Asuris HSA Comprehensive Healthplan > Own Your Health Care Dollars

Asuris HSA Comprehensive Healthplan
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Unique Features

Own your health care dollars with a tax-advantaged account that covers medical expenses beyond your health plan. Or choose to save.
More robust coverage than most HSAs, such as maternity and prescription coverage, plus a lower deductible.
Comprehensive wellness programs like Care Enhance^® Nurseline & Asuris Health Coach^SM.

Coverage at a Glance

Deductible:	$1,500 single, $3,000 family	Prescriptions Dental Vision No Referrals Maternity Preventive Care Alternative Care Mental Health
Annual OOP Max:	$5,000 single, $10,000 family
Coinsurance Max:	varies with deductible
Lifetime Max:	$2,000,000 per member
Copay:	none
Coinsurance:	80% Preferred, 60% Participating
Providers:	Preferred Network

Basic Features

Cost Sharing
Deductible	$1,500 single $3,000 family
Annual OOP Max	$5,000 single/$10,000 family Amount includes your deductible Maximum only applies to Preferred providers' services. No maximum for Participating providers.
Coinsurance Max	varies with deductible
Lifetime Max	$2,000,000 per member
Copay	none
Coinsurance	You pay 20% for most Preferred providers' services. You pay 40% for most Participating providers' services.
Everyday Needs
Prescriptions	You pay 50% at Participating pharmacies. $2,000 calendar year maximum Subject to deductible
Preventive Care	You pay 20% for Preferred providers. You pay 40% for Participating providers. Deductible waived No annual limit
Vision	Not covered
Office Visits	Deductible and coinsurance apply
X-Ray Services	Deductible and coinsurance apply
Lab Services	Deductible and coinsurance apply
Special Needs
Alternative Care	12 acupuncture visits per calendar year 10 spinal manipulations per calendar year Deductible and coinsurance apply
Maternity	Deductible and coinsurance apply
Mental Health Care	12 visit limit for outpatient services per calendar year 8 day limit for inpatient services per calendar year Deductible and coinsurance apply
Other Considerations
Networks	Preferred Network

Benefit Summaries

Medical Summary: Asuris HSA Comprehensive Healthplan

Prescription Summary: Asuris HSA Comprehensive Healthplan

Rates

As part of our annual adjustment for rising medical costs, rates will increase August 1 for our Individual members, no matter when coverage began. Please call our Individual Marketing Specialists at 1-866-704-2708 with questions and read our message on rates.

Rates: Asuris HSA Comprehensive Healthplan
Deductibles: $1,500 single; $3,000 family