Cost and Coverage Comparisons
2023 Health Plans
These plans have different deductibles, copayments, coinsurance, out-of-pocket maximums and per paycheck contributions.
- Coverage level - you can choose coverage for Employee-Only, Employee & Spouse/Domestic Partner, Employee & Children or Employee & Family.
- Under the Purple plan, coverage is provided for in-network care only.
- Under the Blue, Green and Orange plans, 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. The Purple plan does not have an account associated with it.
2023 Health Plans
What the plan pays
|In-Network Preventive Care|
|Health Plan Account||N/A||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||N/A||$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||$251.46||$372.17||$222.17||$107.03|
|Employee & Child(ren)||$231.46||$336.88||$201.60||$100.50|
|Employee & Family||$336.46||$513.54||$303.44||$133.42|
|Annual Deductible (Individual/Family)1,3,4|
|In-Network Services||$500 / $1,000||$950 / $1,900||$1,700 / $3,400||$3,000 / $6,000|
|Out-of-Network Services||N/A||$1,950 / $3,900||$2,700 / $5,400||$4,000 / $8,000|
|Annual Out-of-Pocket Maximum (Individual/Family)1,3,4|
|In-Network Services||$4,000 / $8,000||$3,450 / $6,900||$4,200 / $8,400||$5,000 / $10,000|
|Out-of-Network Services||N/A||$6,450 / $12,900||$7,200 / $14,400||$8,000 / $16,000|
2023 Prescription Drug Coverage
|Retail (30-day supply)||Mail order prescriptions or retail maintenance prescriptions at a CVS pharmacy (90-day supply)6|
|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’s a combined $30,000 medical and prescription drug lifetime maximum benefit for infertility treatment. Precertification is required to receive this benefit.
3 An embedded deductible means that the Family deductible includes an Individual deductible. If an individual in the family reaches the Individual deductible before the Family deductible is reached, benefits for that family member will begin. An embedded out-of-pocket maximum means that the Family out-of-pocket maximum includes an Individual out-of-pocket maximum. If an individual in the family reaches the Individual out-of-pocket maximum before the Family out-of-pocket maximum is reached, covered benefits for that family member will be paid at 100%.
4 Deductibles and out-of-pocket maximums for in- and out-of-network services must be met separately — they don’t cross-accumulate.
5 Under all health plans, Generic preventive prescriptions are covered at 100%, and brand name preventive prescriptions are not subject to the plan’s deductible. Under the Blue, Green, and Orange plans, all non-preventive prescriptions are subject to the plan’s deductible. Under the Purple plan, prescriptions are not subject to the deductible. Caremark periodically reviews their formulary. Certain formulary medications may be excluded from coverage from time to time and impacted members will be notified.
6 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.