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Health Care Plans

2026 Health Plans Comparison

YOUR PPO Plan

Generally higher employee premium contributions

YOUR HSA-Eligible Plan

Generally lower employee premium contributions

Tier 1 Tier 2 Tier 3 Tier 1 Tier 2 Tier 3
Excellus Using AHP Network Excellus National Network Out-of-Network Excellus Using AHP Network Excellus National Network Out-of-Network
Overall Coverage: Single
YOUR PPO Plan deductible applies to services as noted
below.
YOUR HSA-Eligible Plan deductible applies to all
medical and pharmacy expenses.
Deductible13 $500 $1,250 $3,0007 $1,800 $3,000 $4,0007
Coinsurance Plan pays 90% Plan pays 75% Plan pays 60% Plan pays 85% Plan pays 65% Plan pays 60%
Out-of-Pocket Maximum13 (includes deductible, coinsurance and copays) Full-time employees earning less than $72,400/year12 and SMH Residents or Fellows $2,000 $3,000 $5,000 $3,500 $6,000 $6,750
Out-of-Pocket Maximum13 (includes deductible, coinsurance and copays) Full-time employees earning$72,400/year12 or more and all part-time employees $2,750 $4,250 $6,500 $4,000 $6,500 $6,750
Lifetime Maximum Unlimited Unlimited
Flexible Spending Account and/or Health Savings Account Flexible Spending Account maximum: $3,300 Health Savings Account maximum: $4,400

Health Care Flexible Spending Account and Limited

Flexible Spending Account maximum: $3,3003

 

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YOUR PPO Plan

Generally, higher employee premium contributions

YOUR HSA-Eligible Plan

Generally, lower employee premium contributions
Tier 1Tier 2Tier 3Tier 1Tier 2Tier 3
Excellus Using AHP NetworkExcellus National NetworkOut-of-NetworkExcellus Using AHP NetworkExcellus National NetworkOut-of-Network

Overall Coverage Single

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YOUR PPO Plan deductible applies to services as noted below.YOUR HSA-Eligible Plan deductible applies to all medical and pharmacy expenses.
Deductible13$500 $1,250 $30,0007$1,800$3,000$40,0007
CoinsurancePlan pays 90%Plan pays 75%Plan pays 60%Plan pays 85%Plan pays 65%Plan pays 60%
Out-of-Pocket Maximum13 (includes deductible, coinsurance and copays)Full-time employees earning less than $72,400/year12 and SMH Residents or Fellows$2,000 $3,000$5,000 $3,500$6,000$6,750
Out-of-Pocket Maximum13 (includes deductible, coinsurance and copays) Full-time employees earning$72,400/year12 or more and all part-time employees$2,750 $4,250 $6,500 $4,000$6,500$6,750
Lifetime MaximumUnlimitedUnlimited
Flexible Spending Account and/or Health Savings AccountFlexible Spending Account maximum: $3,300Health Savings Account maximum: $4,400 Health Care Flexible Spending Account and Limited Flexible Spending Account maximum: $3,3003