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Golden Rule Platinum Health Insurance in NEBRASKA – Health Plan Options

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	$1,000	$1,000

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	$1,000	$1,000

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	$1,000	$1,000

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	$1,000	$1,000

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	$1,000	$1,000

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	$1,000	$1,000

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	$1,000	$1,000

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	$1,000	$1,000

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	$1,000	$1,000

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	$1,000	$1,000

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	$1,000	$1,000

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	$1,000	$1,000

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	$2,500	$2,500

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	$2,500	$2,500

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	$2,500	$2,500

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	$2,500	$2,500

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	$2,500	$2,500

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	$2,500	$2,500

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	$2,500	$2,500

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	$2,500	$2,500

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	see brochure	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	see brochure	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	see brochure	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	see brochure	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	see brochure	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	see brochure	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 — 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: $5,000, Family: $15,000	Individual: $5,000, Family: $15,000

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: $5,000, Family: $15,000	Individual: $5,000, Family: $15,000

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: $5,000, Family: $15,000	Individual: $5,000, Family: $15,000

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: $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: $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: $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 — 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: $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: $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: $2,500, Family: $7,500	Individual: $2,500, Family: $7,500

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 (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 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, 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: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

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	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): Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible. Specialist and Non Specialist share visit max. (Unlimited visits); Specialist Visit: Visit 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): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible. Specialist and Non Specialist share visit max. (Unlimited visits); Specialist Visit: Visit 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): 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 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.	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	see brochure	see brochure
Copay	Not Covered	Not Covered
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	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)

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	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered (Unlimited visits); Specialist Visit: Not covered (Includes Chiropractic Care Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered (Unlimited visits); Specialist Visit: Not covered (Includes Chiropractic Care Visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered (Unlimited visits); Specialist Visit: Not covered (Includes Chiropractic Care Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered (Unlimited visits); Specialist Visit: Not covered (Includes Chiropractic Care Visits)
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Golden Rule Platinum — PPO 7500 with Unlimited Primary Care Visits plus Dental

A comparison of the PPO 7500 with Unlimited Primary Care Visits plus 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: $30 copay deductible waived (unlimited visits), Specialist Visit: 80% after deductible (unlimited visits).	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist Office Visit: $30 copay deductible waived (unlimited visits), Specialist Visit: 80% after deductible (unlimited visits).	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $7,500, Family: $15,000	Individual: $10,000, Family: $20,000

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: $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 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 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	50% after deductible
Office Visit	Visit 1-2: $30.	N/A
Copay	Visit 1-2: $30.	N/A
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

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)	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: $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): 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 (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: $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. ($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: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

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	$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	$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	$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	$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	$2,500 (maximum 2 per family, per calendar year)	$2,500 (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
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (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
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (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
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (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
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (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
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Saver 80

A comparison of the Saver 80 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%	80%
Office Visit	Not covered	Not covered
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 — Saver 80

A comparison of the Saver 80 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%	80%
Office Visit	Not covered	Not covered
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 — Saver 80

A comparison of the Saver 80 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%	80%
Office Visit	Not covered	Not covered
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 — Saver 80

A comparison of the Saver 80 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%	80%
Office Visit	Not covered	Not covered
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 — Saver 80

A comparison of the Saver 80 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%	80%
Office Visit	Not covered	Not covered
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 — Saver 80

A comparison of the Saver 80 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%	80%
Office Visit	Not covered	Not covered
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 — Saver 80

A comparison of the Saver 80 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%	80%
Office Visit	Not covered	Not covered
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 — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

A comparison of the Copay 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	see brochure	see brochure
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $1,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $1,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $2,000

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $2,000

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $2,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $2,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $5,000	Individual:$1,500, Family: $3,000 $5,000

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $5,000	Individual:$1,500, Family: $3,000 $5,000

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $1,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $1,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $2,000

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $2,000

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $2,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $2,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $1,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $1,500	Individual:$1,500, Family: $3,000 $1,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $2,000

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,000	Individual:$1,500, Family: $3,000 $2,000

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $2,500

Golden Rule Platinum — Generations HSA

A comparison of the Generations 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	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$1,500, Family: $3,000 $2,500	Individual:$1,500, Family: $3,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $750

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $750

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $1,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $1,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $2,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $2,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $5,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $5,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $10,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $10,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $15,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $15,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $20,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $20,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $750

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $750

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $1,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $1,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $2,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $2,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $5,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $5,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $10,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $10,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $15,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $15,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $20,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $20,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $750

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $750

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $1,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $1,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $2,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $2,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $5,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $5,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $10,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $10,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $15,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $15,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $20,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $20,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $750

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $750

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $1,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $1,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $2,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $2,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $5,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $5,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $10,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $10,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $15,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $15,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $20,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $20,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $750

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $750	Individual: $25,000, Family: $75,000 $750

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $1,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $1,500	Individual: $25,000, Family: $75,000 $1,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $2,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,000	Individual: $25,000, Family: $75,000 $2,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $2,500	Individual: $25,000, Family: $75,000 $2,500

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $5,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $5,000	Individual: $25,000, Family: $75,000 $5,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $10,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $10,000	Individual: $25,000, Family: $75,000 $10,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $15,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $15,000	Individual: $25,000, Family: $75,000 $15,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $20,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $20,000	Individual: $25,000, Family: $75,000 $20,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Golden Rule Platinum — Generations One

A comparison of the Generations One 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	Individual: $25,000, Family: $75,000 $25,000	Individual: $25,000, Family: $75,000 $25,000

Golden Rule Platinum — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Golden Rule Platinum — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Golden Rule Platinum — ExpressMed Premier PPO

A comparison of the ExpressMed Premier 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	see brochure	see brochure
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier HSA PPO

A comparison of the ExpressMed Premier HSA 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	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,600,Family: $7,500	Individual: $11,200, Family: $15,000

Golden Rule Platinum — ExpressMed Premier PPO

A comparison of the ExpressMed Premier 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	see brochure	see brochure
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — ExpressMed Premier HSA PPO

A comparison of the ExpressMed Premier HSA 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	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,600,Family: $7,500	Individual: $11,200, Family: $15,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier PPO

A comparison of the ExpressMed Premier 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	see brochure	see brochure
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — ExpressMed Premier PPO

A comparison of the ExpressMed Premier 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	see brochure	see brochure
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier PPO

A comparison of the ExpressMed Premier 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	see brochure	see brochure
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier HSA PPO

A comparison of the ExpressMed Premier HSA 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	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,600,Family: $7,500	Individual: $11,200, Family: $15,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — ExpressMed Premier PPO

A comparison of the ExpressMed Premier 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	see brochure	see brochure
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,000	$2,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($15,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$3,500	$7,000

Golden Rule Platinum — ExpressMed Premier Plus PPO ($10,000 SL)

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) 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%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan 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	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,000, Family: $2,000	Out of Network Deductible is $1500 + Annual Deductible

Golden Rule Platinum — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan 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	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,000, Family: $2,000	Out of Network Deductible is $1500 + Annual Deductible

Golden Rule Platinum — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan 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	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,000, Family: $2,000	Out of Network Deductible is $1500 + Annual Deductible

Golden Rule Platinum — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan 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	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,000, Family: $2,000	Out of Network Deductible is $1500 + Annual Deductible

Golden Rule Platinum — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan 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	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,000, Family: $2,000	Out of Network Deductible is $1500 + Annual Deductible

Golden Rule Platinum — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan 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	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,000, Family: $2,000	Out of Network Deductible is $1500 + Annual Deductible

Golden Rule Platinum — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO Plan 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	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,000, Family: $2,000	Out of Network Deductible is $1500 + Annual Deductible

Golden Rule Platinum — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO Plan 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	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,000, Family: $2,000	Out of Network Deductible is $1500 + Annual Deductible

Golden Rule Platinum — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO Plan 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	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,000, Family: $2,000	Out of Network Deductible is $1500 + Annual Deductible

Golden Rule Platinum — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO Plan 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