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Golden Rule Platinum Health Insurance in WISCONSIN – Health Plan Options

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 — 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 — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Golden Rule Platinum — Next Generation HSA

A comparison of the Next Generation 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	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — Copay Saver

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

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

Golden Rule Platinum — Copay Saver

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

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

Golden Rule Platinum — Copay Saver

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

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

Golden Rule Platinum — Copay Saver

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

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

Golden Rule Platinum — Copay Saver

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

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

Golden Rule Platinum — Single HSA 100

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

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

Golden Rule Platinum — Single HSA 100

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

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

Golden Rule Platinum — Single HSA 100

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

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

Golden Rule Platinum — Single HSA 100

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

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

Golden Rule Platinum — Single HSA 100

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

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

Golden Rule Platinum — Single HSA 70

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

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

Golden Rule Platinum — Single HSA 70

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

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

Golden Rule Platinum — Single HSA 70

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

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

Golden Rule Platinum — Single HSA 70

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

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

Golden Rule Platinum — Single HSA 70

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

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

Golden Rule Platinum — Plan 100

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

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

Golden Rule Platinum — Plan 100

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

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

Golden Rule Platinum — Plan 100

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

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

Golden Rule Platinum — Plan 100

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

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

Golden Rule Platinum — Plan 100

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

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

Golden Rule Platinum — Plan 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Plan 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Plan 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Plan 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Plan 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Saver 80

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Copay Select

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Golden Rule Platinum — Generations HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$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 — ExpressMed Premier PPO ($15,000 SL)

A comparison of the ExpressMed Premier PPO ($15,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

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

A comparison of the ExpressMed Premier PPO ($15,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

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

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$7,500	$15,000

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

A comparison of the ExpressMed Premier PPO ($15,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

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

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$10,000	$20,000

Golden Rule Platinum — ExpressMed Premier PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$10,000	$20,000

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

A comparison of the ExpressMed Premier PPO ($15,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

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

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$7,500	$15,000

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

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$10,000	$20,000

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

A comparison of the ExpressMed Premier PPO ($15,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

Golden Rule Platinum — ExpressMed Premier HSA PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,900, Family: $5,800	Individual: $5,800,Family: $11,600

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

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$7,500	$15,000

Golden Rule Platinum — ExpressMed Premier PPO

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$10,000	$20,000

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

A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$7,500	$15,000

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

A comparison of the ExpressMed Premier PPO ($15,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	$50 Copay, no Calendar Year Maximum	Subject to Deductible and Coinsurance
Copay	$50	Subject to Deductible and Coinsurance
Deductible	$1,500	$3,000

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

A comparison of the ExpressMed Premier Plus PPO ($10,000 SL) offered by Golden Rule Platinum is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Copay	$50 Copay, First 2 copays waived	Subject to Deductible and Coinsurance
Deductible	$10,000	$20,000

Golden Rule Platinum — ExpressMed Premier HSA PPO

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