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SMALL BUSINESSES

Compare all plan options below

2020 Small Business Plans

 

Bronze 8150/100Bronze HSA 6750/100
Deductible – In-Network
(Single/Family)
$8,150/$16,300$6,750/$13,500
Your deductible increases when you go out of network.
(Single/Family)
$16,300/$32,600$13,500/$27,000
Out-of-Pocket Maximum
In-Network (Single/Family)
$8,150/$16,300$6,750/$13,500
Out-of-Pocket Maximum
Out-of-Network (Single/Family)
$32,600/$65,200$27,000/$54,000
Coinsurance In-Network
(you pay)
0%0%
Coinsurance Out-of-Network (you pay)30%30%
PCP1 (In-Network)$35 Deductible/Coinsurance
Specialist (In-Network)Deductible/Coinsurance Deductible/Coinsurance
Urgent Care (In-Network)Deductible/Coinsurance Deductible/Coinsurance
Aurora QuickCare /Bellin FastCareCounts as PCP visit Deductible/Coinsurance
Emergency Room2 (In- & Out-of-Network)In-Network Deductible/CoinsuranceIn-Network Deductible/Coinsurance
In-Network Preventive Care3$0$0
Prescription Drugs (Tier 1)Deductible/CoinsuranceDeductible/Coinsurance
Prescription Drugs (Tier 2)Deductible/CoinsuranceDeductible/Coinsurance
Prescription Drugs (Tier 3)Deductible/CoinsuranceDeductible/Coinsurance
Prescription Drugs (Specialty)Deductible/CoinsuranceDeductible/Coinsurance
More DetailsMore Details
Silver 4000/80Silver HSA 4200/100Silver 3600/80/
Copay 40
Silver 2500/80
Deductible – In-Network
(Single/Family)
$4,000/$8,000$4,200/$8,400$3,600/$7,200$2,500/$5,000
Your deductible increases when you go out of network.
(Single/Family)
$8,000/$16,000$8,400/$16,800$7,200/$14,400$5,000/$10,000
Out-of-Pocket Maximum – In-Network
(Single/Family)
$8,150/$16,300$4,200/$8,400$8,150/$16,300$8,150/$16,300
Out-of-Pocket Maximum – Out-of-Network
(Single/Family)
$16,300/$32,600$16,800/$33,600$16,300/$32,600$16,300/$32,600
Coinsurance In-Network
(you pay)
20%0%20%20%
50%30%50%50%
PCP1 (In-Network)$45 CopayDeductible; Coinsurance$40 CopayDeductible; Coinsurance
Specialist (In-Network)$80 CopayDeductible; Coinsurance$75 CopayDeductible; Coinsurance
Urgent Care (In-Network)$50 CopayDeductible; Coinsurance$50 CopayDeductible; Coinsurance
Aurora QuickCare /Bellin FastCare$15 CopayDeductible; Coinsurance$15 CopayDeductible; Coinsurance
Emergency Room2 (In- & Out-of-Network)Deductible; CoinsuranceIn-Network
Deductible; Coinsurance
Deductible; CoinsuranceIn-Network
Deductible; Coinsurance
In-Network Preventive Care3$0$0$0$0
Prescription Drugs
(Tier 1)
$25 CopayDeductible; Coinsurance$25 CopayDeductible; Coinsurance
Prescription Drugs
(Tier 2)
$50 CopayDeductible; Coinsurance$65 CopayDeductible; Coinsurance
Prescription Drugs
(Tier 3)
$75 CopayDeductible; CoinsuranceDeductible; CoinsuranceDeductible; Coinsurance
Prescription Drugs (Specialty)Deductible; CoinsuranceDeductible; CoinsuranceDeductible; CoinsuranceDeductible; Coinsurance
More DetailsMore DetailsMore DetailsMore Details
Gold 800/80Gold 1000/80
Deductible – In-Network
(Single/Family)
$800/$1,600$1,000/$2,000
Your deductible increases when you go out of network.
(Single/Family)
$1,600/$3,200$2,000/$4,000
Out-of-Pocket Maximum
In-Network (Single/Family)
$8,150/$16,300$8,150/$16,300
Out-of-Pocket Maximum
Out-of-Network (Single/Family)
$16,300/$32,600$16,300/$32,600
Coinsurance In-Network
(you pay)
20%20%
Coinsurance Out-of-Network (you pay)50%50%
PCP1 (In-Network)$35 Copay$35 Copay
Specialist (In-Network)$60 Copay$60 Copay
Urgent Care (In-Network)$50 Copay$50 Copay
Aurora QuickCare /Bellin FastCare$15 Copay$15 Copay
Emergency Room2 (In- & Out-of-Network)$300 Copay$300 Copay
In-Network Preventive Care3$0$0
Prescription Drugs (Tier 1)$10 Copay$10 Copay
Prescription Drugs (Tier 2)$45 Copay$45 Copay
Prescription Drugs (Tier 3)$75 Copay$75 Copay
Prescription Drugs (Specialty)Deductible; CoinsuranceDeductible; Coinsurance
More DetailsMore Details

Click the links below to access the Schedule of Benefits for these plans:

Bronze 7900/100   |   Bronze HSA 6650/100

 Silver 3300/80 Copay 35  |  Silver HSA 3900/100

Silver 4000/80  |   Silver 2000/80

Gold 600/80  |  Gold 1000/80

 

 

1 PCP = Primary Care Provider (includes general pediatrics, internal medicine, OB/GYN, family practice, general medicine, chiropractor and geriatrics) Urgent = Urgent Care Services Emergency = Emergency Room Care Services

2 Services that meet the definition of emergency are paid at the in-network rate even when care is delivered in a non-network ER. Because we do not have a contract with out of network ER facilities, we cannot prevent these facilities from billing our members for the balance of the charge. The copay applies to the facility charge only. All other charges related to ER visit are subject to deductible/coinsurance.

3 Preventive Care received out of network is not covered

Our Deductibles, Explained: All plans have a January 1 to December 31 deductible. All deductibles, coinsurance, and copayments accumulate toward the out-of-pocket maximum. In-network and out-of-network deductibles and out-of-pocket maximums must be satisfied separately. All plans described on this page have embedded deductibles for family coverage. This means that if you are enrolled in 2-person or family coverage, an individual family member only has to satisfy the single person deductible before the plan begins to make payment for covered services for that family member. 

Common Ground Healthcare Cooperative does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.

This page provides summary information.  Please refer to the certificate of coverage and schedule of benefits for a complete listing of benefits and terms of coverage.  A list of exclusions and limitations can be found here.