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CDPHP Plans

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Oxford - Freedom (HSA) - Click here for the detailed plan summary.
Option #6
This policy is an HSA (Health Saving Account) with no out of network coverage, no referrals needed. There is a $2,850 (single) a $5,700 (family) in network deductible with a 100% coinsurance. Primary office visits, specialist office visits, in-patient hospital, & emergency room visits are all covered 100% after meeting the deductible. There is a 10/25/50 prescription drug card that is subject to the deductible.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $343.65

$393.70

$1,181.10
Individual + Spouse

$744.03

$854.13

$2,562.39
Individual + Child(ren) $627.25

$719.84

$2,159.52
Family $1,044.32

$1,199.47

$3,598.41
 

Plan Selection

Plan Selection

Plan Selection
 

Instructions

Instructions

Instructions
 

Application

Application

Application
 

Student Verification Form

Oxford - Freedom (HSA) - Click here for the detailed plan summary.
Option #1
This policy is an HSA (Health Saving Account) with no out of network coverage, referrals needed. There is a $1250 (single) a $2500 (family) in network deductible with a 100% coinsurance. Primary office visits, specialist office visits, in-patient hospital, & emergency room visits are all covered 100% after meeting the deductible. There is a 10/25/50 prescription drug card that is subject to the deductible.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $463.82

$531.89

 $1,595.67
Individual + Spouse

$1,008.41

$1,158.17

 $3,474.51
Individual + Child(ren) $849.57

$975.51

 $2,926.53
Family $1,416.84

$1,627.87

 $4,883.61
 

Plan Selection

Plan Selection

Plan Selection
 

Instructions

Instructions

Instructions
 

Application

Application

Application
 

Student Verification Form

Oxford - Freedom Metro (EPO) - Click here for the detailed plan summary.
Option #10

This policy is an EPO (Exclusive Provider Organization) with no out of network coverage, no referrals needed. There is $25 primary & a $50 specialist office visit co-pay. The In-patient hospital has a $300 co-pay per day 5 days maximum per calendar year. There's a 15/30/60 prescription drug card with a $100 deductible and a $3,000 maximum.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $421.61

N/A

 N/A
Individual + Spouse

$927.54

N/A

 N/A
Individual + Child(ren) $779.98

N/A

 N/A
Family $1,306.99

N/A

 N/A
 

Plan Selection

    
 

Instructions

    
 

Application

    
 

Student Verification Form

Oxford - Freedom Metro (POSc) - Click here for the detailed plan summary.
Option #8
This policy is a POS (Point of Service) cost share plan (it has in & out of network deductibles). With in & out of network coverage, & no referrals needed. There is an In-network deductible $1,000 (single) & $2,000 (family) with a 100% co-insurance. There is a $25 primary & a $40 specialist office visit co-pay. With the in-patient hospital you must meet the deductible & co-insurance. The plan has a $100 emergency room co-pay and the prescription drug card is 15/30/60 with a $100 deductible and a $3,000 maximum.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $465.28

N/A

 N/A
Individual + Spouse

$1,023.62

N/A

 N/A
Individual + Child(ren) $860.76

N/A

 N/A
Family $1,470.28

N/A

 N/A
 

Plan Selection

    
 

Instructions

    
 

Application

    
 

Student Verification Form

Oxford - Freedom Metro (EP0) - Click here for the detailed plan summary.
Option #9
This policy is an EPO (Exclusive Provider Organization) with no out of network coverage, no referrals needed. There is $25 primary & a $50 specialist office visit co-pay. The In-patient hospital has a $300 co-pay per day 5 days maximum per calendar year. There's a 15/30/60 prescription drug card with a $100 deductible and a $3,000 maximum.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $490.63

N/A

 N/A
Individual + Spouse

$1,079.39

N/A

 N/A
Individual + Child(ren) $907.67

N/A

 N/A
Family $1,520.95

N/A

 N/A
 

Plan Selection

    
 

Instructions

    
 

Application

    
 

Student Verification Form

Oxford - Liberty (HMO) - Click here for the detailed plan summary.
Option #3
This policy is a HMO(Health Maintenance Organization) plan with in network coverage only, & referrals are required. It has a $30 primary & $50 specialist office visit co-pay. The inpatient hospital is a $500 co-pay and a $150 co-pay for an emergency room visit. The Prescription coverage is 15/35/75 with $100 deductible.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $389.13

$446.00

$1,338.00
Individual + Spouse

$844.08

$969.19

$2,907.57
Individual + Child(ren) $711.39

$816.60

$2,449.80
Family $1,185.30

$1,361.60

 $4,084.80
 

Plan Selection

Plan Selection

Plan Selection
 

Instructions

 Instructions Instructions
 

Application

 Application Application
 

Student Verification Form

Oxford - Liberty (EP0) - Click here for the detailed plan summary.
Option #4
This policy is an EPO (Exclusive Provider Organization) with no out of network coverage, no referrals needed. There is a $25 primary & a $50 specialist office visit co-pay. The In-patient hospital is a $300 co-pay per day 5 days max per calendar year. There's a 10/25/50 prescription drug card with a $50 deductible.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $500.18

$573.71

$1,721.13
Individual + Spouse

$1,088.38

$1,250.14

$3,750.42
Individual + Child(ren) $916.84

$1,052.87

$3,158.61
Family $1,529.56

$1,757.49

$5,272.47
 

Plan Selection

Plan Selection

Plan Selection
 

Instructions

 Instructions Instructions
 

Application

 Application Application
 

Student Verification Form

Oxford - Liberty Direct (POSc) - Click here for the detailed plan summary.
Option #7
This policy is a POS (Point of Service) cost share plan (with in & out of network deductibles). The plan has in & out of network coverage, & no referrals needed. There is an in-network deductible $500 (single) & $1,000 (family) with a 90% co-insurance. A primary & specialist office visits, in-patient hospital stays & emergency room visits are all covered at 90% after deductible for in-network doctors. The prescription drug card is 15/30/60 with a $100 deductible and a $3,000 maximum.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $520.90

$597.54

$1,792.62
Individual + Spouse

$1,133.98

$1,302.58

$3,907.74
Individual + Child(ren) $955.17

$1,096.95

$3,290.85
Family $1,624.45

$1,866.62

$5,599.86
 

Plan Selection

Plan Selection

Plan Selection
 

Instructions

 Instructions Instructions
 

Application

 Application Application
 

Student Verification Form

Oxford - Freedom Metro(EPO) - Click here for the detailed plan summary.
Option #8
This policy is an EPO (Exclusive Provider Organization) with no out of network coverage, & no referrals needed. This plan has a $25 primary & a $50 specialist office visit co-pay. The Hospital co-pay is a $300 co-pay per day up to 5 days max per calendar year with a $75 emergency room co-pay. The prescription drug card is 10/25/50 with a $100 deductible.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $526.95

$604.49

$1,813.47
Individual + Spouse

$1,147.29

$1,317.88

$3,953.64
Individual + Child(ren) $966.36

$1,109.81

$3,329.43
Family $1,612.56

$1,852.94

$5,558.82
 

Plan Selection

Plan Selection

Plan Selection
 

Instructions

 Instructions Instructions
 

Application

Application

Application
 

Student Verification Form

Oxford - Freedom (POS) - Click here for the detailed plan summary.
Option #2
This policy is a POS (Point of Service) plan with in & out of network coverage, & referrals are required. There is an out of network deductible of $1,000 (single) & $3,000 (family) with a 70% co-insurance. There is a $25 primary & $40 specialist office visit co-pay. The in-patient hospital is a $250 per day ($1,250 calendar year max), emergency room visits are a $75 co-pay. The prescription drug card is 10/25/50 with a $50 deductible.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $666.53

$765.01

$2,295.03
Individual + Spouse

$1,454.37

$1,671.03

$5,013.09
Individual + Child(ren) $1,224.57

$1,406.76

$4,220.28
Family $2,045.24

$2,350.53

$7,051.59
 

Plan Selection

Plan Selection

Plan Selection
 

Instructions

 Instructions Instructions
 

Application

 Application Application
 

Student Verification Form

Oxford - Freedom (POS) - Click here for the detailed plan summary.
Option #5
This policy is a POS (Point of Service) plan with in & out of network coverage, & no referrals needed. There is an out of network deductible of $3,000 (single) & $9,000 (family) with a 70% co-insurance. This plan has a $30 primary & $50 specialist office visit co-pay. In-patient hospital is $500 per admission, emergency room visits are a $150 co-pay. The prescription drug card is 15/30/60 with a $100 deductible and a $3,000 maximum.
 

Monthly

 Monthly

Quarterly

Small Group

Sole Proprietor

Sole Proprietor
Individual $580.62

$666.21

$1,998.63
Individual + Spouse

$1,265.37

$1,453.68

$4,361.04
Individual + Child(ren) $1,065.65

$1,224.00

$3,672.00
Family $1,778.91

$2,044.25

$6,132.75
 

Plan Selection

Plan Selection

Plan Selection
 

Instructions

 Instructions Instructions
 

Application

 Application Application
 

Student Verification Form
 

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