Decide

Take some time and review the many new choices, programs and resources available to help keep you and your family healthy. See your guide for details.

Your medical plans are offered through Aetna and in-network preventative care is covered at 100%.

Benefits	Basic Managed Care (You Pay)	Managed Care (You Pay)	HCRA Plan (You Pay)	Premium Managed Care (You Pay)
Comparison to Marketplace plans	Bronze	Silver Plus	Gold	Gold Plus
In-network preventive care covered at 100%	Yes	Yes	Yes	Yes
Well-being resources and special programs	Yes	Yes	Yes	Yes
Provider network	Broad or APCN Plus	Broad or APCN Plus	Broad or APCN Plus	Broad or APCN Plus
Use of in- and out-of- network providers	Yes	Yes	Yes	Yes
Must select a Primary Care Physician (PCP)	No	Yes	No	Yes
PCP referrals needed for specialty care	No	Yes	No	Yes
HCRA Funded	No	No	Yes	No
In-network deductible	Yes	Yes	Yes	Yes
Out-of-pocket maximum for in-network care	$6,500 single $13,000 family	$4,000 single $8,000 family	$3,750 single $7,500 family	$2,000 single $4,000 family

Note: Prescription drug coverage is included in the medical plan. Prescription drug expenses are not subject to the medical plan deductible

Comparison to Marketplace plans

In-network Medical Services

Benefits	Basic Managed Care (You Pay)	Managed Care (You Pay)	HCRA Plan (You Pay)	Premium Managed Care (You Pay)
Office Visits Primary Care Physician (PCP)/Specialist (SPC)	$30 PCP copay (after deductible) $45 SPC (after deductible)	$30 PCP copay $45 SPC	Deductible and Coinsurance	$30 PCP copay $45 SPC copay
Emergency Room	$150 copay (after deductible)	$150 copay	Deductible and Coinsurance	$150 copay
Urgent Care Facility	$45 copay (after deductible)	$40 copay	Deductible and Coinsurance	$45 copay
Deductible	$2,750 single $5,500 family	$1,000 single $2,000 family	$2,250 single $4,500 family	$1,000 single $2,000 family
HCRA Fund	N/A	N/A	$1,500 single $3,000 family	N/A
Deductible after HCRA Fund	N/A	N/A	$750 single $1,500 family	N/A
Coinsurance	35%	10%	10%	10%
Annual Out-of-Pocket Maximum	$6,500 single $13,000 family	$4,000 single $8,000 family	$3,750 single $7,500 family	$2,000 single $4,000 family

Note: Prescription drug coverage is included in the medical plan. Prescription drug expenses are not subject to the medical plan deductible

Comparison to Marketplace plans

Out-of-Network Medical Services

Benefits	Basic Managed Care (You Pay)	Managed Care (You Pay)	HCRA Plan (You Pay)	Premium Managed Care (You Pay)
Office Visits and Preventative Care	Deductible and Coinsurance	Deductible and Coinsurance	Deductible and Coinsurance	Deductible and Coinsurance
Emergency Room	$150 copay (after deductible)	$150 copay	Deductible and Coinsurance	$150 copay
Deductible	$7,500 single $15,000 family	$1,500 single $3,000 family	$4,000 single $8,000 family	$2,000 single $4,000 family
Coinsurance*	50%	30%	40%	40%
Annual Out-of-Pocket Maximum	$12,500 single $25,000 family	$6,000 single $12,000 family	$8,000 single $16,000 family	$5,000 single $10,000 family

* The plan pays out-of-network benefits based on Medicare reimbursement levels of 140% of Medicare. In addition to your coinsurance, and any deductible, you are responsible for amounts that exceed these levels.

2026 DECIDE

Take some time and review the many new choices, programs and resources available to help keep you and your family healthy. See your guide for details.

Your medical plans are offered through Aetna and in-network preventative care is covered at 100%.

In-network Medical Services

Out-of-Network Medical Services