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Compare all plan options below
Click the links below to access the Schedule of Benefits for these plans:
Bronze 8550/100 | Bronze HSA 7000/100 | Bronze 5500/70 | Bronze 6500/60
Silver 4000/80/Copay40 | Silver HSA 3000/80 | Silver 5500/80/Rx250
HSA Silver 4500/100 | Silver 5000/80 | Silver 6000/80
Gold 800/80 | Gold 1500/80 | Gold 2000/80 | Gold 2750/80
Gold 2750/80/Copay ER | Gold 2200/80/Rx 250 | HSA Gold 3000/100
Click the links below to access the Schedule of Benefits for these plans:
Bronze HSA 7000/100 OOA | Bronze 6500/60 OOA
Click the links below to access the Schedule of Benefits for these plans:
Bronze 8150/100 | Bronze HSA 6750/100
Silver 3600/80 Copay 40 | Silver HSA 4200/100
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.
To view the Summary of Benefits and Coverage (SBC) for your employer plan, click here.
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.