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Overview of Option C—2018

Option C is a PPO (preferred provider organization) option under which you choose where to receive care. You’ll generally pay less and receive a higher level of benefits when you use providers in the Anthem network. This option pays benefits after you have satisfied the annual deductible. But, preventive care is free (no deductible) when you receive it from network providers.

And, you may take advantage of a Healthcare Flexible Spending Account to pay out-of-pocket expenses not covered by your medical coverage.

This option has the next to the highest per paycheck premiums of all three medical options.

Plan Feature Option C
In-Network Out-of-Network
Annual medical deductible
Employee only coverage $524
Employee and dependent coverage (including domestic partners)  
  • Per person
$524
  • Per family   
$1,048
Annual medical out-of-pocket maximum*
Employee only coverage $2,103 $3,681
Employee and dependent coverage (including domestic partners)    
  • Per person
$2,103 $3,681
  • Per family   
$4,206 $7,362
Your share of covered medical expenses**

You pay 20%, after deductible

Preventive care is free

You pay 40%, after deductible
Emergency room copay

You pay a $100 copay per visit plus 20% of the remaining charge after the deductible

You pay a $100 copay per visit plus 20% of the remaining charge after the deductible
Prescription drug coverage After you meet the $75 per person annual prescription drug deductible, you’ll pay a copayment. When your covered out-of-pocket costs reach the $930 annual per person prescription drug out-of-pocket maximum, the plan pays 100% of your prescription costs for the rest of the calendar year; see Your Prescription Drug Coverage
Healthcare Flexible Spending Account available? Yes
Health Savings Account available? No, available with Option A only

* Does not include non-covered services, out-of-network provider charges that are above the plan allowance, and amounts above plan limits.

** Maximum benefit of 20 visits per person per year for chiropractic services.

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