Cost and Coverage Comparisons
2022 Health Plans
These plans have different deductibles, coinsurance, out-of-pocket maximums and per paycheck contributions. Under all three plans:
- Coverage level - you can choose coverage for Employee-Only, Employee & Spouse/Domestic Partner, Employee & Children or Employee & Family.
- Coverage is provided for both in-network and out-of-network care.
- In-network preventive care is 100% covered.
- Prescription drug coverage is included.
- Care from specialists can be covered even without a referral.
- Coverage offers protection from catastrophic expenses.
- Wellbeing programs are available for you and your family.
The Blue plan has a Health Reimbursement Account (HRA). The Green and Orange plans have a Health Savings Account (HSA). These health accounts work differently so be sure that you fully understand the benefits of each.
|2022 Health Plans|
|What the plan pays|
|In-Network Preventive Care||100%|
|Health Plan Account||Health Reimbursement Account||Health Savings Account|
|Flexible Spending Account Eligibility||Health Care FSA||Limited Purpose FSA|
|Annual Assurant contributions to your HRA or HSA (Individual/Family)1||$400/$800|
|What you pay|
Per Paycheck Contribution (Full-Time Employees)
|Non-tobacco users will receive a separate Tobacco-Free Health Credit of $18.46 per paycheck, lowering your total contribution.|
|Employee & Spouse/Domestic Partner||$360.35||$215.36||$104.07|
|Employee & Child(ren)||$326.24||$195.48||$97.76|
|Employee & Family||$497.00||$293.92||$129.58|
|Annual Deductible (Individual/Family)1,3,6|
|In-Network Services||$950 / $1,900||$1,700 / $3,400||$2,800 / $5,600|
|Out-of-Network Services||$1,950 / $3,900||$2,700 / $5,400||$3,800 / $7,600|
|Annual Out-of-Pocket Maximum (Individual/Family)1,6,7|
|In-Network Services||$3,450 / $6,900||$4,200 / $8,400||$4,800 / $9,600|
|Out-of-Network Services||$6,450 / $12,900||$7,200 / $14,400||$7,800 / $15,600|
2022 Prescription Drug Coverage
|Retail (30-day supply)||Mail order prescriptions or retail maintenance prescriptions at a CVS pharmacy (90-day supply)5|
|Coinsurance||Minimum per prescription||Maximum per prescription||Coinsurance||Minimum per prescription||Maximum per prescription|
1 Family" includes Employee & Spouse/Domestic Partner, Employee & Child(ren), and Employee & Family
2 There is a combined $30,000 medical and prescription drug lifetime maximum benefit for infertility treatment. Precertification is required to receive the benefit.
3 If you elect Family coverage under the Blue or Green health plan, benefits begin once the entire family deductible is met (except for preventive care benefits and preventive prescription drugs). If you elect Family coverage under the Orange health plan, benefits begin for a family member once that family member satisfies the individual deductible. Benefits begin for the entire family once the entire family deductible is met.
4 Generic preventive prescriptions are covered at 100%. Brand name preventive prescriptions are not subject to the plan’s deductible. All non-preventive prescriptions are subject to the plan’s deductible. Caremark periodically reviews their formulary. Certain formulary medications may be excluded from coverage from time to time and impacted members will be notified.
5 For long-term maintenance medications, the plan allows for two 30-day fills of maintenance medications at any pharmacy in the CVS Caremark network. After that, the plan will cover maintenance medications only if you have 90-day supplies filled through mail-order or at a CVS Caremark Pharmacy. Specialty medication supply is limited to 30 days.
6 If you elect family coverage under the Blue, Green, or Orange plan, eligible expenses for all covered family members can be combined to meet the family annual in-network out-of-pocket maximum. However, under the Green and Orange plans, an individual enrolled in family coverage may also meet the individual in-network out-of-pocket maximum and covered eligible expenses for that individual will be paid at 100%.
7 Deductibles and out-of-pocket maximums for in- and out-of-network services must be met separately — they do not cross-accumulate.