How much would an insured pay in premiums for Plan DEF in one year? $ How much
Question:
How much would an insured pay in premiums for Plan DEF in one year? $
How much would an insured pay in premiums for Plan JKL in one year for family coverage? $
Which plan has thehighest PCP copaymentfor office visits?
Which plan has thelowest non zero PCP copaymentfor office visits?
Note: The Plan Year for all Plans is Jan 1 - Dec 31. | PLANS | |||||||
ABC | DEF | GHI | JKL | MNO | PQR | |||
Plan Type | PPO | HMO | POS | PPO | HMO | PPO | ||
Category | Group | Individual | Group | Group | Group | Individual | ||
% Premium Paid by Employer | 100 | N/A | 80 | 50 | 90 | N/A | ||
Annual Single Premium | $ 3,341.10 | N/A | $ 5,200.20 | $ 5,608.52 | $ 4,782.95 | $ 6,680.35 | ||
Annual Family Premium | N/A | $ 7,151.05 | $ 10,451.48 | $ 12,000.00 | N/A | $ 14,024.00 | ||
Stop Gap? | YES | NO | YES | NO | NO | YES | ||
Annual Deductible | $ 1,300.00 | $ - | $ 1,400.00 | $ 1,500.00 | $ 400.00 | $ 2,500.00 | ||
Deductible Counts Toward Stop Gap? | NO | N/A | YES | N/A | N/A | YES | ||
Copayments Count Toward Stop Gap? | YES | N/A | YES* | N/A | N/A | YES* | ||
Copayment (PCP/Specialist/ED) | $55/$80/$375 | $0/$0/$400 | $35/$60/$500 | $50/$75/$450 | $0/$0/$425 | $40/$65/$500 | ||
Coinsurance - Hospital | 25% | 15% | 40% | 35% | 5% | 33% | ||
Coinsurance - Laboratory | 33% | 0% | 35% | 45% | 20% | 55% | ||
Maximum Out-of-Pocket | $ 4,000.00 | N/A | $ 4,500.00 | N/A | N/A | $ 3,750.00 | ||
Out of Network Coverage? | YES | NO | YES | NO | NO | YES | ||
Prescription Drug Benefit | YES | YES | YES | YES | YES | YES | ||
Prescription Drug Co-Payments | ||||||||
Tier 1 | $ 20.00 | $ 10.00 | $ 25.00 | $ 15.00 | $ 10.00 | $ 20.00 | ||
Tier 2 | $ 45.50 | $ 20.00 | $ 35.50 | $ 30.00 | $ 16.00 | $ 28.50 | ||
Tier 3 | $ 75.00 | $ 50.00 | $ 85.00 | $ 75.00 | $ 40.00 | $ 100.00 | ||
Tier 4 | $ 125.00 | $ 75.00 | $ 140.00 | $ 130.00 | $ 55.00 | $ 150.00 | ||
* Excluding ED Copayments |