11
This comparison chart shows a brief summary of the medical benefits available.
Anthem Blue Cross
80-M PPO 3 Plan
Anthem Blue Cross
PPO HDHP-HSA Plan
Kaiser Permanente HMO
Traditional Plan
20% of charges
$40 (deductible waived)
10% of charges
10% of charges
Plan pays 100%
$30
$200 Individual/
$500 Family
Combined Medical/Pharmacy
None
$2,500 Individual/
$3,500 Family
Deductible & Out-of-Pocket
None
$10-Generic/$35-Brand
$0 Generic/$35 Brand (30 day supply)
$0 Generic/$90 Brand (90-day supply)
$0 Generic/ $90 Brand
$35 Specialty
$9- Generic/$35- Brand
$0 Generic/$35 Brand (30-day supply)
$0 Generic/$90 Brand (90-day supply)
$18 Generic / $70 Brand
N/A
$10-Generic/$30- Brand (up to 100 day supply)
$10-Generic/$30 Brand (up to 100-day supply)
$10 Generic / $30 Brand (up to 100 day supply)
N/A
Plan pays 80% of charges
Plan pays 90% of charges
Plan pays 100%
$40 (deductible waived)
Plan pays 90% of charges
$30
Plan pays 80% of charges
Plan pays 90% of charges
$30
Play pays 100%
Play pays 100%
Play pays 100%
Plan pays 80% of charges
Plan pays 90% of charges
Plan pays 100%