductible, $35 Urgent care No deductible, $35 Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $8,150 Family $16,300 Out-of-pocket max Individual $8,150 Family $16,300 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Bronze 9100 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $9,100 Family $18,200 Out-of-pocket max Individual $9,100 Family $18,200 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Gold HSA 3000 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $3,000 Family $6,000 Out-of-pocket max Individual $3,000 Family $6,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Silver HSA 3000 Office Visits Primary care After deductible, 20% Urgent care After deductible, 20% Specialist After deductible, 20% Tier 1 prescription Drug coverage After deductible, 20% In-network Costs Deductible Individual $3,000 Family $6,000 Out-of-pocket max Individual $7,050 Family $14,100 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Silver HSA 4800 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $4,800 Family $9,600 Out-of-pocket max Individual $4,800 Family $9,600 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Silver HSA 5500 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $5,500 Family $11,000 Out-of-pocket max Individual $5,500 Family $11,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Bronze HSA 7050 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $7,050 Family $14,100 Out-of-pocket max Individual $7,050 Family $14,100 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Standard Gold Office Visits Primary care No deductible, $20 Urgent care No deductible, $60 Specialist No deductible, $40 Tier 1 prescription Drug coverage No deductible, $10 In-network Costs Deductible Individual $1,800 Family $3,600 Out-of-pocket max Individual $7,300 Family $14,600 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Standard Silver Office Visits Primary care No deductible, $40 Urgent care No deductible, $70 Specialist No deductible, $80 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $4,800 Family $9,600 Out-of-pocket max Individual $9,100 Family $18,200 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Standard Bronze Office Visits Primary care No deductible, $50 Urgent care No deductible, $100 Specialist No deductible, $100 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $8,800 Family $17,600 Out-of-pocket max Individual $8,800 Family $17,600 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Request a quote Share additional info with us. Dental Choice 0-20-50 50-1000^||| Members Pay Deductible Individual $50 Family $150 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Choice Plus 0-20-50 25-1000^ Members Pay Deductible Individual $25 Family $75 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Choice Plus 0-20-50 50-1000^ Members Pay Deductible Individual $50 Family $150 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Choice Plus 0-20-50 25-1500^ Members Pay Deductible Individual $25 Family $75 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Choice Plus 0-20-50 50-1500^ Members Pay Deductible Individual $50 Family $150 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Advantage Core||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% (age 19+ not covered) Annual Max. Benefit $500 on basic dental services, per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Advantage 20-20-50 1000^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 20% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Advantage 20-20-50 1500^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 20% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Advantage 0-20-50 1000^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Advantage 0-20-50 1500^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Advantage Plus 0-20-50 1000^ Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Dental Advantage Plus 0-20-50 1500^ Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Request a quote Share additional info with us. Kids Dental Advantage 0-20-50 Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit N/A More about this plan Summary of benefits Request a quote Share additional info with us. Kids Dental Advantage 20-40-50^ Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 20% Basic No deductible, 40% Major No deductible, 50% Annual Max. Benefit N/A More about this plan Summary of benefits Request a quote Share additional info with us. Platinum 500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $10 Urgent care No deductible, $10 Specialist No deductible, $20 Tier 1 prescription Drug coverage No deductible, $5 In-network Costs Deductible Individual $500 Family $1,000 Out-of-pocket max Individual $4,000 Family $8,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Gold 1000‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $1,000 Family $2,000 Out-of-pocket max Individual $7,000 Family $14,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Gold 2000‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $2,000 Family $4,000 Out-of-pocket max Individual $6,500 Family $13,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Gold 2500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $2,500 Family $5,000 Out-of-pocket max Individual $6,500 Family $13,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Gold 3500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $3,500 Family $7,000 Out-of-pocket max Individual $6,500 Family $13,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver 3500 Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $50 Urgent care No deductible, $50 Specialist No deductible, $100 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $3,500 Family $7,000 Out-of-pocket max Individual $9,400 Family $18,800 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver 4500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $40 Urgent care No deductible, $40 Specialist No deductible, $100 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $4,500 Family $9,000 Out-of-pocket max Individual $9,400 Family $18,800 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver 5000‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $40 Urgent care No deductible, $40 Specialist No deductible, $80 Tier 1 prescription Drug coverage No deductible, $10 In-network Costs Deductible Individual $5,000 Family $10,000 Out-of-pocket max Individual $9,400 Family $18,800 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver 5500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $35 Urgent care No deductible, $35 Specialist No deductible, $70 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $5,500 Family $11,000 Out-of-pocket max Individual $9,400 Family $18,800 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver 6500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $35 Urgent care No deductible, $35 Specialist No deductible, $70 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $6,500 Family $13,000 Out-of-pocket max Individual $9,400 Family $18,800 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Bronze 7500 Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $35 Urgent care No deductible, $35 Specialist No deductible, $100 Tier 1 prescription Drug coverage After deductible, 30% In-network Costs Deductible Individual $7,500 Family $15,000 Out-of-pocket max Individual $9,400 Family $18,800 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Bronze 9400 Office Visits Primary care 1-3 no deductible, $5; visits 4+ after deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $9,400 Family $18,800 Out-of-pocket max Individual $9,400 Family $18,800 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Gold HSA 3200 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $3,200 Family $6,400 Out-of-pocket max Individual $3,200 Family $6,400 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver HSA 3500 Office Visits Primary care After deductible, 20% Urgent care After deductible, 20% Specialist After deductible, 20% Tier 1 prescription Drug coverage After deductible, 20% In-network Costs Deductible Individual $3,500 Family $7,000 Out-of-pocket max Individual $7,500 Family $15,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver HSA 5100 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $5,100 Family $10,200 Out-of-pocket max Individual $5,100 Family $10,200 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver HSA 5500 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $5,500 Family $11,000 Out-of-pocket max Individual $5,500 Family $11,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Bronze HSA 7500 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $7,500 Family $15,000 Out-of-pocket max Individual $7,500 Family $15,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Standard Gold Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $20 Urgent care No deductible, $60 Specialist No deductible, $40 Tier 1 prescription Drug coverage No deductible, $10 In-network Costs Deductible Individual $1,800 Family $3,600 Out-of-pocket max Individual $7,550 Family $15,100 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Standard Silver Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $40 Urgent care No deductible, $70 Specialist No deductible, $80 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $5,500 Family $10,200 Out-of-pocket max Individual $9,450 Family $18,900 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Standard Bronze Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $50 Urgent care No deductible, $100 Specialist No deductible, $150 Tier 1 prescription Drug coverage No deductible, $25 In-network Costs Deductible Individual $9,450 Family $18,900 Out-of-pocket max Individual $9,450 Family $18,900 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Dental Choice 0-20-50 50-1000^||| Members Pay Deductible Individual $50 Family $150 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental Choice Plus 0-20-50 25-1000^ Members Pay Deductible Individual $25 Family $75 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental Choice Plus 0-20-50 50-1000^ Members Pay Deductible Individual $50 Family $150 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental Choice Plus 0-20-50 25-1500^ Members Pay Deductible Individual $25 Family $75 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Dental Choice Plus 0-20-50 50-1500^ Members Pay Deductible Individual $50 Family $150 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Dental PPO Core||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% (age 19+ not covered) Annual Max. Benefit $500 on basic dental services, per person, age 19 and older More about this plan Summary of benefits Dental PPO 20-20-50 1000^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 20% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental PPO 20-20-50 1500^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 20% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Dental PPO 0-20-50 1000^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental PPO 0-20-50 1500^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Dental PPO Plus 0-20-50 1000^ Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental PPO Plus 0-20-50 1500^ Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Kids Dental PPO 0-20-50 Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit N/A More about this plan Summary of benefits Kids Dental PPO 20-40-50^ Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 20% Basic No deductible, 40% Major No deductible, 50% Annual Max. Benefit N/A More about this plan Summary of benefits Platinum 500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $10 Urgent care No deductible, $10 Specialist No deductible, $20 Tier 1 prescription Drug coverage No deductible, $5 In-network Costs Deductible Individual $500 Family $1,000 Out-of-pocket max Individual $4,000 Family $8,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Gold 1000‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $1,000 Family $2,000 Out-of-pocket max Individual $7,000 Family $14,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Gold 2000‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $2,000 Family $4,000 Out-of-pocket max Individual $6,500 Family $13,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Gold 2500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $2,500 Family $5,000 Out-of-pocket max Individual $6,500 Family $13,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Gold 3500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $25 Urgent care No deductible, $25 Specialist No deductible, $75 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $3,500 Family $7,000 Out-of-pocket max Individual $6,500 Family $13,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver 3500 Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $50 Urgent care No deductible, $50 Specialist No deductible, $100 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $3,500 Family $7,000 Out-of-pocket max Individual $9,200 Family $18,400 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver 4500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $40 Urgent care No deductible, $40 Specialist No deductible, $100 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $4,500 Family $9,000 Out-of-pocket max Individual $9,200 Family $18,400 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver 5000‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $40 Urgent care No deductible, $40 Specialist No deductible, $80 Tier 1 prescription Drug coverage No deductible, $10 In-network Costs Deductible Individual $5,000 Family $10,000 Out-of-pocket max Individual $9,200 Family $18,400 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver 5500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $35 Urgent care No deductible, $35 Specialist No deductible, $70 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $5,500 Family $11,000 Out-of-pocket max Individual $9,200 Family $18,400 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver 6500‡‡ Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $35 Urgent care No deductible, $35 Specialist No deductible, $70 Tier 1 prescription Drug coverage No deductible, $20 In-network Costs Deductible Individual $6,500 Family $13,000 Out-of-pocket max Individual $9,200 Family $18,400 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Bronze 7500 Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $35 Urgent care No deductible, $35 Specialist No deductible, $100 Tier 1 prescription Drug coverage After deductible, 30% In-network Costs Deductible Individual $7,500 Family $15,000 Out-of-pocket max Individual $9,200 Family $18,400 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Gold HSA 3400 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $3,400 Family $6,800 Out-of-pocket max Individual $3,400 Family $6,800 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver HSA 3500 Office Visits Primary care After Deductible, First 3 visits No Charge, then 20% Coinsurance Urgent care After deductible, 20% Specialist After deductible, 20% Tier 1 prescription Drug coverage After deductible, 20% In-network Costs Deductible Individual $3,500 Family $7,000 Out-of-pocket max Individual $7,500 Family $15,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver HSA 5100 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $5,100 Family $10,200 Out-of-pocket max Individual $5,100 Family $10,200 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Silver HSA 5500 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $5,500 Family $11,000 Out-of-pocket max Individual $5,500 Family $11,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Bronze HSA 8050 Office Visits Primary care After deductible, covered in full Urgent care After deductible, covered in full Specialist After deductible, covered in full Tier 1 prescription Drug coverage After deductible, covered in full In-network Costs Deductible Individual $8,050 Family $16,100 Out-of-pocket max Individual $8,050 Family $16,100 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Standard Gold Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $20 Urgent care No deductible, $60 Specialist No deductible, $40 Tier 1 prescription Drug coverage No deductible, $10 In-network Costs Deductible Individual $1,500 Family $3,000 Out-of-pocket max Individual $7,000 Family $14,000 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Standard Silver Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $40 Urgent care No deductible, $70 Specialist No deductible, $80 Tier 1 prescription Drug coverage No deductible, $15 In-network Costs Deductible Individual $5,500 Family $11,000 Out-of-pocket max Individual $9,200 Family $18,400 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Standard Bronze Office Visits Primary care 1-3 no deductible, $5; visits 4+ no deductible, $50 Urgent care No deductible, $100 Specialist No deductible, $150 Tier 1 prescription Drug coverage No deductible, $25 In-network Costs Deductible Individual $9,200 Family $18,400 Out-of-pocket max Individual $9,200 Family $18,400 Preventive services No deductible, covered in full Plan Downloads (PDFs) More details for this plan on the following networks Navigator Dental Choice 0-20-50 50-1000^||| Members Pay Deductible Individual $50 Family $150 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental Choice Plus 0-20-50 25-1000^ Members Pay Deductible Individual $25 Family $75 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental Choice Plus 0-20-50 50-1000^ Members Pay Deductible Individual $50 Family $150 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental Choice Plus 0-20-50 25-1500^ Members Pay Deductible Individual $25 Family $75 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Dental Choice Plus 0-20-50 50-1500^ Members Pay Deductible Individual $50 Family $150 Services Preventive No deductible, 0% Basic After deductible, 20% Major After deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Dental PPO Core||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% (age 19+ not covered) Annual Max. Benefit $500 on basic dental services, per person, age 19 and older More about this plan Summary of benefits Dental PPO 20-20-50 1000^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 20% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental PPO 20-20-50 1500^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 20% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Dental PPO 0-20-50 1000^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental PPO 0-20-50 1500^||| Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Dental PPO Plus 0-20-50 1000^ Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,000 per person, age 19 and older More about this plan Summary of benefits Dental PPO Plus 0-20-50 1500^ Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit $1,500 per person, age 19 and older More about this plan Summary of benefits Kids Dental PPO 0-20-50 Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50% Annual Max. Benefit N/A More about this plan Summary of benefits Kids Dental PPO 20-40-50^ Members Pay Deductible Individual $0 Family $0 Services Preventive No deductible, 20% Basic No deductible, 40% Major No deductible, 50% Annual Max. Benefit N/A More about this plan Summary of benefits
