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| Comparative Features | High Deductible Health Plan (HDHP) Benefits Covered Employees Elect Either a Companion HSA or HRA | |
|---|---|---|
| In-Network | Out-of-Network | |
| Deductible | ||
| Individual | $2,000500 | N/A (In- and out-of-network Deductible cross-accumulate |
| Family | $4$5,000 | |
| Out-of-Pocket (OOP) Maximum | ||
Individual | $3$4,425000 | N/A (In- and out-of-network Deductible cross-accumulate |
| Family | $6$8,850000 | |
| *within Family coverage, Individual Max also applies | $4,000 | |
| The OOP max includes deductible, coinsurance, and any other covered medical expenses | ||
| SPU Funding to offset Deductible for HSA Plan | Individual HSA Plan: Up to $1,408608, (assuming 12-months of participation and employee meets full dollar-for-dollar match) Family HSA Plan: Up to $2$3,816 016 (assuming 12-months of participation and employee meets full dollar-for-dollar match) | |
SPU Funding to offset Deductible for HRA Plan | Individual HRA Plan: SPU makes $1,008 available for reimbursement Family HRA Plan: SPU makes $2,016 available for reimbursement | |
| Coinsurance - You pay: | 10% | 40% |
| Office Visits | No copay; You pay 10% AFTER Deductible | No copay; You pay 40% AFTER Deductible |
| Covered 100%; deductible waived Diagnostic mammograms covered under Diagnostic Lab/X-ray | |
In-Network Diagnostic Lab/X-ray Outpatient | No copay; You pay 10% AFTER Deductible | No copay; You pay 40% AFTER Deductible |
Urgent Care Provider (both In and Out-of-Network) | No copay; You pay 10% AFTER Deductible | |
Emergency Room (both In and Out-of-Network) | No copay; You pay 10% AFTER Deductible | |
Ambulance (both In and Out-of-Network) | No copay; You pay 10% AFTER Deductible | |
Hospital - Inpatient (both In and Out-of-Network) | No copay; You pay 10% AFTER Deductible | |
| Prescription Drugs | ||
In-Network - Pharmacy – Retail | 10% (generic) /20% (preferred brand)/30% (non-preferred brand) AFTER Deductible
| Not covered |
Pharmacy – Mail Order Drug (90 day supply) | 10% (generic) /20% (preferred brand) /30% non-preferred brand) AFTER Deductible
| Not covered |
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