2012 HIRSP Plans

  HIRSP 1,000 HIRSP 2,500 HIRSP 5,000
Premiums
Medical deductible
(you pay)
$1,000 per year $2,500 per year $5,000 per year
Medical Coinsurance 20% of allowed amount $1,000 per year 20% of allowed amount $1,000 per year 20% of allowed amount $1,000 per year
Individual medical out-of- pocket maximum (your total expenditures for medical deductible and medical coinsurance, after which HIRSP will pay at 100%) $2,000 per year $3,500 per year $6,000 per year
Family medical out-of-pocket maximum (all family members must be on the same plan) $4,000 per year $7,000 per year $12,000 per year
Drug Copay (you pay) $5 Tier 1 / $55 Tier 2 / $75 Tier 3
Up to a maximum of $2,500 per year
$5 Tier 1 / $55 Tier 2 $75 Tier 3
Up to a maximum of $2,500 per year
$5 Tier 1 / $55 Tier 2 $75 Tier 3
Up to a maximum of $2,500 per year
Drug out-of-pocket maximum reductions available if you qualify Yes Yes Yes
Maximum lifetime benefit $2,000,000 $2,000,000 $2,000,000
Premium, Medical and Drug out-of-pocket reductions available if you qualify Yes Yes Yes
HIRSP Health Savings Account (HSA)
  HIRSP HSA 2500 HIRSP HSA 3500
Premiums
Medical/Drug deductible
(you pay)
$2,500 per year $3,500 per year
Medical Coinsurance 20% of allowed amount (after deductible is met) 20% of allowed amount (after deductible is met)
Drug Coinsurance (you pay) 20% of allowed amount (after deductible is met) HIRSP HSA does not offer first-dollar drug coverage 20% of allowed amount (after deductible is met) HIRSP HSA does not offer first-dollar drug coverage
Individual medical/drug coinsurance maximum $2,100 per year $2,100 per year
Individual medical/drug out-of-pocket maximum (your total expenditures for deductible and coinsurance, after which HIRSP will pay at 100%) $4,600 per year $5,600 per year
Family out-of-pocket maximum (all family members must be on the same plan) $9,200 per year $11,200 per year
Maximum lifetime benefit $2,000,000 $2,000,000
Premium, Medical and Drug out-of-pocket deductible reductions available if you qualify Yes Yes