$1,000 / $3,000
Annual Deductible
$3,000 / $9,000
Out-of-Pocket Maximum
$25 copay
Primary Care/Office Visit
$50 copay
Specialist Visit
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$1,000 / $3,000
Annual Deductible
$3,000 / $9,000
Out-of-Pocket Maximum
$25 copay
Primary Care/Office Visit
$50 copay
Specialist Visit
$3,300 / $6,600
Annual Deductible
$4,500 / $8,000
Out-of-Pocket Maximum
You pay 0% after deductible
Primary Care/Office Visit
You pay 0% after deductible
Specialist Visit
$1,000 / $2,000
Annual Deductible
$3,000 / $6,000
Out-of-Pocket Maximum
$30 copay
Primary Care/Office Visit
$30 copay
Specialist Visit
None
Annual Deductible
$6,350 / $12,700
Out-of-Pocket Maximum
$10 copay
Primary Care/Office Visit
$10 copay
Specialist Visit
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A Piper Jordan Advocate is ready to help you with your benefits.
You do not need to be a member of Costco to take advantage of your Prescription Drug benefit.
Triple tax savings for health expenses now and later.
Stretch your dollars on everyday medical expenses.
Pre-tax savings for daycare, after-school care & more.
Extra savings for dental and vision care.
$50 (I) / $150 (F)
Annual Deductible
$2,000/person
Calendar Year Maximum
You pay 20% after deductible
Basic Services
Plan pays 50%, no deductible
Orthodontic Services
None
Annual Deductible
None
Calendar Year Maximum
Subject to copay schedule
Basic Services
Subject to copay schedule
Orthodontic Services
None
Annual Deductible
Calendar Year Maximum
Subject to copay schedule
Basic Services
$50 copay/visit
Orthodontic Services
$10
Eye Exam Copay
$70+
Lenses
35% discount
Frames
15% off retail price
Contacts
$10
Eye Exam Copay
$10 copay
Lenses
$200 allowance + 20% off balance
Frames
$200 allowance + 15% off balance
Contacts
Core coverage your family can count on.
Additional coverage for you and your family if you want it.
Income protection for life's temporary detours.
Support when recovery takes longer than expected.
Perks and savings on brands you love.
A financial cushion during life's biggest curveballs.
Get cash support when the unexpected hits.
Cash benefits for hospital stays and recovery.
Affordable help with life's legal moments.
Peace of mind for your furry (or feathery) family.
Free, confidential support for mental health, legal, and financial guidance.
The person(s) you choose to receive certain benefits (like life insurance or 401(k) funds) if you pass away.
A flat dollar amount you pay when you receive certain healthcare services, such as a doctor visit or prescription.
The amount you pay out of pocket for healthcare before your insurance starts to share costs.
A free and confidential program that provides support for personal, family, and work-related issues — such as counseling, legal or financial advice, and other life resources.
A statement from your insurance company showing what was paid for a healthcare service, what you may owe, and what the provider billed. An EOB is not a bill.
Tax-advantaged accounts you can use to pay for eligible healthcare expenses. HSAs are paired with high-deductible health plans and can roll over year to year.
Healthcare providers and facilities that contract with your insurance plan — using them typically costs you less.
The most you’ll pay in a plan year for covered services. After you reach this limit, your plan pays 100% of covered costs.
The amount you pay (usually through payroll deductions) to have coverage under an insurance plan.
Routine care — like checkups, screenings, and vaccines — designed to help you stay healthy. Covered at 100% in-network on most plans.
A life change — like marriage, birth of a child, or loss of other coverage — that allows you to update your benefits outside of the annual enrollment period.
Optional extras you can elect (often at a group rate), like accident insurance, legal services, identity theft protection, or pet insurance.
Benefits Summaries
2024 - 2025_ East Coast - Vision Benefit Summary (Principal)2024 - 2025_ East Coast - Vision Benefit Summary (Principal)Compliance Notices
West Coast Patient Protection DisclosureWest Coast Patient Protection DisclosureCompliance Notices
UHC Nondiscrimination and Languages_Accessibility NoticeUHC Nondiscrimination and Languages_Accessibility NoticeSummary of Benefits and Coverage (SBC)
2023-2024 West Coast_ SBC UHC Signature Silver HMO2023-2024 West Coast_ SBC UHC Signature Silver HMOSummary of Benefits and Coverage (SBC)
2023-2024 East Coast_ BlueChoice Open Access HSA2023-2024 East Coast_ BlueChoice Open Access HSASummary of Benefits and Coverage (SBC)
2024-2025 West Coast SBC UHC Signature Silver HMO2024-2025 West Coast SBC UHC Signature Silver HMOSummary of Benefits and Coverage (SBC)
2024-2025 East Coast_ BlueChoice Open Access HSA2024-2025 East Coast_ BlueChoice Open Access HSASummary of Benefits and Coverage (SBC)
2024-2025 East Coast_ BlueChoice Advantage HMO2024-2025 East Coast_ BlueChoice Advantage HMO