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Golden Rule Platinum Health Insurance in ILLINOIS – Health Plan Options

Golden Rule Platinum — Blue Value Advantage

A comparison of the Blue Value Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$250 Individual, $750 Family	$250 Individual, $750 Family

Golden Rule Platinum — Blue Value Advantage

A comparison of the Blue Value Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Blue Value Advantage

A comparison of the Blue Value Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Blue Value Advantage

A comparison of the Blue Value Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,750 Individual, $5,250 Family	$1,750 Individual, $5,250 Family

Golden Rule Platinum — Blue Value Advantage

A comparison of the Blue Value Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Blue Value Advantage

A comparison of the Blue Value Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individual, $15,000 Family	$5,000 Individual, $15,000 Family

Golden Rule Platinum — Select Blue Advantage

A comparison of the Select Blue Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	100% after you pay $30 copayment per visit (Deductible does not apply and does not apply to out-of-pocket expense limit.)	subject to deductible and coinsurance
Copay	$30	N/A
Deductible	$250 Individual, $750 Family	$250 Individual, $750 Family

Golden Rule Platinum — Select Blue Advantage

A comparison of the Select Blue Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	100% after you pay $30 copayment per visit (Deductible does not apply and does not apply to out-of-pocket expense limit.)	subject to deductible and coinsurance
Copay	$30	N/A
Deductible	$250 Individual, $750 Family	$250 Individual, $750 Family

Golden Rule Platinum — Select Blue Advantage

A comparison of the Select Blue Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	100% after you pay $30 copayment per visit (Deductible does not apply and does not apply to out-of-pocket expense limit.)	subject to deductible and coinsurance
Copay	$30	N/A
Deductible	$250 Individual, $750 Family	$250 Individual, $750 Family

Golden Rule Platinum — Select Blue Advantage

A comparison of the Select Blue Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	100% after you pay $30 copayment per visit (Deductible does not apply and does not apply to out-of-pocket expense limit.)	subject to deductible and coinsurance
Copay	$30	N/A
Deductible	$250 Individual, $750 Family	$250 Individual, $750 Family

Golden Rule Platinum — Select Blue Advantage

A comparison of the Select Blue Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	100% after you pay $30 copayment per visit (Deductible does not apply and does not apply to out-of-pocket expense limit.)	subject to deductible and coinsurance
Copay	$30	N/A
Deductible	$250 Individual, $750 Family	$250 Individual, $750 Family

Golden Rule Platinum — Select Blue Advantage

A comparison of the Select Blue Advantage offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	100% after you pay $30 copayment per visit (Deductible does not apply and does not apply to out-of-pocket expense limit.)	subject to deductible and coinsurance
Copay	$30	N/A
Deductible	$250 Individual, $750 Family	$250 Individual, $750 Family

Golden Rule Platinum — BlueEdge Individual HSA

A comparison of the BlueEdge Individual HSA offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Deductible then Coinsurance	Deductible then Coinsurance
Copay	N/A	N/A
Deductible	$1,150 Individual, $2,300 Family	$1,150 Individual, $2,300 Family

Golden Rule Platinum — BlueEdge Individual HSA

A comparison of the BlueEdge Individual HSA offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Deductible then Coinsurance	Deductible then Coinsurance
Copay	N/A	N/A
Deductible	$1,750 Individual, $3,500 Family	$1,750 Individual, $3,500 Family

Golden Rule Platinum — BlueEdge Individual HSA

A comparison of the BlueEdge Individual HSA offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Deductible then Coinsurance	Deductible then Coinsurance
Copay	N/A	N/A
Deductible	$2,600 Individual, $5,200 Family	$2,600 Individual, $5,200 Family

Golden Rule Platinum — BlueEdge Individual HSA

A comparison of the BlueEdge Individual HSA offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Deductible then Coinsurance	Deductible then Coinsurance
Copay	N/A	N/A
Deductible	$3,500 Individual, $7,000 Family	$3,500 Individual, $7,000 Family

Golden Rule Platinum — BlueEdge Individual HSA

A comparison of the BlueEdge Individual HSA offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Deductible then Coinsurance	Deductible then Coinsurance
Copay	N/A	N/A
Deductible	$1,150 Individual, $2,300 Family	$1,150 Individual, $2,300 Family

Golden Rule Platinum — BlueEdge Individual HSA

A comparison of the BlueEdge Individual HSA offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Deductible then Coinsurance	Deductible then Coinsurance
Copay	N/A	N/A
Deductible	$1,750 Individual, $3,500 Family	$1,750 Individual, $3,500 Family

Golden Rule Platinum — BlueEdge Individual HSA

A comparison of the BlueEdge Individual HSA offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Deductible then Coinsurance	Deductible then Coinsurance
Copay	N/A	N/A
Deductible	$2,600 Individual, $5,200 Family	$2,600 Individual, $5,200 Family

Golden Rule Platinum — BlueEdge Individual HSA

A comparison of the BlueEdge Individual HSA offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Deductible then Coinsurance	Deductible then Coinsurance
Copay	N/A	N/A
Deductible	$3,500 Individual, $7,000 Family	$3,500 Individual, $7,000 Family

Golden Rule Platinum — BlueEdge Individual HSA 5000

A comparison of the BlueEdge Individual HSA 5000 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Deductible then Coinsurance	Deductible then Coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$5,000 Individual, $10,000 Family

Golden Rule Platinum — SelecTEMP PPO

A comparison of the SelecTEMP PPO offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	80%	60%
Copay	N/A	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Golden Rule Platinum — SelecTEMP PPO

A comparison of the SelecTEMP PPO offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	80%	60%
Copay	N/A	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Golden Rule Platinum — SelecTEMP PPO

A comparison of the SelecTEMP PPO offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	80%	60%
Copay	N/A	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Golden Rule Platinum — SelecTEMP PPO

A comparison of the SelecTEMP PPO offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	80%	60%
Copay	N/A	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Golden Rule Platinum — SelecTEMP PPO

A comparison of the SelecTEMP PPO offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	80%	60%
Copay	N/A	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Golden Rule Platinum — SelecTEMP PPO

A comparison of the SelecTEMP PPO offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	80%	60%
Copay	N/A	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Golden Rule Platinum — Basic Blue

A comparison of the Basic Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Not Covered	Not Covered
Copay	N/A	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Basic Blue

A comparison of the Basic Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Not Covered	Not Covered
Copay	N/A	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Basic Blue

A comparison of the Basic Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Not Covered	Not Covered
Copay	N/A	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Traditional Blue

A comparison of the Traditional Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Traditional Blue

A comparison of the Traditional Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Traditional Blue

A comparison of the Traditional Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Traditional Blue

A comparison of the Traditional Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Traditional Blue

A comparison of the Traditional Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Traditional Blue

A comparison of the Traditional Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Traditional Blue

A comparison of the Traditional Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Traditional Blue

A comparison of the Traditional Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Traditional Blue

A comparison of the Traditional Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Traditional Blue

A comparison of the Traditional Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual, $3,000 Family	$1,000 Individual, $3,000 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Select Blue

A comparison of the Select Blue offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	100% after you pay $20 copayment per visit (Deductible does not apply)	subject to deductible and coinsurance
Copay	$20	N/A
Deductible	$2,500 Individual, $7,500 Family	$2,500 Individual, $7,500 Family

Golden Rule Platinum — Blue Value

A comparison of the Blue Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Blue Value

A comparison of the Blue Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Blue Value

A comparison of the Blue Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Blue Value

A comparison of the Blue Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Blue Value

A comparison of the Blue Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Blue Value

A comparison of the Blue Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Blue Value

A comparison of the Blue Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Blue Value

A comparison of the Blue Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Blue Value

A comparison of the Blue Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Blue Value

A comparison of the Blue Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$500 Individual, $1,500 Family

Golden Rule Platinum — Patriot Class 1

A comparison of the Patriot Class 1 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	see brochure	see brochure
Deductible	see brochure	see brochure

Golden Rule Platinum — Patriot Class 3

A comparison of the Patriot Class 3 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	see brochure	see brochure
Deductible	see brochure	see brochure

Golden Rule Platinum — Patriot Class 4

A comparison of the Patriot Class 4 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Copay	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Deductible	N/A	N/A

Golden Rule Platinum — Patriot Class 5

A comparison of the Patriot Class 5 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Copay	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Deductible	N/A	N/A

Golden Rule Platinum — Healthy Savings

A comparison of the Healthy Savings offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	Benefits reduced by 25%
Office Visit	Subject to deductible & coinsurance	Benefits reduced by 25%
Copay	N/A	N/A
Deductible	$1,500	$1,500

Golden Rule Platinum — Healthy Savings

A comparison of the Healthy Savings offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	Benefits reduced by 25%
Office Visit	Subject to deductible & coinsurance	Benefits reduced by 25%
Copay	N/A	N/A
Deductible	$2,500	$2,500

Golden Rule Platinum — Healthy Savings

A comparison of the Healthy Savings offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	Benefits reduced by 25%
Office Visit	Subject to deductible & coinsurance	Benefits reduced by 25%
Copay	N/A	N/A
Deductible	$2,500	$2,500

Golden Rule Platinum — Healthy Savings

A comparison of the Healthy Savings offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	Benefits reduced by 25%
Office Visit	Subject to deductible & coinsurance	Benefits reduced by 25%
Copay	N/A	N/A
Deductible	$3,750	$3,750

Golden Rule Platinum — Healthy Savings

A comparison of the Healthy Savings offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	Benefits reduced by 25%
Office Visit	Subject to deductible & coinsurance	Benefits reduced by 25%
Copay	N/A	N/A
Deductible	$1,500	$1,500

Golden Rule Platinum — Healthy Savings

A comparison of the Healthy Savings offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	Benefits reduced by 25%
Office Visit	Subject to deductible & coinsurance	Benefits reduced by 25%
Copay	N/A	N/A
Deductible	$5,000	$5,000

Golden Rule Platinum — Health Select

A comparison of the Health Select offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	Benefits reduced by 25%
Office Visit	$25 copay per non-preventive visit	Benefits reduced by 25%
Copay	$25 copay per non-preventive visit	$25 copay per non-preventive visit
Deductible	Individual: $1,500, Family: $4,500	Individual: $1,500, Family: $4,500

Golden Rule Platinum — Health Select

A comparison of the Health Select offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	Benefits reduced by 25%
Office Visit	$25 copay per non-preventive visit	Benefits reduced by 25%
Copay	$25 copay per non-preventive visit	$25 copay per non-preventive visit
Deductible	Individual: $1,500, Family: $4,500	Individual: $1,500, Family: $4,500

Golden Rule Platinum — Health Select

A comparison of the Health Select offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	Benefits reduced by 25%
Office Visit	$25 copay per non-preventive visit	Benefits reduced by 25%
Copay	$25 copay per non-preventive visit	$25 copay per non-preventive visit
Deductible	Individual: $1,500, Family: $4,500	Individual: $1,500, Family: $4,500

Golden Rule Platinum — Health Select

A comparison of the Health Select offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	Benefits reduced by 25%
Office Visit	$25 copay per non-preventive visit	Benefits reduced by 25%
Copay	$25 copay per non-preventive visit	$25 copay per non-preventive visit
Deductible	Individual: $1,500, Family: $4,500	Individual: $1,500, Family: $4,500

Golden Rule Platinum — Preferred Value

A comparison of the Preferred Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	Benefits reduced by 25%
Office Visit	$30 copay per non-preventive visit. 4 visits per year. (Office visit fee only)	Benefits reduced by 25%
Copay	$30 copay per non-preventive visit, 4 visits per year (Office visit fee only)	$30 copay per non-preventive visit, 4 visits per year (Office visit fee only)
Deductible	Individual: $1,500, Family: $4,500	Individual: $1,500, Family: $4,500

Golden Rule Platinum — Preferred Value

A comparison of the Preferred Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	Benefits reduced by 25%
Office Visit	$30 copay per non-preventive visit. 4 visits per year. (Office visit fee only)	Benefits reduced by 25%
Copay	$30 copay per non-preventive visit, 4 visits per year (Office visit fee only)	$30 copay per non-preventive visit, 4 visits per year (Office visit fee only)
Deductible	Individual: $2,500, Family: $7,500	Individual: $2,500, Family: $7,500

Golden Rule Platinum — Preferred Value

A comparison of the Preferred Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	Benefits reduced by 25%
Office Visit	$30 copay per non-preventive visit. 4 visits per year. (Office visit fee only)	Benefits reduced by 25%
Copay	$30 copay per non-preventive visit, 4 visits per year (Office visit fee only)	$30 copay per non-preventive visit, 4 visits per year (Office visit fee only)
Deductible	Individual: $5,000, Family: $15,000	Individual: $5,000, Family: $15,000

Golden Rule Platinum — Preferred Value

A comparison of the Preferred Value offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	Benefits reduced by 25%
Office Visit	$30 copay per non-preventive visit. 4 visits per year. (Office visit fee only)	Benefits reduced by 25%
Copay	$30 copay per non-preventive visit, 4 visits per year (Office visit fee only)	$30 copay per non-preventive visit, 4 visits per year (Office visit fee only)
Deductible	Individual: $10,000, Family: $30,000	Individual: $10,000, Family: $30,000

Golden Rule Platinum — Unlimited Access

A comparison of the Unlimited Access offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	N/A
Office Visit	Subject to deductible & coinsurance	N/A
Copay	N/A	N/A
Deductible	Individual: $500, Family: $1,500	Individual: $500, Family: $1,500

Golden Rule Platinum — Unlimited Access

A comparison of the Unlimited Access offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	N/A
Office Visit	Subject to deductible & coinsurance	N/A
Copay	N/A	N/A
Deductible	Individual: $1,000, Family: $3,000	Individual: $1,000, Family: $3,000

Golden Rule Platinum — Unlimited Access

A comparison of the Unlimited Access offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	N/A
Office Visit	Subject to deductible & coinsurance	N/A
Copay	N/A	N/A
Deductible	Individual: $2,500, Family: $7,500	Individual: $2,500, Family: $7,500

Golden Rule Platinum — Unlimited Access

A comparison of the Unlimited Access offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	N/A
Office Visit	Subject to deductible & coinsurance	N/A
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000	Individual: $5,000, Family: $15,000

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — Short Term Medical

A comparison of the Short Term Medical offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Golden Rule Platinum — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Golden Rule Platinum — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Golden Rule Platinum — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Golden Rule Platinum — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Golden Rule Platinum — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Golden Rule Platinum — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Golden Rule Platinum — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Golden Rule Platinum — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	ubject to deductible and coinsurance	ubject to deductible and coinsurance
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	ubject to deductible and coinsurance	ubject to deductible and coinsurance
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	ubject to deductible and coinsurance	ubject to deductible and coinsurance
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,000	$5,000

Golden Rule Platinum — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,700	$2,850

Golden Rule Platinum — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,000	$4,000

Golden Rule Platinum — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,000	$4,000

Golden Rule Platinum — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,700	$2,850

Golden Rule Platinum — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,850	$5,700

Golden Rule Platinum — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,850	$5,700

Golden Rule Platinum — HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,500	$11,000

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Copay	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60	Physician Office Visit (Office co-pay rider included: 4 visits maximum; After 4 visits deductible and co-insurance apply): Primary care physician: $15 Specialist: $60
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,000	$5,000

Golden Rule Platinum — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	30% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,000	$4,000

Golden Rule Platinum — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,000	$4,000

Golden Rule Platinum — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,000	$4,000

Golden Rule Platinum — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	30% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,850	$5,700

Golden Rule Platinum — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,850	$5,700

Golden Rule Platinum — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$2,850	$5,700

Golden Rule Platinum — HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	$5,500	$11,000

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,000	$5,000

Golden Rule Platinum — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,000	$4,000

Golden Rule Platinum — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	None	None
Deductible	$2,000	see brochure

Golden Rule Platinum — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,000	$4,000

Golden Rule Platinum — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,850	$5,700

Golden Rule Platinum — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	None	None
Deductible	$2,850	see brochure

Golden Rule Platinum — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,850	$5,700

Golden Rule Platinum — HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,500	$11,000

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to copay, after 4 visits- subject to deductible and coinsurance	Subject to copay, after 4 visits- subject to deductible and coinsurance
Copay	4 Visits- $15 Primary Care Physician/$60 Specialist	4 Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,000	$5,000

Golden Rule Platinum — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	None	None
Deductible	$2,000	$4,000

Golden Rule Platinum — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,000	see brochure

Golden Rule Platinum — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,000	$4,000

Golden Rule Platinum — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	None	None
Deductible	$2,850	$5,700

Golden Rule Platinum — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,850	see brochure

Golden Rule Platinum — HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$2,850	$5,700

Golden Rule Platinum — HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	None	None
Deductible	$5,500	$11,000

Golden Rule Platinum — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$7,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$7,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$5,000	$5,000

Golden Rule Platinum — The Edge HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the The Edge HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$2,000	see brochure

Golden Rule Platinum — The Edge HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the The Edge HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$2,850	see brochure

Golden Rule Platinum — The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$5,500	$11,000

Golden Rule Platinum — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$1,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$5,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$7,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

A comparison of the The Edge PPO Platinum Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$2,500(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

Golden Rule Platinum — The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$5,000	$5,000

Golden Rule Platinum — The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	80% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	None	None
Deductible	$5,500	$11,000

Golden Rule Platinum — PPO First Dollar 30 with Dental

A comparison of the PPO First Dollar 30 with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Non-specialist Office Visit: $30 Copay, Specialist Visit: $40 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-specialist Office Visit: $30 Copay, Specialist Visit: $40 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $0, Family: $0	Individual: $5,000, Family: $10,000

Golden Rule Platinum — PPO First Dollar 40 with Dental

A comparison of the PPO First Dollar 40 with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $0, Family: $0	Individual: $7,000, Family: $14,000

Golden Rule Platinum — PPO 2500 with Dental

A comparison of the PPO 2500 with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Golden Rule Platinum — PPO 5000 with Dental

A comparison of the PPO 5000 with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay, deductible waived (Unlimited visits); Specialist Visit: $50 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay, deductible waived (Unlimited visits); Specialist Visit: $50 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Golden Rule Platinum — PPO Value 2500 with Dental

A comparison of the PPO Value 2500 with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Golden Rule Platinum — PPO Value 5000 with Dental

A comparison of the PPO Value 5000 with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist and Specialist Office Visit: Visits 1-2 $30 copay, deductible waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (unlimited visits).	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist and Specialist Office Visit: Visits 1-2 $30 copay, deductible waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (unlimited visits).	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Golden Rule Platinum — PPO High Deductible 3000 (HSA Compatible) with Dental

A comparison of the PPO High Deductible 3000 (HSA Compatible) with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $0 copay after deductible (Unlimited visits); Specialist Visit: $0 copay after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $0 copay after deductible (Unlimited visits); Specialist Visit: $0 copay after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Golden Rule Platinum — PPO High Deductible 5000 (HSA Compatible) with Dental

A comparison of the PPO High Deductible 5000 (HSA Compatible) with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Golden Rule Platinum — Preventive and Hospital Care 1250 with Dental

A comparison of the Preventive and Hospital Care 1250 with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Not covered	Not covered
Copay	Not covered	Not covered
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Golden Rule Platinum — Preventive and Hospital Care 3000 (HSA Compatible) with Dental

A comparison of the Preventive and Hospital Care 3000 (HSA Compatible) with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max.	50% after deductible up to out-of-pocket max.
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Golden Rule Platinum — PPO Value 1500 with Dental

A comparison of the PPO Value 1500 with Dental offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Visit 1-2: $30 copay, deductible waived. Visits 3+: 70% after deductible. Specialist and Non- Specialist share visit max.	Non-Specialist Office Visit: 50% after deductible, Specialist: 50% after deductible
Copay	Visit 1-2: $30 copay, deductible waived. Visits 3+: 70% after deductible. Specialist and Non- Specialist share visit max.	Non-Specialist Office Visit: 50% after deductible, Specialist: 50% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Golden Rule Platinum — PPO First Dollar 30

A comparison of the PPO First Dollar 30 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Non-specialist Office Visit: $30 Copay, Specialist Visit: $40 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-specialist Office Visit: $30 Copay, Specialist Visit: $40 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $0, Family: $0	Individual: $5,000, Family: $10,000

Golden Rule Platinum — PPO First Dollar 40

A comparison of the PPO First Dollar 40 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Non-specialist Office Visit: $40 Copay, Specialist Visit: $50 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-specialist Office Visit: $40 Copay, Specialist Visit: $50 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $0, Family: $0	Individual: $7,000, Family: $14,000

Golden Rule Platinum — PPO 2500

A comparison of the PPO 2500 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Golden Rule Platinum — PPO 5000

A comparison of the PPO 5000 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $40 copay deductible waived (unlimited visits), Specialist Visit: $50 copay deductible waived (unlimited visits).	50% after deductible (unlimited visits)
Copay	Non-Specialist Office Visit: $40 copay deductible waived (unlimited visits), Specialist Visit: $50 copay deductible waived (unlimited visits).	50% after deductible (unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Golden Rule Platinum — PPO Value 2500

A comparison of the PPO Value 2500 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. $0 once out-of-pocket max. is satisfied	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visits 1-5 $30 copay, deductible waived; Specialist Visits 1-5 $50 copay, deductible waived.	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist Office Visits 1-5 $30 copay, deductible waived; Specialist Visits 1-5 $50 copay, deductible waived.	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Golden Rule Platinum — PPO Value 5000

A comparison of the PPO Value 5000 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	65% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Golden Rule Platinum — PPO High Deductible 3000 (HSA Compatible)

A comparison of the PPO High Deductible 3000 (HSA Compatible) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Includes Chiropractic Care Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Includes Chiropractic Care Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Golden Rule Platinum — PPO High Deductible 5000 (HSA Compatible)

A comparison of the PPO High Deductible 5000 (HSA Compatible) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Golden Rule Platinum — Preventive and Hospital Care 1250

A comparison of the Preventive and Hospital Care 1250 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Golden Rule Platinum — Preventive and Hospital Care 3000 (HSA Compatible)

A comparison of the Preventive and Hospital Care 3000 (HSA Compatible) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Not covered	Not covered
Copay	Not covered	Not covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Golden Rule Platinum — PPO Value 1500

A comparison of the PPO Value 1500 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible, up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible, up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max(Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max(Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deductible waived; Visit 3+ 70% after deductible. Specialist and non-specialist share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Golden Rule Platinum — Copay Saver

A comparison of the Copay Saver offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Saver

A comparison of the Copay Saver offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Saver

A comparison of the Copay Saver offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Saver

A comparison of the Copay Saver offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Saver

A comparison of the Copay Saver offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Single HSA 100

A comparison of the Single HSA 100 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$1,250 (one per family, per calendar year)	$1,250 (one per family, per calendar year)

Golden Rule Platinum — Single HSA 100

A comparison of the Single HSA 100 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$2,500 (one per family, per calendar year)	$2,500 (one per family, per calendar year)

Golden Rule Platinum — Single HSA 100

A comparison of the Single HSA 100 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$3,000 (one per family, per calendar year)	$3,000 (one per family, per calendar year)

Golden Rule Platinum — Single HSA 100

A comparison of the Single HSA 100 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Golden Rule Platinum — Single HSA 100

A comparison of the Single HSA 100 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Golden Rule Platinum — Single HSA 70

A comparison of the Single HSA 70 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$1,250 (one per family, per calendar year)	$1,250 (one per family, per calendar year)

Golden Rule Platinum — Single HSA 70

A comparison of the Single HSA 70 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$2,500 (one per family, per calendar year)	$2,500 (one per family, per calendar year)

Golden Rule Platinum — Single HSA 70

A comparison of the Single HSA 70 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$3,000 (one per family, per calendar year)	$3,000 (one per family, per calendar year)

Golden Rule Platinum — Single HSA 70

A comparison of the Single HSA 70 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Golden Rule Platinum — Single HSA 70

A comparison of the Single HSA 70 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Golden Rule Platinum — Plan 100

A comparison of the Plan 100 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Plan 100

A comparison of the Plan 100 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Plan 100

A comparison of the Plan 100 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Plan 100

A comparison of the Plan 100 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Plan 100

A comparison of the Plan 100 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Plan 80

A comparison of the Plan 80 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network