Employer group health plans

Your plan documents

Certificate of Coverage

The Certificate of Coverage is your official policy. It outlines the covered and non-covered benefits, information on how to access benefits and details any exclusions/limitations associated with benefits. The Certificate of Coverage also includes term definitions, enrollment and disenrollment issues, coordination of benefit information, member rights/responsibilities and complaints/appeals procedures. If you can’t find the information you need in your certificate or if you need a copy of your certificate, please contact your human resources department or call Health Tradition at 1-877-832-1823.

Summary of Benefits and Coverage (SBC)

The Summary provides information on some covered and non-covered services, including some exclusions. It indicates your out-of-pocket maximums for annual deductible and coinsurance per member and per family, defines office copays, confinement fees and emergency room co-payments.

The summary provides a quick reference for many benefit questions but does not include everything and does not replace your Certificate of Coverage. Health Tradition sends a copy of your Summary of Benefits annually to your employer. To clarify which plan you have, or if you need additional information, please call us at 1-888-459-3020.

See the Summary of Benefits for your plan below:

2020 plans

HMO plans

Plan
Annual Deductible
Coinsurance
Out-of-pocket maximum

Platinum Level

Health Tradition Platinum 500 w/copay

$500 / $1,000
80%
$1,500 / $3,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Platinum 1000 w/copay

$1,000 / $2,000
80%
$3,000 / $6,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Gold Level

Health Tradition Gold 1000/80 w/copay

$1,000 / $2,000
80%
$4,500 / $9,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Gold 1500/80

$1,500 / $3,000
80%
$4,000 / $8,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Gold 2500/70 w/copay

$2,500 / $5,000
70%
$5,500 / $11,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Gold HDHP 100

$3,000 / $6,000
100%
$3,000 / $6,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Silver Level

Health Tradition Silver 2000/70 w/copay

$2,000 / $4,000
70%
$8,150 / $16,300

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Silver 2000/70

$2,000 / $4,000
70%
$8,150 / $16,300

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Silver 3000/80 w/copay

$3,000 / $6,000
80%
$8,150 / $16,300

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Silver 5000/80 w/copay

$5,000 / $10,000
80%
$8,150 / $16,300

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Silver HDHP 100

$5,500 / $11,000
100%
$5,500 / $11,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Bronze Level

Health Tradition Bronze 7750/60 w/copay

$7,750 / $15,500
60%
$8,150 / $16,300

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Bronze HDHP 100

$6,900 / $13,800
100%
$6,900 / $13,800

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

 

Point of service plans

Plan
Annual Deductible
Coinsurance
Out-of-pocket maximum

Platinum Level

Health Tradition Platinum 500 w/copay POS

$500 / $1,000
80%
$1,500 / $3,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Platinum 1000 w/copay POS

$1,000 / $2,000
80%
$3,000 / $6,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Gold Level

Health Tradition Gold 1000/80 w/copay POS

$1,000 / $2,000
80%
$4,500 / $9,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Gold 1500/80 POS

$1,500 / $3,000
80%
$4,000 / $8,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Gold 2500/70 w/copay POS

$2,500 / $5,000
70%
$5,500 / $11,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Gold HDHP 100 POS

$3,000 / $6,000
100%
$3,000 / $6,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Silver Level

Health Tradition Silver 2000/70 w/copay POS

$2,000 / $4,000
70%
$8,150 / $16,300

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Silver 2000/70 POS

$2,000 / $4,000
70%
$8,150 / $16,300

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Silver 3000/80 w/copay POS

$3,000 / $6,000
80%
$8,150 / $16,300

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Silver 5000/80 w/copay POS

$5,000 / $10,000
80%
$8,150 / $16,300

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Silver HDHP 100 POS

$5,500 / $11,000
100%
$5,500 / $11,000

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Bronze Level

Health Tradition Bronze 7750/60 w/copay POS

$7,750 / $15,500
60%
$8,150 / $16,300

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

Health Tradition Bronze HDHP 100 POS

$6,900 / $13,800
100%
$6,900 / $13,800

What will I pay after meeting my deductible? [ See more + ] [ See less - ]

 

View 2019 plan details

 

* This Benefit Plan provides 100% coverage for preventive health services. Coverage may be subject to reasonable medical management techniques to determine the frequency, method, treatment, or setting for receipt of preventive health services and as defined in Section 1001 of the Patient Protection and Affordable Care Act, with no cost sharing.

** Out-of-network medical emergencies, urgent care and prior plan-approved referrals are covered as in-network benefit. See Certificate of Coverage for plan detail.

*** Once a member of a family plan meets the individual deductible or maximum out-of-pocket, Health Tradition begins paying for covered services for that person, regardless of whether the family deductible or out-of-pocket maximum has been met.