HDHP
Our company offers medical plans administered through BCBS that support different healthcare needs and budgets.
HDHP
Video coming soon
Carrier
BCBS
Plan type
HDHP
Out-of-network coverage
Yes
HSA eligible
Yes
FSA eligible
Limited-Purpose FSA
Employer contribution
up to $750 per calendar year
BI-WEEKLY PAYROLL CONTRIBUTIONS
| Coverage tier | Bi-Weekly Payroll Contribution |
|---|---|
| Employee Only | $22.52 |
| Employee + Spouse | $133.64 |
| Employee + Child(ren) | $80.86 |
| Family | $179.69 |
Employee Only
- Bi-Weekly Payroll Contribution
- $22.52
Employee + Spouse
- Bi-Weekly Payroll Contribution
- $133.64
Employee + Child(ren)
- Bi-Weekly Payroll Contribution
- $80.86
Family
- Bi-Weekly Payroll Contribution
- $179.69
Medical Services
| Feature | In-network |
|---|---|
| Annual deductible (individual/family) | $4,000 / $8,000 |
| Out-of-pocket maximum (individual/family) * | $7,500 / $15,000 |
| Coinsurance | 30% |
| Primary physician office visit | 30% after deductible |
| Specialist office visit | 30% after deductible |
| Inpatient hospital services | 30% after deductible |
| Outpatient hospital services | 30% after deductible |
| Urgent care | 30% after deductible |
| Emergency room care | 30% after deductible |
Annual deductible (individual/family)
- In-network
- $4,000 / $8,000
Out-of-pocket maximum (individual/family) *
- In-network
- $7,500 / $15,000
Coinsurance
- In-network
- 30%
Primary physician office visit
- In-network
- 30% after deductible
Specialist office visit
- In-network
- 30% after deductible
Inpatient hospital services
- In-network
- 30% after deductible
Outpatient hospital services
- In-network
- 30% after deductible
Urgent care
- In-network
- 30% after deductible
Emergency room care
- In-network
- 30% after deductible
- *Includes deductible and copayments
Out-of-network coverage
| Feature | Out-of-network coverage |
|---|---|
| Annual deductible (individual/family) | $8,000 / $16,000 |
| Out-of-pocket maximum (individual/family) * | $16,000 / $32,000 |
| Coinsurance | 40% |
Annual deductible (individual/family)
- Out-of-network coverage
- $8,000 / $16,000
Out-of-pocket maximum (individual/family) *
- Out-of-network coverage
- $16,000 / $32,000
Coinsurance
- Out-of-network coverage
- 40%
- *Includes deductible and copayments
Prescription drugs (30-day supply)
| Feature | In-network |
|---|---|
| Prescription deductible | Subject to medical deductible |
| Generic | $10 copay after deductible |
| Preferred Brand | $50 copay after deductible |
| Non-Preferred Brand | $80 copay after deductible |
Prescription deductible
- In-network
- Subject to medical deductible
Generic
- In-network
- $10 copay after deductible
Preferred Brand
- In-network
- $50 copay after deductible
Non-Preferred Brand
- In-network
- $80 copay after deductible
Plan Notes
- The HDHP has the highest deductible ($4,000 individual / $8,000 family in-network) and 30% coinsurance; all non-preventive services, including prescriptions, are subject to the deductible.
- This is the only plan that is HSA-eligible, and the company contributes up to $750 per year to your HSA.
- To locate an in-network medical provider, please visit myhealthtoolkitfl.com.