High Deductible Health Plan Comparison
This is a comparison of the high deductible health plans for FY 2019-20 open enrollment. Please see the Copay Plan Comparison page as well.
| United Healthcare (UHC) HDHP with HSA Plan | Kaiser Permanente (KP) HDHP with HSA Plan | ||||
|---|---|---|---|---|---|
| Annual Deductible1 | Network | Non-Network | Annual Deductible1 | Network | Non-Network |
| Individual | $1,500 | $4,500 | Individual | $1,500 | Not Covered |
| Family | $3,000 | $9,000 | Family | $3,000 | |
| Annual Out-of-Pocket Max: UHC 2 | Annual Out-of-Pocket Max: KP 2 | ||||
|---|---|---|---|---|---|
| Annual Deductible | Network | Non-Network | Annual Deductible | Network | Non-Network |
| Individual | $3,000 | $9,000 | Individual | $3,000 | Not Covered |
| Family | $6,000 | $18,000 | Family | $6,000 | |
| Co-Insurance: UHC | Co-Insurance: KP | ||||
|---|---|---|---|---|---|
| Annual Deductible | Network | Non-Network | Annual Deductible | Network | Non-Network |
| Percentage you pay after you have satisfied your deductible. | 20% | 50% | Percentage you pay after you have satisfied your deductible. | 20% | Not Covered |
| Office Visits/Urgent Care: UHC | Office Visits/Urgent Care: KP | ||||
|---|---|---|---|---|---|
| Service | Network | Non-Network | Service | Network | Non-Network |
| Preventative Care/Screenings | No Charge | 50% of eligible expenses after deductible | Preventative Care/Screenings | No Charge | Not Covered |
| Primary Care - Illness/Injury | 20% after deductible | Primary Care - Illness/Injury | 20% after deductible | ||
| Specialist | Specialist | ||||
| Inpatient Hospital | Inpatient Hospital | ||||
| Urgent Care | Urgent Care | 20% after deductible | |||
| Ambulance | 20% after in network deductible | Ambulance | |||
| Emergency Room | Emergency Room | ||||
| Virtual Visits (Network Benefits are available only when services are delivered through a Designated Virtual Network Provider.) | Not Covered | Virtual Care - Primary/Specialty - Phone Visit, Video Visit - Chat Online, Email, E-visits | - No Charge after deductible - No Charge | Not Covered | |
| Mental Health: UHC | Mental Health: KP | ||||
|---|---|---|---|---|---|
| Service | Network | Non-Network | Service | Network | Non-Network |
| Inpatient (Hospitalization/Day Treatment) | 20% after deductible | 50% of eligible expenses after deductible | Inpatient (Hospitalization/Day Treatment) | 20% after deductible | Not Covered |
| Outpatient (Therapy) | Outpatient (Therapy) | ||||
| Substance-Related & Addictive Disorders Services: UHC | Substance-Related & Addictive Disorders Services: KP | ||||
|---|---|---|---|---|---|
| Service | Network | Non-Network | Service | Network | Non-Network |
| Inpatient | 20% after deductible | 50% of eligible expenses after deductible | Inpatient | 20% after deductible | Not Covered |
| Outpatient | Outpatient | ||||
| Vision: UHC | Vision: KP | ||||
|---|---|---|---|---|---|
| Service | Network | Non-Network | Service | Pediatric (up to end of month he/she turns age 19) | Adult (members age 19 and over) |
| Up to 1 Routine Exam per plan year under the Medical Plan | 20% after deductible | - Allowances apply to network providers only. - Please refer to your plan details for out-of-network allowances | Optometrist/ Ophthalmologist | 20% after deductible | |
| Optical hardware | - Frames $130 allowance OR - Contact lens $150 allowance | Optical hardware | After deductible, 20% coinsurance once every 24 month | $150 Credit once every 24 months towards optical hardware | |
| Prescription: UHC | Prescription (3): KP | ||||
|---|---|---|---|---|---|
| Retail: 30-day supply | Mail Order: 90-day supply | Retail: 30-day supply | Mail Order: 90-day supply | ||
| Tier 1 | Deductible, then $10 Copay | Deductible, then $20 Copay | Generic | Deductible, then $10 Copay | Deductible, then $20 Copay |
| Tier 2 | Deductible, then $30 Copay | Deductible, then $60 Copay | Preferred Brand Name | Deductible, then $30 Copay | Deductible, then $60 Copay |
| Tier 3 | Deductible, then $50 Copay | Deductible, then $100 Copay | Non-Preferred Brand Name | Approved drugs covered at generic costshare | |
| Specialty (30 day supply) | Deductible, then 20% up to $100 | Specialty | Deductible, then 20% up $100 | ||
* Please refer to the official plan documents for detailed information and listing of covered services.
- If more than one person is covered under the policy, the single coverage deductible stated above does not apply. For more than one person, the family Annual Deductible is $3,000 per policy year.
- If more than one person is covered under the policy, the single coverage out of pocket maximum stated above does not apply. For more than one person, the family out of pocket maximum is $6,000 per policy year.
- For Southern Colorado Kaiser Permanente members: maintenance medications must be filled at a Pharmacy in a Kaiser Permanente medical office or through Kaiser Permanente mail order.
Rates - Employee Monthly Contribution
| United Healthcare HDHP with HSA Plan | Kaiser Permanente HDHP with HSA Plan | ||
|---|---|---|---|
| Employee Only | $25.18 | Employee Only | $36.78 |
| Employee + Spouse | $156.26 | Employee + Spouse | $178.00 |
| Employee + Child(ren) | $55.80 | Employee + Child(ren) | $82.36 |
| Family | $237.02 | Family | $268.46 |