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The plans differ in your cost of coverage, tax-advantaged account eligibility, deductibles, and out-of-pocket costs.
| Medical Plan Highlights | |||
|---|---|---|---|
| Surest Plan In-Network* |
Saver Plan with HSA In-Network* |
PPO Plan In-Network* |
|
| Your Cost of Coverage each paycheck | Lowest | Higher | Highest |
| Tax Advantaged Accounts | Health Care Flexible Spending Account (FSA) | Health Savings Account (HSA) Limited Purpose Flexible Spending Account (FSA) |
Health Care Flexible Spending Account (FSA) |
| Calendar year deductible | $0 | $1,800 Individual $3,600 Family |
$2,000 Individual $4,000 Family |
| Calendar year out-of-pocket maximum |
$5,000 Individual $10,000 Family |
$3,600 Individual $7,200 Family |
$4,500 Individual $9,000 Family |
| Annual HSA funding by ZOLL |
N/A | $650 Employee $1,300 Employee + 1 $1,300 Family |
N/A |
| Office visits: | |||
| Preventive care | $0 | Covered at 100%, no deductible |
Covered at 100%, no deductible |
| Diagnosis treatment | $10 to $65 | 10% after deductible | $30 copay, no deductible |
| Specialist | $10 to $65 | 10% after deductible | $45 copay, no deductible |
| Telemedicine – $ | Primary and Urgent $0 Specialty $0 to $65 |
Covered at 100% after deductible |
$15 copay, no deductible |
| Urgent Care – $$ | $35 | 10% after deductible | $30 copay, no deductible |
| Emergency room – $$$ | $375 | 10% after deductible | 20% after deductible |
| Inpatient care (includes physician and surgeon fees) |
$150 to $2,500 | 10% after deductible | 20% after deductible |
| Outpatient care (includes physician and surgeon fees) |
$15 to $2,500 | 10% after deductible | Covered at 100% after $150 copay per procedure |
| Maternity Care | Prenatal and Postnatal Care $0 Delivery $625 to $1,600 |
10% after deductible | 20% after deductible Inpatient: Covered at 100% after $150 copay per procedure |
| Hospital and other day surgical facility services | Procedures range from $150 to $2,500 | 10% after deductible | Inpatient: 20% after deductible Outpatient: $150 per admission, no deductible |
| Fertility Treatment (in-network coverage only) |
$100 to $1,500, $25,000 LTM (Rx + Medical) | 10% after deductible, no limits |
20% after deductible, no limits |
| Hearing Benefit | Every 36 months $2,000 allowance per ear |
Every 36 months UHC: $2,000 allowance per ear Aetna: $4,000 allowance |
Every 36 months UHC: $2,000 allowance per ear Aetna: $4,000 allowance |
| CT scans, MRIs, PET scans and other high-end imaging | $75 to $550 | 10% after deductible | 20% after deductible |
| Diagnostic X-ray and lab | $0 | 10% after deductible | 20% after deductible |
| Mental hospital or substance abuse facility |
$75 to $1,600 | 10% after deductible | 20% after deductible |
| Short-term rehabilitation therapy, PT, and OT | $5 to $85 (up to 60 visits per calendar year) |
10% after deductible (up to 40 visits per calendar year) |
PCP: $30 copay, no deductible Specialist: $45 copay, no deductible (up to 40 visits per calendar year) |
| Best for Employees who… | …are looking for a plan with no deductible or coinsurance, transparent pricing before you make an appointment so you can choose your care based on location, provider, and cost. | …are actively engaged in decisions about their benefits. …are looking for short- and long-term savings opportunities. |
…want a plan design based on a copay/coinsurance structure, and don’t mind paying higher premiums. |