Plan Features

  • The EASE Bronze plan is an actuarially certified Minimum Value Plan, which means that on top of Minimum Essential Coverage, this plan offers employers full protection from ACA penalties if offered to full time employees at an affordable level.
  • The EASE Bronze plan is both more accessible, comprehensive coverage and more efficient than other Bronze plans in the market.
  • Not only does the Bronze plan offer low copays, it also has no deductibles, saving participants thousands of dollars a year compared to other Bronze plans.

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DEDUCTIBLE
(Individual | Family)
$0 | $0
OUT OF POCKET MAXIMUM
(Individual | Family)
$8,150 | $16,300
PREVENTIVE & WELLNESS SERVICES $0 Copay
(Plan pays 100% of covered preventive and wellness services)
TELEMEDICINE SERVICES $0
DIRECT PRIMARY CARE (DPC) $10 Copay for Primary Doctor
$25 for Urgent Care
PRIMARY CARE OFFICE VISIT
(when not through the DPC benefit)
$25 Copay
(Limited to 8 visits per plan year)
SPECIALIST OFFICE VISIT $50 Copay
(Limited to 8 visits per plan year)
LABORATORY SERVICE & RADIOLOGY $50 Copay
(Combined limit of 3 visits per plan year)
CT/MRI/MRA/PET SCAN $350 Copay
(Limited to 1 per plan year)
URGENT CARE
(when not through the DPC benefit)
$50 Copay
(Limited to 2 visits per plan year)
OUTPATIENT HOSPITAL OR FREE STANDING FACILITY SERVICES AND SURGERY $350 Copay
(Limited to 1 visit per plan year)
INPATIENT HOSPITALIZATION &
INPATIENT SURGERY
$350 Copay per admission
(Limited to 5 days and 2 Surgeries per plan year)
EMERGENCY ROOM SERVICES $350 Copay
(Limited to 1 visit per plan year)
PHARMACY BENEFITS
(Subject to Formulary)
Generic - $0 Copay
(Limited to Preventive Generic drugs. Plan pays 100% of covered preventive drugs. In addition, a discount pharmacy program is provided that allows other drugs to be obtained at payments ranging from $0 to $50).
TREATMENT FOR CHEMICAL ABUSE & DEPENDENCY Outpatient: $25 Copay per day
Inpatient: $250 Copay per day
(Both limited to 5 days per plan year)
HOME HEALTH CARE $25 Copay
(Limited to 10 visits per plan year)

Please note:

  • Out of Network services, and services provided at a hospital, will not be covered, unless otherwise specified.
  • Refer to the Schedule of Benefits or DPC Product Flyer, as applicable, for a more in-depth list of Benefits Coverage, Limitations and Exclusions. If this document differs from the Schedule of Benefits or DPC Product Flyer, the Schedule of Benefits or DPC Product Flyer, as applicable, will govern.