Anchor Choice with HSA Plan. Each member that enrolls in the Anchor Choice Plan with HSA shall receive an HSA contribution from the State in the amount of $1,500 for individuals or $3,000 for families. Fifty percent (50%) of each State HSA contribution shall be deposited on January 1st and 50% shall be deposited on July 1st during each year of the collective bargaining agreement. The State will not pro-rate its HSA contributions for members enrolling after January 1st or July 1st. In Network Deductible* $1,500 ($3,000 family) In network Out of Pocket Max** $3,000 ($6,000 family) Out of Network Deductible* $2,250 ($4,500 family) Out of Network Out of Pocket Max** $4,500 ($9,000 family) In-Network Coinsurance 10% Out of Network Coinsurance 30% *The family deductible is cumulative, meaning any combination of items covered by the deductible paid by family members counts toward the deductible until the full amount of the deductible has been met. The in-network and out of network deductibles and out-of-pocket maximums are combined deductibles and out-of-pocket maximums with the pharmacy deductibles and out-of-pocket maximum. The following in-network copays shall be in effect for the Anchor Choice HSA Plan:
Anchor Choice with HSA Plan. On the Anchor Choice Plan with HSA, MBUs shall pay the full retail rate for most prescriptions prior to meeting the deductible. However, if the medication is listed on the pharmacy benefit manager’s preventive therapy drug list, the applicable copay amount shall apply instead of the full retail rate. For all covered drugs, after the deductible is met, the applicable copay amount shall apply until the applicable OOPM is met. The drug copay after deductible for a 31-day supply shall be as follows: Tier 1 Tier 2 Tier 3 Tier 4 $10.00 $35.00 $60.00 $100.00 The drug copay after deductible by mail order shall be as follows: Tier 1 Tier 2 Tier 3 $20.00 $70.00 $120.00 Mail order network pharmacies: 3-month supply of a prescription drug for two (2) copayments. Maximum fill is a 3-month supply.
Anchor Choice with HSA Plan. On the Anchor Choice Plan with HSA, members shall pay the full retail rate for most prescriptions prior to meeting the deductible. However, if the medication is listed on the pharmacy benefit manager’s preventive therapy drug list, the applicable copay amount shall apply instead of the full retail rate. For all covered drugs, after the deductible is met, the applicable copay amount shall apply until the applicable OOPM is met. The drug copay after deductible for a 31-day supply shall be as follows: Tier 1 Tier 2 Tier 3 Tier 4 $10.00 $35.00 $60.00 $100.00 The drug copay after deductible by mail order shall be as follows: Tier 1 Tier 2 Tier 3 $20.00 $70.00 $120.00 Mail order network pharmacies: 3-month supply of a prescription drug for two (2) copayments. Maximum fill is a 3-month supply. The State will provide a vision/optical care program for the employee. Dental and Vision Programs:
Anchor Choice with HSA Plan. Each member that enrolls in the Anchor Choice Plan with HSA shall receive an HSA contribution from the State in the amount of $1,500 for individuals or $3,000 for families. Fifty percent (50%) of each State HSA contribution shall be deposited on January 1st and 50% shall be deposited on July 1st during each year of the collective bargaining agreement. The State will not pro-rate its HSA contributions for members enrolling after January 1st or July 1st. In-Network Deductible* $1,500 ($3,000 family) In-Network Out-of-Pocket Max** $3,000 ($6,000 family) Out-of-Network Deductible*, ** $2,250 ($4,500 family) Out-of-Network Out-of-Pocket Max** $4,500 ($9,000 family) In-Network Co-insurance 10% Out-of-Network Co-insurance 30% *The family deductible is cumulative, meaning any combination of items covered by the deductible paid by family-members counts toward the deductible until the full amount of the deductible has been met. **The in-network and out-of-network deductibles and out-of-pocket maximums are combined deductibles and out-of-pocket maximums with the pharmacy deductibles and out-of-pocket maximum. The following in-network co-pays shall be in effect for the Anchor Choice HSA Plan:
