Plan Features

  • The EASE Essential plan offers Minimum Essential Coverage, which includes certain preventive and wellness benefits at no cost sharing, as well as primary care coverage, specialist visits, and includes a supplemental benefit for hospitalization.
  • EASE Essential offers coverage for the everyday and some rainy days without overwhelming your budget.

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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)
PRIMARY CARE OFFICE VISIT $25 Copay
(Combined limit of 6 visits per plan year with Specialist Office Visits.)
SPECIALIST OFFICE VISIT $50 Copay
(Combined limit of 6 visits per plan year with Primary Care Office Visits.)
OUTPATIENT SERVICES
(Limited to Mental & Behavioral Health or Substance Abuse)
$50 Copay
(Considered a Specialist Visit. Combined limit of 6 visits per plan year with Primary Care Office Visit.)
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).
SUPPLEMENTAL HOSPITAL BENEFIT $5,000
(Limited to $1,000 per day; maximum of 5 days)

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 for a more in-depth list of Benefits Coverage, Limitations and Exclusions. If this document differs from the Schedule of Benefits, the Schedule of Benefits will govern.