Monthly Premiums
| Plan Option* | Employee | Family | Employee + Spouse | Employee + Child(ren) |
|---|---|---|---|---|
| Plan 1 | $930 | $3069 | $1860 | $1581 |
| Plan 2 | $802 | $2647 | $1604 | $1363 |
| Plan 3 | $647 | $2136 | $1294 | $1100 |
| Plan 4 | $638 | $2106 | $1277 | $1085 |
Rates effective for rate region 1.
For individuals in 2026 Rate Region A, the estimated 2027 regional rating factor = +2.4%.
For individuals in 2026 Rate Region B, the estimated 2027 regional rating factor = 0%.
For individuals in 2026 Rate Region C, the estimated 2027 regional rating factor = -6.6%.
Please see the 2027 rate announcement page for additional details regarding the 2027 rate changes.
| Plan | Plan 1 | Plan 2 | Plan 3 | Plan 4 |
|---|---|---|---|---|
| Medical Deductible Individual | $1,000 | $2,000 | $3,500 | $4,000 |
| Medical Deductible Family | $2,000 | $4,000 | $7,000 | $8,000 |
| Member Cost Share (Co-Insurance) for Covered Medical Expenses After Deductible | 15% In-Network 30% Non-Network | 20% In-Network 30% Non-Network | 20% In-Network 30% Non-Network | 20% In-Network 50% Non-Network |
| Medical Out-of-Pocket Maximum Individual | $3,000 | $5,000 | $6,000 | $8,000 |
| Medical Out-of-Pocket Maximum Family | $6,000 | $10,000 | $12,000 | $16,000 |
| Rx Out-of-Pocket Maximum Individual | $1,000 | $1,000 | Applied to Medical Deductible; then Plan pays 100% | $1,000 |
| Rx Out-of-Pocket Maximum Family | $2,000 | $2,000 | Applied to Medical Deductible; then Plan pays 100% | $2,000 |
| Total Plan Out-of-Pocket Maximum Individual | $4,000 | $6,000 | $6,000 | $9,000 |
| Total Plan Out-of-Pocket Maximum Family | $8,000 | $12,000 | $12,000 | $18,000 |
Plan design notes
- Plan 3 is a Health Savings Account (HSA)-compliant High Deductible Health Plan (HDHP). Benefits and coverage under Plan 3 may be different from other plan options. Please consult the Plan 3 Summary Plan Description for additional details or contact the Benefit Plans Office.
- Medical Out-of-Pocket Maximum amounts include Medical Deductible amounts.
- Total Plan Out-of-Pocket Maximum amounts for Individual and Family are the total of Medical Out-of-Pocket Maximum amounts and Rx Out-of-Pocket Maximum amounts for Individual and Family, respectively.
