Cost and Coverage Comparisons
2025 Health Plans
These plans have different deductibles, copayments, coinsurance, out-of-pocket maximums and per paycheck contributions.
- Coverage level - you can choose coverage for Employee-Only, Employee & Spouse/Domestic Partner, Employee & Children or Employee & Family.
- Under the Purple plan, coverage is provided for in-network care only.
- Under the Blue, Green and Orange plans, coverage is provided for both in-network and out-of-network care.
- In-network preventive care is 100% covered.
- Prescription drug coverage is included.
- Care from specialists can be covered even without a referral.
- Coverage offers protection from catastrophic expenses.
- Wellbeing programs are available for you and your family.
Under the Green and Orange plans, you can contribute to a Health Savings Account (HSA) and/or Limited Purpose Flexible Spending Account (FSA). These accounts work differently so be sure that you fully understand the benefits of each. Under the Purple and Blue plans, you can contribute to a Healthcare FSA.
2025 Health Plans | ||||
---|---|---|---|---|
PURPLE | BLUE | GREEN | ORANGE | |
What the plan pays | ||||
In-Network Preventive Care | 100% | |||
Health Savings Account (HSA) | N/A | Health Savings Account | ||
Flexible Spending Account Eligibility | Health Care FSA | Limited Purpose FSA | ||
Annual Assurant contributions to your HSA (Individual/Family)1 | N/A | $500/$1,000 | ||
Lifetime Maximum2 | Unlimited | |||
Medical Coverage | ||||
In-Network Services | 80% | 80% | 90% | |
Out-of-Network Services | N/A | 60% | 70% | |
What you pay | ||||
Per Paycheck Contribution (Full-Time Employees)
| Non-tobacco users will receive a separate Tobacco-Free Health Credit of $18.46 per paycheck, lowering your total contribution. | |||
Employee-Only | $98.41 | $165.25 | $93.60 | $50.54 |
Employee & Spouse/Domestic Partner | $277.19 | $411.23 | $244.66 | $116.81 |
Employee & Child(ren) | $254.98 | $372.04 | $221.82 | $109.56 |
Employee & Family | $371.58 | $568.20 | $334.91 | $146.12 |
Annual Deductible (Individual/Family)1,3,4 | ||||
Embedded3 | No | No | No | Yes |
In-Network Services | $500 / $1,000 | $450 / $900 | $1,700 / $3,400 | $3,300 / $6,600 |
Out-of-Network Services | N/A | $1,450 / $2,900 | $2,700 / $5,400 | $4,300 / $8,600 |
Medical Coinsurance or Copay | What you Pay: In-Network/Out-of-Network | |||
Primary Care Physician | $25 copay | 20%/40% | 10%/30% | |
Specialist | $45 copay (includes urgent care) | 20%/40% | 10%/30% | |
Emergency Room | $300 copay | 20%/40% | 10%/30% | |
Hospital Inpatient & Outpatient |
| 20%/40% | 10%/30% | |
Annual Out-of-Pocket Maximum (Individual/Family)1,3,4 | ||||
Embedded3 | Yes | No | Yes | Yes |
In-Network Services | $4,000 / $8,000 | $3,450 / $6,900 | $4,200 / $8,400 | $5,200 / $10,400 |
Out-of-Network Services | N/A | $6,450 / $12,900 | $7,200 / $14,400 | $8,200 / $16,400 |
2025 Prescription Drug Coverage
Retail (30-day supply) | Mail order prescriptions or retail maintenance prescriptions at a CVS pharmacy (90-day supply)6 | |||||
Coinsurance | Minimum per prescription | Maximum per prescription | Coinsurance | Minimum per prescription | Maximum per prescription | |
Generic5 | 50% | $0 | $50 | 50% | $0 | $125 |
Preferred Brand | 50% | $15 | $100 | 50% | $30 | $200 |
Non-Preferred Brand | 50% | $40 | $150 | 50% | $80 | $300 |
1 “Family” includes Employee & Spouse/Domestic Partner, Employee & Child(ren) and Employee & Family.
2 There’s a combined $30,000 medical and prescription drug lifetime maximum benefit for infertility treatment. Precertification is required to receive this benefit.
3 An embedded deductible means that the Family deductible includes an Individual deductible. If an individual in the family reaches the Individual deductible before the Family deductible is reached, benefits for that family member will begin. An embedded out-of-pocket maximum means that the Family out-of-pocket maximum includes an Individual out-of-pocket maximum. If an individual in the family reaches the Individual out-of-pocket maximum before the Family out-of-pocket maximum is reached, covered benefits for that family member will be paid at 100%.
4 Deductibles and out-of-pocket maximums for in- and out-of-network services must be met separately — they don’t cross-accumulate.
5 Under all health plans, Generic preventive prescriptions are covered at 100%, and brand name preventive prescriptions are not subject to the plan’s deductible. Under the Blue, Green, and Orange plans, all non-preventive prescriptions are subject to the plan’s deductible. Under the Purple plan, prescriptions are not subject to the deductible. Caremark periodically reviews their formulary. Certain formulary medications may be excluded from coverage from time to time and impacted members will be notified.
6 For long-term maintenance medications, the plan allows for two 30-day fills of maintenance medications at any pharmacy in the CVS Caremark network. After that, the plan will cover maintenance medications only if you have 90-day supplies filled through mail-order or at a CVS Caremark Pharmacy. Specialty medication supply is limited to 30 days.
2025 Resources
Health Support Resources
- AIM Musculoskeletal Program
- Autism Spectrum Disorder Program
- Building Healthy Families Flyer
- Fertility Assistance Program
- Learn to Live
- LiveHealth Flyer
- My Medical Ally
- NurseLine Overview
- Preventive Services List
- Sword Health Bloom Program
- Sword Health Thrive Program
- Sydney App
- Teladoc Health (formerly Livongo)
- Teladoc Health FAQs
- Total Health Total You
- Urgent Care