Which Coverage Level Is Best?

You get to choose how much coverage you need and how you want to pay for it. When you choose your coverage level, you get to pick the one with the features you want.

Your coverage level determines how much you pay out of your paycheck (premiums). It also determines how much you pay out of your pocket when you receive care (deductibles, coinsurance, copays).

Don’t let the names of the coverage levels fool you. One option isn’t better than another. The coverage levels are designed to give you choices. It’s up to you to find the one that makes sense for your situation.

Medical Coverage Level Options

You have several coverage levels to choose from. Each coverage level is available from different insurance carriers at different costs.

When you enroll, you’ll find plenty of tools and resources to help you choose a coverage level.


Option type
Paycheck contributions

2025 Annual Deductible
In-network (individual / family)
Out-of-network (individual / family)
Traditional or true family?

2025 Annual-Out-of-Pocket-Maximum
In-network (individual / family)
Out-of-network (individual / family)
Traditional or true family?

2025 In-Network Benefits
Preventive care
Doctor's office visit
Emergency room
Urgent care
Inpatient care
Outpatient care

Prescription Drug Coverage


Preventive drugs

30-Day Retail Supply
Tier 1 (generally lowest cost options)
Tier 2 (generally medium cost options)
Tier 3 (generally highest cost options)

90-Day Mail Order Supply
Tier 1 (generally lowest cost options)
Tier 2 (generally medium cost options)
Tier 3 (generally highest cost options)

These charts may not take into account how each coverage level covers any state-mandated benefits, its plan administration capabilities, or the approval from the state Department of Insurance of the benefits offered by the plan. If you have questions about a specific benefit, contact the insurance carrier for additional information. Individual carriers may offer coverage that differs slightly from the standard coverage reflected here. In the event that there is a discrepancy between this site and the official plan documents, the official plan documents will control.

These charts are a high-level listing of commonly covered benefits across carriers and coverage levels for the Aon Benefit Experience. They are intended to provide you with a snapshot of benefits provided across coverage levels. In general, carriers have agreed to the majority of standardized plan benefits recommended by BenX.

For a more detailed look at these and additional coverages, go to at . It does account for any carrier adjustments to standardized plan benefits. To see summaries when you enroll online, check the boxes next to the options you want to review and click Compare. In order to get the most comprehensive information about any specific coverage, you will need to call the carrier directly.

Note: For additional comparison, you may find Summaries of Benefits and Coverage on at .

Out-of-Area: Your specific options are based on your home zip code. If you live outside the service areas of all the insurance carriers, you can choose an out-of-area option at the Silver coverage level. Aetna will be the insurance carrier.

Choosing a Primary Care Physician: Certain options require you to choose a primary care physician. You may need to designate a primary care physician to coordinate your care if you choose Kaiser Permanente or Health Net as your insurance carrier.

Do You Take Any Prescription Drugs?

Your prescription drug coverage will be provided through your insurance carrier’s pharmacy benefit manager.

While your coverage level will determine your coverage for prescription drugs, each pharmacy benefit manager has its own rules. You need to make sure you’re comfortable with how your family's medications will be covered. Get the details.

Questions?

Check out the Frequently Asked Questions (PDF) and the Glossary.