Archives
2016/2017 Health Savings Plan In-Network Maximum Annual Out-of-Pocket Per Individual
In-Network: $5,500 (includes prescription drugs) Out-of-Network: $11,000 (includes prescription drugs)
2016/2017 Premier Plan (Cigna or UHC) In-Network Maximum Annual Out-of-Pocket Per Individual
In-Network: $2,000 Out-of-Network: $4,000
2016/2017 Standard Plan (Cigna or UHC) In-Network Maximum Annual Out-of-Pocket Per Individual
In-Network: $3,000 Out-of-Network: $7,500
Kaiser Permanente Southern California In-Network Only Individual OOP Max
$1,500
Kaiser Permanente Northern California In-Network Only Individual OOP Max
$3,000
Kaiser Permanente Hawaii In-Network Only Individual OOP Max
$2,500
2016/2017 HMSA In-Network Individual OOP Max
In-Network: $2,500 Prescription coverage: $3,600 Out-of-Network: $2,500 Prescription coverage: $3,600
Non-Participating Retail Pharmacy Family Annual Out-of-Pocket Maximum
$3,600 (combined with Mail Service and Participating Retail Pharmacy)
Mail Service Individual Annual Out-of-Pocket Maximum
$3,600 (combined with Participating and Non-Participating Retail Pharmacy)
Participating Retail Pharmacy Individual Annual Out-of-Pocket Maximum
$3,600 (combined with Mail Service and Non-Participating Retail Pharmacy)
2016/2017 Cigna Global Health Medical Plan In-Network OOP Max Individual
In-Network: $4,000 Out-of-network: $4,000