Plan Name | A | B | C | D | E | F | No Insurance |
---|---|---|---|---|---|---|---|
Annual Premium | $108 | $156 | $400 | $492 | $1148 | $1348 | $695 |
Annual Deductible | $5500 | $4500 | $2250 | $3350 | $1000 | $2000 | Not applicable |
OOP Maximum for the year | $6350 | $6500 | $6350 | $5500 | $3000 | $3000 | Not applicable |
Primary Doctor Copay | $40 | $35 | $35 | $45 | $30 | $30 | 100% |
Cost of a 30 day supply of generic Rx | $20 | $20 | $15 | $15 | $15 | $15 | 100% |