Plan Information
What you need to know during Open Season
Our Find Care tool will allow you to easily look up your healthcare providers to make sure they are still in-network.
Are my prescriptions still covered? Our prescription tool will allow you to look up all your current medications and their costs. Questions? We are here to help 24/7 – call our advocacy service at 833-960-4025 TTY: 711 for answers to all of your questions.
2026 Plan Documents:
Take a closer look at your plan (in-network coverage only)
| 2026 Plan Design | What You Will Pay |
|---|---|
| Annual Deductible (Ind/Fam) | $2,000 / $4,000 |
| Out-of-Pocket Maximum (Ind/Fam) | $7,000 / $14,000 |
| Employee Coinsurance | 30% |
| Primary Care Office Visits | $30 |
| Specialist Care Office Visits | $60 |
| Inpatient Hospital | Deductible + 30% coins |
| Emergency Room | Emergent: $300 + 30% coinsurance; Non-emergency: $600 subject to deductible & coinsurance |
| Urgent Care | $50 |
| Routine Lab & X-Ray | 30% after deductible |
| Prescription Drugs (Retail) | |
| Generic | $10 non-maintenance/$20 maintenance |
| Formulary Brand | 30% max $250 |
| Non-Formulary Brand | 40% max $350 |
| Prescription Drugs (Mail) | |
| Generic | $20 |
| Formulary Brand | 30% max $500 |
| Non-Formulary Brand | 40% max $700 |