Office of Human Resources

Compare changes

Cost Structure	2025	2026
Aggregate Out of Pocket Maximums	$2,500 / $5,000	$4,000 / $8,000
Calendar Year Deductible	$1,650 / $3,300	$2,000 / $4,000
Outpatient Care	2025	2026
Urgent Care	Covered in full after deductible is met	$30 copay after deductible is met
Emergency room visits	Covered in full after deductible is met	$100 copay after deductible is met
Non-Routine Office visits (outside of annual routine preventative services)	Covered in full after deductible is met	Level 1: $30 copay after deductible is met Level 2: $50 copay after deductible is met
Short term rehabilitation therapy: physical and occupational	Covered in full after deductible is met (max of 60 visits each for OT and PT)	$30 copay after deductible is met (max of 60 visits each for OT and PT)
Short term rehabilitation therapy: speech	Covered after deductible	$30 copay after deductible is met
Chiropractor and Acupuncture services	Covered in full after deductible is met (unlimited visits)	$30 copay after deductible is met (unlimited visits)
Mental/Behavioral/ Substance Abuse Outpatient	Covered after deductible	$30 copay after deductible met
Durable medical equipment / Prosthetics	20% coinsurance after deductible is met	30% coinsurance after deductible is met

Cost Structure	2025	2026
Aggregate Out of Pocket Maximums	$2,500 / $5,000	$5,000/$10,000
Calendar Year Deductible	$500 / $1,000	$1,000 / $2,000
Outpatient Care	2025	2026
Surgery and related anesthesia	$250 per visit after deductible is met	Covered in full after deductible is met
Short term rehabilitation therapy: physical and occupational	$25 per visit – 60 visits per type of therapy	Covered in full after deductible is met (60 visits per type of therapy)
Short term rehabilitation therapy: speech	$25 per visit - unlimited visits	Covered in full after deductible is met (unlimited visits)
Inpatient Care (including maternity care)	2025	2026
Hospital care	$500 per admission after deductible is met	Covered in full after deductible is met
Rehabilitation hospital care	$500 per admission after deductible is met (max of 60 days per year)	Covered in full after deductible is met (max of 60 days per year)
Skilled nursing facility care	$500 per admission after deductible is met (max of 100 days per year)	Covered in full after deductible is met (max of 100 days per year)