PPO plans
Copays for doctor visits and prescriptions. Plans 1 and 2 are the closest matches to Give’s Premium and High plans today.
| In network | Plan 1Matches Premium | Plan 2Matches High | Plan 3 | Plan 4 | Plan 5 | Plan 6 |
|---|---|---|---|---|---|---|
| DeductibleSingle / family | $500 / $1,000 | $1,000 / $2,000 | $3,000 / $6,000 | $4,000 / $8,000 | $5,000 / $10,000 | $6,350 / $12,700 |
| Coinsurance | 20% | 20% | 20% | 20% | 20% | 20% |
| Out-of-pocket maxSingle / family | $2,000 / $4,000 | $3,500 / $7,000 | $6,000 / $12,000 | $6,300 / $12,600 | $6,500 / $13,000 | $8,000 / $16,000 |
| Doctor / specialist | $20 / $40 | $30 / $50 | $50 / $75 | $25 / $50 | $25 / $50 | $25 / $50 |
| Emergency room | $150 | 20% after deductible | 20% after deductible | $500 | 20% after deductible | 20% after deductible |
| PrescriptionsGeneric / brand | $10 / $35 | $40 / $50 | $45 / $50 | $5 / $25 | $40 / $50 | $40 / $50 |
| Monthly premium | ||||||
| Employee only | $1,265.35 | $1,094.73 | $1,013.27 | $803.60 | $672.96 | $637.94 |
| Employee + spouse | $2,478.17 | $2,143.74 | $1,984.09 | $1,573.13 | $1,317.08 | $1,248.43 |
| Employee + children | $2,149.70 | $1,859.63 | $1,721.16 | $1,364.71 | $1,142.63 | $1,083.09 |
| Family | $3,577.28 | $3,094.41 | $2,863.90 | $2,270.52 | $1,900.82 | $1,801.70 |
High-deductible plans
All five work with an HSA. Plan 3 is the closest match to Give’s HDHP. Plan 5, like today’s HDHP, has a deductible that is also the out-of-pocket max.
| In network | Plan 1 | Plan 2 | Plan 3Matches HDHP | Plan 4 | Plan 5 |
|---|---|---|---|---|---|
| DeductibleSingle / family | $2,500 / $5,000 | $3,300 / $6,600 | $4,000 / $8,000 | $5,500 / $11,000 | $7,400 / $14,800 |
| Coinsurance | 20% | 20% | 30% | 20% | 0% |
| Out-of-pocket maxSingle / family | $5,000 / $10,000 | $5,000 / $9,600 | $6,500 / $13,000 | $8,000 / $16,000 | $7,400 / $14,800 |
| Doctor visits | After deductible | After deductible | After deductible | After deductible | After deductible |
| PrescriptionsGeneric / brand, after deductible | 40% / 50% | 40% / 50% | 30% / 30% | 40% / 50% | 0% / 0% |
| Monthly premium | |||||
| Employee only | $952.48 | $801.72 | $641.63 | $569.77 | $493.14 |
| Employee + spouse | $1,864.94 | $1,569.45 | $1,255.67 | $1,114.82 | $964.64 |
| Employee + children | $1,617.82 | $1,361.52 | $1,089.36 | $967.20 | $836.94 |
| Family | $2,691.86 | $2,265.20 | $1,812.14 | $1,608.78 | $1,391.93 |
Dental and vision
Three dental designs, each through MetLife or Delta Dental. Give has MetLife today. MetLife High is the closest match.
| Dental, in network | Low | Mid | HighMatches MetLife today |
|---|---|---|---|
| Deductible | $50 | $50 | $50 |
| Annual max per person | $1,000 | $2,000 | $3,000 |
| Preventive / basic / major | 100% / 80% / 50% | 100% / 80% / 50% | 100% / 90% / 60% |
| Orthodontia | $1,500, to age 19 | $1,500, to age 19 | $1,500, to age 19 |
| MetLife, a month | |||
| Employee only | $23.28 | $28.62 | $47.03 |
| Employee + spouse | $49.44 | $60.79 | $99.92 |
| Employee + children | $49.75 | $61.19 | $100.59 |
| Family | $110.53 | $135.89 | $223.33 |
| Delta Dental, a month | |||
| Employee only | $22.91 | $28.16 | $44.11 |
| Employee + spouse | $48.66 | $59.83 | $93.71 |
| Employee + children | $48.98 | $60.22 | $94.34 |
| Family | $108.75 | $133.72 | $209.45 |
| Vision, VSP or Superior | Low | HighMatches Cigna vision today |
|---|---|---|
| Eye exam and lenses | $10 copay each | $10 copay each |
| Frames | $150, one pair every 24 months | $225, one pair every 12 months |
| Contacts instead of glasses | Up to $150 | Up to $225 |
| A month | ||
| Employee only | $6.96 | $9.30 |
| Employee + spouse | $13.90 | $18.35 |
| Employee + children | $13.26 | $17.72 |
| Family | $21.00 | $28.10 |
From LBMC’s October 29 proposal. Rates hold for 90 days. The carrier can change rates if enrollment moves 10% or more, needs at least 5 people on medical, and requires Give to pay at least half of the cheapest plan’s employee-only rate.