The Annual Deductible

Under Options 1 and 2, certain expenses are subject to an annual deductible. The annual deductible is the amount you must pay "up front" each calendar year before the Plan begins to pay benefits for most covered expenses.

Under Options 1 and 2, there are certain services that are provided before the deductible (meaning the Plan begins paying immediately):

Eligible preventive care that is received from in-network providers is covered in full without having to satisfy the deductible;

In-network primary care is covered at 90% without having to satisfy the deductible; and

Virtual doctor visits are covered for approximately $5, before the deductible for primary care services. Mental health virtual visits are covered at 80% after the deductible.

For more information on what is considered "eligible preventive care" and "primary care," please see the chart under "Coinsurance Paid for Covered Benefits."

Out-of-network care has a higher deductible that is separate from the in-network deductible. Amounts in excess of reasonable and customary (R&C) charges do not count toward the out-of-network deductible. As a reminder, the Prescription Drug Plan has a separate plan design and has separate deductibles from those listed in the following table.

In addition to separate deductibles for in-network and out-of-network medical care, the annual deductible you are subject to also varies by (1) your Total Annual Cash Compensation (TACC), and (2) your coverage level.

The following table shows the annual deductibles for the different coverage levels under each option.


In- and Out-of-Network Deductibles (Medical Only)
Coverage Level	Option 1		Option 2
	In-Network	Out-of-Network	In-Network	Out-of-Network
Total Annual Cash Compensation: less than $60,000
Employee*	$1,000	$2,750	$2,000	$4,750
Employee + spouse/domestic partner or Employee + child(ren)	$1,875	$4,125	$3,375	$7,125
Family (employee + spouse/domestic partner + child(ren))	$2,750	$5,500	$4,750	$9,500
Total Annual Cash Compensation: $60,000 or more
Employee*	$1,750	$2,750	$2,750	$4,750
Employee + spouse/domestic partner or Employee + child(ren)	$2,625	$4,125	$4,125	$7,125
Family (employee + spouse/domestic partner + child(ren))	$3,500	$5,500	$5,500	$9,500

* Also functions as a "per person" deductible under the other coverage levels.

If you elect coverage for yourself, you must pay up front for all eligible expenses (except for preventive care and primary care) until you meet the per-person deductible. After you meet the annual per-person deductible, the Plan will begin to pay its portion of covered expenses — known as the coinsurance rate (please see chart under "Coinsurance Paid for Covered Benefits" for the Plan's coinsurance for various expenses).

If you cover dependents, all eligible expenses paid by you and/or your covered dependents combine to meet the deductible amount for the coverage level.

However, no individual must satisfy more than the per-person deductible amount. This means that once an individual's expenses meet the per-person deductible, the Plan will begin to pay benefits for that person, even if the family has not yet met the full deductible for the coverage level. Please see "The Per-Person Deductible and Coinsurance Maximum Provision."