Under Plan Option 1 and Plan Option 2, the annual out-of-pocket maximum is the maximum amount you must pay in annual deductibles, coinsurance, and copays during a plan year toward eligible expenses. There is a separate out-of-pocket maximum for prescription drug expenses.

There are separate out-of-pocket maximums for in-network and out-of-network charges.

The out-of-pocket maximum varies based on coverage level and TACC, which provides greater financial protection for lower-paid employees, as shown in the following table.

The out-of-pocket maximum functions as your "financial safety net." It prevents you from having to pay very high healthcare expenses in the event of a serious medical situation. Once the in-network out-of-pocket maximum is reached, you pay no deductible, coinsurance, or copays for covered in-network care for the rest of the year. Once the out-network out-of-pocket maximum is reached, you pay no deductible, coinsurance, or copays for covered out of-network care for the rest of the year.

Amounts that you pay toward costs above the reasonable and customary charges for out-of-network care do not count toward your out-of-pocket maximum.