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Rates for the coming plan year, Employee Only
HMO PPO* CDHP*
Biweekly
Premium
$252.42 $102.24 $46.60
Annual Deductible None None $2000/$4000
Annual Out-of-
Pocket Maximum
$4000 $6850 $6600/$12000
Medical Account No No HRA
Office Visit $20 $30/$50 20%/50%
Specialist $35 $50/$75 20%/50%
Emergency Care $125 $200 20%
Urgent Care $30 $30/$100 20%/50%
Prescriptions –
Generic
$10 $20/$50 $10/50%
Prescriptions –
Brand Name
$35 $40/$100 $50/50%
*Prices listed are In-Network/Out-of-Network
Knights Healthcare

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Rates for the coming plan year, employee only

  • 1. Rates for the coming plan year, Employee Only HMO PPO* CDHP* Biweekly Premium $252.42 $102.24 $46.60 Annual Deductible None None $2000/$4000 Annual Out-of- Pocket Maximum $4000 $6850 $6600/$12000 Medical Account No No HRA Office Visit $20 $30/$50 20%/50% Specialist $35 $50/$75 20%/50% Emergency Care $125 $200 20% Urgent Care $30 $30/$100 20%/50%
  • 2. Prescriptions – Generic $10 $20/$50 $10/50% Prescriptions – Brand Name $35 $40/$100 $50/50% *Prices listed are In-Network/Out-of-Network Knights Healthcare