CDPHP Health Plans

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CDPHP - (HD-PPO) - Click here for the detailed plan summary. HD-PPO
This policy is a High Deductible PPO cost share plan (has in & out of network deductibles). The plan has in & out of network coverage. The is an in-network deductible $2,700 (single) & $5,400 (family) with a 90% co-insurance. Primary office visits, specialist office visits, in-patient hospital, & emergency room visits are all covered at 90% after meeting the in-network deductible. The prescription drug card has a $4 generic and all other prescriptions have a 50% co-pay with no deductible.
	Monthly	Monthly	Quarterly
	Small Group	Sole Proprietor		Sole Proprietor
Individual	$306.94	$348.52		$1,045.56
Individual + Spouse	N/A	N/A		N/A
Individual + Child(ren)	N/A	N/A		N/A
Family	$784.37	$892.78		$2,678.34
	Plan Selection	Plan Selection		Plan Selection
	Instructions	Instructions		Instructions
	Application	Application		Application
	Student Verification Form

CDPHP - (HMO) - Click here for the detailed plan summary. CDPHP -HMO
This plan is an HMO with no out of network coverage & referrals are needed. It has a $25 primary & specialist office visit co-pay. The inpatient hospital is a $500 co-pay and a $100 co-pay for an emergency room visit. The prescription drug card is a 50% co-pay with no deductible.
	Monthly	Monthly	Quarterly
	Small Group	Sole Proprietor	Sole Proprietor
Individual	$471.80	$536.46	$1,609.38
Family	$1,214.26	$1,382.89	$4,148.67
	Plan Selection	Plan Selection	Plan Selection
	Instructions	Instructions	Instructions
	Application	Application	Application
	Student Verification Form

CDPHP - (PPOc) - Click here for the detailed plan summary. CDPHP-PPO
This policy is a PPO cost share plan (has in & out of network deductibles). The is an in-network deductible $200 (single) & $500 (family) with a 100% co-insurance. There is a $20 primary specialist in network office visit co-pay. There is a Hospital co-pay of $240 but you must meet the deductible first. There is a $75 emergency room co-pay and the prescription drug card is 10/30/50 with a $250 annual deductible.
	Monthly	Monthly	Quarterly
	Small Group	Sole Proprietor	Sole Proprietor
Individual	$474.18	$539.16	$1,617.48
Individual + Spouse	N/A	N/A	N/A
Individual + Child(ren)	N/A	N/A	N/A
Family	$1,220.48	$1,389.95	$4,169.85
	Plan Selection	Plan Selection	Plan Selection
	Instructions	Instructions	Instructions
	Application	Application	Application
	Student Verification Form