Page 13 - SOLO Member Guidebook

WHICH PLAN?

ConnectiCare SOLO High-Deductible deductibles are separate; while on a fourth POS
Health Plans HDHP option ($5,000 Individual/ $10,000
Family), the deductibles are combined. This provides
Our High-Deductible Health Plans (HDHPs) are
you and your clients with additional pricing flexibility.
a good choice if you are comfortable with greater
Whether combined or separate, these calendar-year
cost-sharing in exchange for a lower monthly
deductibles must be met before the plan begins to
plan premium.
provide benefits.
With an HDHP, you are required to meet an
(Note: The calendar-year deductibles can be reached by
upfront deductible for the calendar year except for
any combination of covered health services or covered
preventative care. The deductible amount varies
prescription drug services. The individual calendar-year
according to the plan you choose. In general, the
deductible only applies if you are the sole policyholder
higher the upfront deductible is, the lower the plan
on the contract. If you have family coverage (two or
premium will be. You should also know that once
more covered lives), then covered health services and
the deductible is met, covered services will be subject
covered prescription drugs will be applied to the family
to a copayment or coinsurance.
calendar-year deductible until the total amount is
ConnectiCare SOLO offers two HDHP options: met without regard to which family member uses
the benefits.)
• Point-of-Service Open Access HDHP: Provides
the greatest freedom of choice in-network and • HMO Open Access HDHP: Allows you to
out-of-network. You can use our participating pro- see any participating specialist without first
viders to receive a generally higher level of obtaining a referral from your PCP. You must
benefits, or you may choose to go out-of-network meet a calendar-year individual deductible or
to visit a doctor of your choice and receive a calendar-year family deductible before the
generally lower level of benefits. plan begins to provide benefits except for
preventative care.

These plans have an up-front, in-network
plan deductible for individual or family, and
a separate out-of-network plan deductible for
individual or family. On three of the POS HDHP
options, the in-network and out-of-network

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