Compare Plans

Not all coverage is the right coverage.

The healthcare coverage you need is probably very different than the coverage some of your co-workers need. Age, family status, medical conditions, hobbies, lifestyle and a myriad of other factors will help you determine if you need a lot or a very little amount of health coverage. That’s why HealthEZ provides multiple coverage options, so you’re never caught paying too much money, or worse, having too little coverage.


Summary of Medical Benefits

Copay Plan 1

Tier 1: Solarte

Tier 2: America's PPO/The Alliance/PHCS

Tier 3: Out-of-Network

Deductible

Individual

Individual under Family

Family

 

$0

$0

$0

 

$1,000

$1,000

$2,000

 

$3,000

$3,000

$9,000

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$0

$0

$0

 

$2,000

$2,000

$4,000

 

$8,000

$8,000

$16,000

Preventative Services

No Charge

No Charge

40%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

No Charge

No Charge

No Charge

 

10%*

10%*

10%*

 

40%*

40%*

40%*

Urgent Care Services

Not Available

10%*

40%*

Complex Imaging: MRI/CT/PET Scans

No Charge

10%*

40%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

Not Available

Not Available

 

10%*

10%*

 

40%*

40%*

Outpatient Procedures

Facility Fee

Physician Fee

 

No Charge

No Charge

 

10%*

10%*

 

40%*

40%*

Emergency Room Services

Emergency Medical Transportation

Not Available

Not Available

$75 Copay

10%*

40%*

40%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

Not Available

No Charge

 

10%*

10%*

 

40%*

40%*

NOTE: * Coinsurance After Deductible

** Covered as in-network in true-emergency

Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions

 

 

 

 

 

 

 

 

 

HSA Plan 1

Tier 1: Solarte

Tier 2: America's PPO/The Alliance/PHCS

Tier 3 Out of Network

Deductible

Individual

Individual under Family

Family

 

$1,650

$3,300

$3,300

 

$3,300

$3,300

$6,600

 

$9,600

$9,600

$19,200

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$1,650

$3,300

$3,300

 

$4,500

$4,500

$9,000

 

$10,000

$10,000

$20,000

Preventative Services

No Charge

No Charge

40%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

0%*

0%*

0%*

 

10%*

10%*

10%*

40%*

40%*

40%*

40%*

Urgent Care Services

Not Available

10%*

40%*

Complex Imaging: MRI/CT/PET Scans

0%*

10%*

40%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

Not Available

Not Available

 

10%*

10%*

 

40%*

40%*

Outpatient Procedures

Facility Fee

Physician Fee

 

0%*

0%*

 

10%*

10%*

 

40%*

40%*

Emergency Room Services

Emergency Medical Transportation

Not Available

Not Available

10%*

10%*

40%*

40%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

Not Available

0%*

 

10%*

10%*

 

40%*

40%*

NOTE: * Coinsurance After Deductible

** Covered as in-network in true-emergency

Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions

 

 

 

 

 

 

 

 

 


If you prefer talking with a HealthEZ representative, call 844-660-2450