The Basic Plan is the most affordable in terms of your bi-weekly paycheck contributions, however, it is the most expensive when you get care. This is a true high-deductible health plan, designed to offer protection in the case of catastrophic illness or injury. It may not be the best choice for your family if you or a family member require ongoing care.
With the Basic Plan, you have the option of using any provider in or out of network, but you pay more when you use doctors that are outside of the Anthem network. In-network preventive care is covered at 100% before deductible, and most other in-network services are covered at 80% after you meet your deductible.
Because the plan is considered a high-deductible health plan, you have the option of opening a Health Savings Account and making contributions on a before-tax basis. The company does not provide a contribution to HSAs for employees who enroll in this plan.
|
In-Network |
Out-of-Network |
| Annual Deductible |
$3,000 employee only/ $6,000 employee + one or more |
$6,000 employee only/ $12,000 employee + one or more |
| Annual Out-of-Pocket Maximum |
$6,000 employee only/ $12,000 employee + one or more |
$12,000 employee only/ $24,000 employee + one or more |
| Health Savings Account (HSA) Participation |
No company contribution.
Employee IRS maximum contribution: $4,300 employee only, $8,550 family |
| Most Services |
You pay 20% after deductible |
You pay 40% of R&C after deductible |
| Retail Prescription Drugs (after medical deductible) |
Generic - $10
Formulary – you pay 30%, $30 minimum and $90 maximum
Non-Formulary – you pay 50%, $75 minimum and $225 maximum |
To find an in-network provider, click here or download the Sydney Health app. Look for the text box under “Use Member ID for Basic Search” and enter the corresponding alphanumeric prefix based on your state. For employees in Florida, look for a doctor by using the prefix: V5F. For employees in Wisconsin, use the prefix: V7W. All other employees can search for providers by using the prefix: V6L. Select Continue to search for doctors, hospitals and other healthcare professionals in your plan’s network.