Health Savings Account Plans
Embedded Deductible Plans**
| Health Plan # | Ded In/Out Individual | Ded In/Out Family | Office Copay | Coins % In/Out | Out of Pocket Maximum* Indiv/Family | Pharmacy |
|---|---|---|---|---|---|---|
| RSH1 | $2500/$5000 | $5000/$10000 | Ded & Coins | 100% / 70% | $2500/$5000 | 100% after cal year deductible |
| RSH2 | $3000/$6000 | $6000/$12000 | Ded & Coins | 100% / 70% | $3000/$6000 | 100% after cal year deductible |
| RSH3 | $5000/$10000 | $10000/$20000 | Ded & Coins | 100% / 70% | $5000/$10000 | 100% after cal year deductible |
| RSH6 | $3500/$7000 | $7000/$14000 | Ded & Coins | 80% / 60% | $5000/$10000 | 80% after cal year deductible |
| RSH7 | $2500/$5000 | $5000/$10000 | Ded & Coins | 80% / 60% | $5000/$10000 | 80% after cal year deductible |
| RSH8 | $4000/$8000 | $8000/$16000 | Ded & Coins | 100% / 70% | $4000/$8000 | 100% after cal year deductible |
| RSHE1 | $2500/$5000 | $5000/$10000 | Ded & Coins | 100% / 70% | $2500/$5000 | 100% after cal year deductible |
* Deductible plus Coinsurance Stoploss equals Out of Pocket Maximum
** The individual deductible amount must be satisfied by every participant covered, each calendar year. If dependents are covered, all charges applied to the individual deductible amount will be applied toward the family deductible amount. When the family deductible is reached, no further individual deductibles will have to be satisfied for the remainder of that calendar year. No participant will contribute more than the individual deductible amount to the family deductible amount.
