Lowest-priced Gold plan offered through HealthSource RI that has low copays for certain services and a 0% coinsurance after the deductible has been met. Preventive services are covered at 100%.
Who is Eligible?
Qualifying small employers with 2-50 employees.
View Cost-Sharing
Deductible: $2,050 (Individual) / $4,100 (Family)
Out of Pocket Max: $5,000 (individual) / $10,000 (Family)
Primary Care/Behavioral Health Office Visits: $25
Specialist/Urgent Care Visits: $50
Inpatient/Imaging/Lab Services: Only deductible applies
Pharmacy (Tiers 1-6): $5/$10/$35/$50/$100/$100
- I need a doctor.
- I want to know if my medicine is covered.
- I want to know my rights and privacy.
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I want to access my Pharmacy Member Portal.
- Use this portal to check your medications, sign up for mail order pharmacy and review drug costs
- I want to access my Behavioral Health Member Portal.
Where can I learn about my benefits?
- Price Information for Your Medical Benefits [PDF, 301KB]
- Price Information for Your Pharmacy Benefit
- Plan Summary [PDF, 940KB]
- Certificate of Coverage [PDF, 1911KB]
- Summary of Benefits and Coverage [PDF, 485KB]
- Glossary of Health Coverage and Medical Terms [PDF, 139KB]
Read the latest issue of our quarterly member newsletter, Healthy You.
Members who enrolled in PREMIER for the 2018 benefit year, click here for plan information.
