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Golden Rule Platinum Health Insurance in TENNESSEE – Health Plan Options

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:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $5,000	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $5,000	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $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:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $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: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $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: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 100

A comparison of the Community Flex 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Deductible and benefit percentage	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Non-network deductible and benefit percentage
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 100

A comparison of the Community Flex 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Deductible and benefit percentage	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Non-network deductible and benefit percentage
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 100

A comparison of the Community Flex 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Deductible and benefit percentage	Office Visits/Urgent Care Centers (Office Visits/Urgent Care Center evaluation and management services): Non-network deductible and benefit percentage
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 100 with Gold Benefits Option

A comparison of the Community Flex 100 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	In-Network: Deductible, then 100%	In-Network: Deductible, then 100%
Copay	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $5,000, Family: $10,000	In-Network:Individual: $5,000, Family: $10,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 100 with Gold Benefits Option

A comparison of the Community Flex 100 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	In-Network: Deductible, then 100%	In-Network: Deductible, then 100%
Copay	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $5,000, Family: $10,000	In-Network:Individual: $5,000, Family: $10,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 100 with Gold Benefits Option

A comparison of the Community Flex 100 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	In-Network: Deductible, then 100%	In-Network: Deductible, then 100%
Copay	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $5,000, Family: $10,000	In-Network:Individual: $5,000, Family: $10,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 80

A comparison of the Community Flex 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: Deductible, then 80%	In-Network: Deductible, then 80%
Copay	N/A	N/A
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 60

A comparison of the Community Flex 60 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: Deductible, then 60%	In-Network: Deductible, then 60%
Copay	N/A	N/A
Deductible	In-Network:Individual: $500, Family: $1,000	In-Network:Individual: $500, Family: $1,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits Option offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Golden Rule Platinum — Open Access 1000

A comparison of the Open Access 1000 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician - $35 copaySpecialist - $50 copay	CIGNA pays 60% after deductible is fulfilled
Copay	Primary Care Physician - $35, Specialist - $50	CIGNA pays 60% after deductible is fulfilled
Deductible	Individual: $1,000, Family: $2,000	Individual: $2,000, Family: $4,000

Golden Rule Platinum — Open Access 2000

A comparison of the Open Access 2000 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician: $25 copay, deductible waived, Specialist: $45 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Copay	Primary Care Physician: $25 copay, deductible waived, Specialist: $45 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Deductible	Individual: $2,000, Family: $4,000	Individual: $4,000, Family: $8,000

Golden Rule Platinum — Open Access 3000

A comparison of the Open Access 3000 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% after plan deductible	CIGNA pays 60% after plan deductible
Office Visit	Primary Care Physician - $30 copay (deductible waived), Specialist - $60 copay (deductible waived)	CIGNA pays 60% after plan deductible
Copay	Primary Care Physician - $30, Specialist - $60	CIGNA pays 60% after plan deductible
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Golden Rule Platinum — Open Access 5000

A comparison of the Open Access 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	CIGNA pays 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician: $40 copay, deductible waived, Specialist: $60 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Copay	Primary Care Physician: $40 copay, deductible waived, Specialist: $60 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Golden Rule Platinum — Health Savings 1500

A comparison of the Health Savings 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	CIGNA pays 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician or Specialist CIGNA pays 80% after deductible is fulfilled	Primary Care Physician or Specialist CIGNA pays 60% after deductible is fulfilled
Copay	N/A	N/A
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Golden Rule Platinum — Health Savings 3000

A comparison of the Health Savings 3000 offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 100% of eligible charges	CIGNA pays 70% of eligible charges
Office Visit	Primary Care Physician or Specialist CIGNA pays 100% after deductible is fulfilled	Primary Care Physician or Specialist CIGNA pays 70% after deductible is fulfilled
Copay	N/A	N/A
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family; $12,000

Golden Rule Platinum — Health Savings 5000

A comparison of the Health Savings 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	CIGNA pays 100% after deductible is fulfilled	CIGNA pays 70% after deductible is fulfilled
Office Visit	Primary Care Physician - CIGNA pays 100% after deductible is fulfilled, Specialist – CIGNA pays 100% after deductible is fulfilled	CIGNA pays 70% after deductible is fulfilled
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

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 — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — Short Term Medical

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

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

Golden Rule Platinum — HealthSaver Limited-Benefit

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

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

Golden Rule Platinum — HealthSaver Limited-Benefit

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

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

Golden Rule Platinum — HealthSaver Limited-Benefit

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

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

Golden Rule Platinum — HealthSaver Limited-Benefit

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

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

Golden Rule Platinum — HealthSaver Limited-Benefit

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

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

Golden Rule Platinum — HealthSaver Limited-Benefit

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

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

Golden Rule Platinum — HealthSaver Limited-Benefit

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

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

Golden Rule Platinum — HealthSaver Limited-Benefit

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

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

Golden Rule Platinum — PPO 1500

A comparison of the PPO 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	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): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 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): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 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: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Golden Rule Platinum — PPO 2500

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

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

Golden Rule Platinum — PPO 5000

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

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

Golden Rule Platinum — PPO First Dollar 30

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

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

Golden Rule Platinum — PPO Value 5000

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

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

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

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

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

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

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

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

Golden Rule Platinum — Preventative and Hospital Care 1250

A comparison of the Preventative 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 — Preventative and Hospital Care 3000 (HSA Compatible)

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

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

Golden Rule Platinum — PPO 1500 with Dental

A comparison of the PPO 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	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.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): $25 copay; Specialist Visit: $35 copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or internist): 50% after deductible; Specialist Visit: 50% after deductible
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or internist): $25 copay; Specialist Visit: $35 copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or internist): 50% after deductible; Specialist Visit: 50% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Golden Rule Platinum — PPO 2500 with Dental

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

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

Golden Rule Platinum — PPO 5000 with Dental

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

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

Golden Rule Platinum — PPO First Dollar 30 with Dental

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

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

Golden Rule Platinum — PPO Value 5000 with Dental

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

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

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

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

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

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

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

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

Golden Rule Platinum — Preventative and Hospital Care 1250 with Dental

A comparison of the Preventative 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	50% after deductible
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 — Preventative and Hospital Care 3000 (HSA Compatible) with Dental

A comparison of the Preventative 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	Not Covered	Not Covered
Copay	Not Covered	Not Covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Golden Rule Platinum — PremierBlue A01S

A comparison of the PremierBlue A01S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Golden Rule Platinum — PremierBlue A02S

A comparison of the PremierBlue A02S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A04S

A comparison of the PremierBlue A04S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A12S

A comparison of the PremierBlue A12S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A14S

A comparison of the PremierBlue A14S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A18S

A comparison of the PremierBlue A18S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Golden Rule Platinum — PremierBlue A22S

A comparison of the PremierBlue A22S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A24S

A comparison of the PremierBlue A24S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A25S

A comparison of the PremierBlue A25S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A28S

A comparison of the PremierBlue A28S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Golden Rule Platinum — PremierBlue A31S

A comparison of the PremierBlue A31S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Golden Rule Platinum — PremierBlue A32S

A comparison of the PremierBlue A32S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A34S

A comparison of the PremierBlue A34S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A42S

A comparison of the PremierBlue A42S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A44S

A comparison of the PremierBlue A44S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A48S

A comparison of the PremierBlue A48S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Golden Rule Platinum — PremierBlue A52S

A comparison of the PremierBlue A52S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A54S

A comparison of the PremierBlue A54S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A55S

A comparison of the PremierBlue A55S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A58S

A comparison of the PremierBlue A58S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Golden Rule Platinum — PremierBlue A01P

A comparison of the PremierBlue A01P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Golden Rule Platinum — PremierBlue A02P

A comparison of the PremierBlue A02P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A04P

A comparison of the PremierBlue A04P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A12P

A comparison of the PremierBlue A12P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A14P

A comparison of the PremierBlue A14P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A18P

A comparison of the PremierBlue A18P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Golden Rule Platinum — PremierBlue A22P

A comparison of the PremierBlue A22P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A24P

A comparison of the PremierBlue A24P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A25P

A comparison of the PremierBlue A25P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A28P

A comparison of the PremierBlue A28P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Golden Rule Platinum — PremierBlue A31P

A comparison of the PremierBlue A31P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Golden Rule Platinum — PremierBlue A32P

A comparison of the PremierBlue A32P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A34P

A comparison of the PremierBlue A34P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A42P

A comparison of the PremierBlue A42P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A44P

A comparison of the PremierBlue A44P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A48P

A comparison of the PremierBlue A48P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Golden Rule Platinum — PremierBlue A52P

A comparison of the PremierBlue A52P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Golden Rule Platinum — PremierBlue A54P

A comparison of the PremierBlue A54P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A55P

A comparison of the PremierBlue A55P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Golden Rule Platinum — PremierBlue A58P

A comparison of the PremierBlue A58P offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Golden Rule Platinum — SimplyBlue S1S

A comparison of the SimplyBlue S1S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual/ $2,000 Family	$2,000 Individual/ $4,000 Family

Golden Rule Platinum — SimplyBlue S2S

A comparison of the SimplyBlue S2S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	N/A	N/A
Copay	N/A	N/A
Deductible	$1,500 Individual/ $3,000 Family	$3,000 Individual/ $6,000 Family

Golden Rule Platinum — SimplyBlue S3S

A comparison of the SimplyBlue S3S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$2,500 Individual/ $5,000 Family	$5,000 Individual/ $10,000 Family

Golden Rule Platinum — SimplyBlue S4S

A comparison of the SimplyBlue S4S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$3,500 Individual/ $7,000 Family	$7,000 Individual/ $14,000 Family

Golden Rule Platinum — SimplyBlue S5S

A comparison of the SimplyBlue S5S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	N/A	N/A
Copay	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Deductible	$1,000 Individual/ $2,000 Family	$2,000 Individual/ $4,000 Family

Golden Rule Platinum — SimplyBlue S6S

A comparison of the SimplyBlue S6S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	N/A	N/A
Copay	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Deductible	$1,500 Individual/ $3,000 Family	$3,000 Individual/ $6,000 Family

Golden Rule Platinum — SimplyBlue S7S

A comparison of the SimplyBlue S7S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Copay	$30	$30
Deductible	$2,500 Individual/ $5,000 Family	$5,000 Individual/ $10,000 Family

Golden Rule Platinum — SimplyBlue S8S

A comparison of the SimplyBlue S8S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Copay	$30	$30
Deductible	$3,500 Individual/ $7,000 Family	$7,000 Individual/ $14,000 Family

Golden Rule Platinum — BluePartner D1S

A comparison of the BluePartner D1S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$1,200 Individual/ $2,400 Family	$2,400 Individual/ $4,800 Family

Golden Rule Platinum — BluePartner D2S

A comparison of the BluePartner D2S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$1,800 Individual/ $2,400 Family	$3,600 Individual/ $7,200 Family

Golden Rule Platinum — BluePartner D3S

A comparison of the BluePartner D3S offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

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	Network	Non-Network
Network	See Provider	See Provider
Coinsurance