PriorityPPO tiered copay plans—Central East region

  • PriorityPPO 250 100%

    Deductible:
    $250 individual, $500 family
    Coinsurance:
    Employee pays 0%
    Out-of-pocket limit: $5,000 individual, $10,000 family
    Primary / specialist / urgent care:
    $10 / $35 / $75

  • PriorityPPO 250 90%

    Deductible:
    $250 individual, $500 family
    Coinsurance:
    Employee pays 10%
    Out-of-pocket limit: $5,000 individual, $10,000 family
    Primary / specialist / urgent care:
    $10 / $35 / $75

  • PriorityPPO 500

    Deductible:
    $500 individual, $1,000 family
    Coinsurance:
    Employee pays 20%
    Out-of-pocket limit: $7,350 individual, $14,700 family
    Primary / specialist / urgent care:
    $20 / $50 / $75

  • PriorityPPO 1000

    Deductible:
    $1,000 individual, $2,000 family
    Coinsurance:
    Employee pays 20%
    Out-of-pocket limit: $7,350 individual, $14,700 family
    Primary / specialist / urgent care:
    $20 / $50 / $75

  • PriorityPPO 1500

    Deductible:
    $1,500 individual, $3,000 family
    Coinsurance:
    Employee pays 20%
    Out-of-pocket limit: $7,350 individual, $14,700 family
    Primary / specialist / urgent care:
    $20 / $50 / $75

  • PriorityPPO 2000

    Deductible:
    $2,000 individual, $4,000 family
    Coinsurance:
    Employee pays 20%
    Out-of-pocket limit: $7,350 individual, $14,700 family
    Primary / specialist / urgent care:
    $20 / $50 / $75

  • PriorityPPO 2750

    Deductible:
    $2,750 individual, $5,500 family
    Coinsurance:
    Employee pays 30%
    Out-of-pocket limit: $7,260 individual, $14,520 family
    Primary / specialist / urgent care:
    $45 / $75 / $85

  • PriorityPPO 3500

    Deductible:
    $3,500 individual, $7,000 family
    Coinsurance:
    Employee pays 30%
    Out-of-pocket limit: $7,350 individual, $14,700 family
    Primary / specialist / urgent care:
    $35 / $65 / $75

  • PriorityPPO 4500

    Deductible:
    $4,500 individual, $9,000 family
    Coinsurance:
    Employee pays 30%
    Out-of-pocket limit: $7,350 individual, $14,700 family
    Primary / specialist / urgent care:
    $35 / $65 / $75