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.

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Summary Of Medical Benefits

PPO Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$1,500

$4,500

 

$4,500

$9,000

Coinsurance

30%

50%

Out-Of-Pocket Maximum

Employee Only

Family

 

$3,750

$7,500

 

$13,500

$27,000

Preventive Care

100% Covered

50%*

Physician Services

$50 Copay

50%*

Specialist Office Visit

$100 Copay

50%*

Hospital Services- Inpatient & Outpatient Care

30%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$250 Copay

30%*

 

50%*

50%*

Urgent Care Services

$150 Copay

50%*

Chiropractic Services

$100 Copay

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

30%*

$100 Copay

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$12 copay

$45 copay

$90 copay

20% coinsurance, $200 maximum

 

$24 copay

$90 copay

$180 copay

Not Available

*After Deductible

**Covered as in-network in true-emergency

 

 

 

 

HSA 1 Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Individal Only

Individual Under Family Coverage

Family

 

$2,500

$3,000

$5,000

 

$5,000

$5,000

$10,000

Coinsurance

20%

50%

Out-Of-Pocket Maximum

Individual Only

Individual Under Family Coverage

Family

 

$5,000

$5,000

$10,000

 

$10,000

$10,000

$20,000

Preventive Care

100% Covered

50%*

Physician Services

20%*

50%*

Hospital Services- Inpatient & Outpatient Care

20%*

50%*

Emergency Services**

Emergency Roon

Emergency Medical Transportation

 

20%*

20%*

 

50%*

50%*

Urgent Care Services

20%*

50%*

Chiropractic Services

20%*

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

20%*

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

$12 Copay*

$45 Copay*

$90 Copay*

20%*

 

$24 Copay*

$90 Copay*

$180 Copay*

Not Available

*After Deductible

**Covered as in-network in true-emergency

 

 

 

 

HSA 2 Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Individual

Family

 

$3,500

$7,000

 

$5,000

$10,000

Coinsurance

20%

50%

Out-of-Pocket Maximum

Individual

Family

 

$7,000

$14,000

 

$10,000

$20,000

Preventive Care

100% Covered

50%*

Office Visits

Primary Servicves

Specialist Services

 

20%*

20%*

 

50%*

50%*

Hospital Services

20%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

20%*

20%*

 

50%*

50%*

Urgent Care Services

20%*

50%*

Chiropractic Services

20%*

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

20%*

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 Day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$12 Copay*

$45 Copay*

$90 Copay*

20%*

 

$24 Copay

$90 Copay*

$180 Copay*

Not available

* After Deductible

 

 

** Covered as in-network in true-emergency

 

 


If you prefer talking with a HealthEZ representative, call 1-855-697-2027