Great American Health Insurance in COLORADO – Health Plan Options

Great American — Patriot Class 1

A comparison of the Patriot Class 1 offered by Great American is detailed 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

Great American — Patriot Class 3

A comparison of the Patriot Class 3 offered by Great American is detailed 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

Great American — Patriot Class 4

A comparison of the Patriot Class 4 offered by Great American 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

Great American — Patriot Class 5

A comparison of the Patriot Class 5 offered by Great American 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

Great American — Open Access 1000

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% after deductible is fulfilled	CIGNA pays 60% after deductible is fulfilled
Office Visit	Primary Care Physician - $20 (deductible waived), Specialist - $40 (deductible waived)	CIGNA pays 60% after deductible is fulfilled
Copay	Primary Care Physician - $20 Specialist - $40	CIGNA pays 60% after deductible is fulfilled
Deductible	Individual: $1,000, Family: $2,000	Individual: $2,000, Family: $4,000

Great American — Open Access 2000

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

	Network	Non-Network

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

Great American — Open Access 3000

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

	Network	Non-Network

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

Great American — Open Access 5000

A comparison of the Open Access 5000 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician: $40 copay, deductible waived, Specialist: $60 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Copay	Primary Care Physician: $40 copay, deductible waived, Specialist: $60 copay, deductible waived	Primary Care Physician: CIGNA pays 60% after deductible is fulfilled, Specialist: CIGNA pays 60% after deductible is fulfilled
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Great American — Health Savings 1500

A comparison of the Health Savings 1500 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

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

Great American — Health Savings 3000

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

	Network	Non-Network

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

Great American — Health Savings 5000

A comparison of the Health Savings 5000 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	CIGNA pays 100% after deductible is fulfilled	CIGNA pays 70% after deductible is fulfilled
Office Visit	Primary Care Physician - CIGNA pays 100% after deductible is fulfilled, Specialist – CIGNA pays 100% after deductible is fulfilled	CIGNA pays 70% after deductible is fulfilled
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — Short Term Medical

A comparison of the Short Term Medical offered by Great American is detailed 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

Great American — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Great American is detailed 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

Great American — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Great American is detailed 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

Great American — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Great American is detailed 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

Great American — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Great American is detailed 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

Great American — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Great American is detailed 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

Great American — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Great American is detailed 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

Great American — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Great American is detailed 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

Great American — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Great American is detailed 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

Great American — 30 Copayment Plan

A comparison of the 30 Copayment Plan offered by Great American 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	Primary Care- $30 per office visit Specialist Care- $40 per office visit	Primary Care- $30 per office visit Specialist Care- $40 per office visit
Copay	Primary Care- $30 per visit Specialty Care- $40 per visit	Primary Care- $30 per visit Specialty Care- $40 per visit
Deductible	N/A	N/A

Great American — 35 Copayment Plan w/Rx

A comparison of the 35 Copayment Plan w/Rx offered by Great American 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	Primary Care- $35 per primary office visit Specialist Care- $50 per office visit	Primary Care- $35 per primary office visit Specialist Care- $50 per office visit
Copay	Primary care- $35 per visit Specialty care- $50 per visit	Primary care- $35 per visit Specialty care- $50 per visit
Deductible	N/A	N/A

Great American — 40 Copayment Plan w/Rx

A comparison of the 40 Copayment Plan w/Rx offered by Great American 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	Primary Care- $40 per office visit Specialist Care- $60 per office visit	Primary Care- $40 per office visit Specialist Care- $60 per office visit
Copay	Primary Care- $40 per visit Specialty Care- $60 per visit	Primary Care- $40 per visit Specialty Care- $60 per visit
Deductible	N/A	N/A

Great American — 2000 Deductible Plan (70%)

A comparison of the 2000 Deductible Plan (70%) offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Primary Care- $30 per office visit (not subject to deductible) Specialist Care- $50 per office visit (not subject to deductible)	Primary Care- $30 per office visit (not subject to deductible) Specialist Care- $50 per office visit (not subject to deductible)
Copay	Primary Care- $30 per visit Specialist Care- $50 per visit	Primary Care- $30 per visit Specialist Care- $50 per visit
Deductible	$2,000 Individual / $6,000 Family	$2,000 Individual / $6,000 Family

Great American — 5000 Deductible Plan (70%)

A comparison of the 5000 Deductible Plan (70%) offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	li> Primary Care- $30 per office visit(not subject to deductible) Specialist Care- $50 per office visit (not subject to deductible)	li> Primary Care- $30 per office visit(not subject to deductible) Specialist Care- $50 per office visit (not subject to deductible)
Copay	Primary Care- $30 per visit Specialty care- $50 per visit	Primary Care- $30 per visit Specialty care- $50 per visit
Deductible	see brochure	see brochure

Great American — 2000 Deductible Plan (70%) w/Rx

A comparison of the 2000 Deductible Plan (70%) w/Rx offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Primary Care- $30 per office visit (not subject to deductible) Specialist Care- $50 per office visit (not subject to deductible)	Primary Care- $30 per office visit (not subject to deductible) Specialist Care- $50 per office visit (not subject to deductible)
Copay	Primary Care- $30 per visit Specialist Care- $50 per visit	Primary Care- $30 per visit Specialist Care- $50 per visit
Deductible	$2,000 Individual / $6,000 Family	$2,000 Individual / $6,000 Family

Great American — 3000 Deductible Plan (70%) w/Rx

A comparison of the 3000 Deductible Plan (70%) w/Rx offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	li> Primary Care- $30 per office visit (not subject to deductible) Specialist Care- $50 per office visit (not subject to deductible)	li> Primary Care- $30 per office visit (not subject to deductible) Specialist Care- $50 per office visit (not subject to deductible)
Copay	Primary Care- $30 per visit Specialist Care- $50 per visit	Primary Care- $30 per visit Specialist Care- $50 per visit
Deductible	$3,000 Individual / $9,000 Family	$3,000 Individual / $9,000 Family

Great American — 1000 Deductible Plan (80%) w/Rx

A comparison of the 1000 Deductible Plan (80%) w/Rx offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	li> Primary Care- $30 per office visit (not subject to deductible) Specialist Care- $50 per office visit (not subject to deductible)	li> Primary Care- $30 per office visit (not subject to deductible) Specialist Care- $50 per office visit (not subject to deductible)
Copay	Primary Care- $30 per visit Specialist Care- $50 per visit	Primary Care- $30 per visit Specialist Care- $50 per visit
Deductible	$1,000 Individual / $3,000 Family	$1,000 Individual / $3,000 Family

Great American — 1500 Deductible Plan (80%) w/Rx

A comparison of the 1500 Deductible Plan (80%) w/Rx offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Primary Care- $30 per office visit (not subject to deductible) Specialist Care- $50 per office visit(not subject to deductible)	Primary Care- $30 per office visit (not subject to deductible) Specialist Care- $50 per office visit(not subject to deductible)
Copay	Primary Care- $30 per visit Specialist Care- $50 per visit	Primary Care- $30 per visit Specialist Care- $50 per visit
Deductible	$1,500 Individual / $4,500 Family	$1,500 Individual / $4,500 Family

Great American — 2000 HSA-Qualified Deductible Plan (80%)

A comparison of the 2000 HSA-Qualified Deductible Plan (80%) offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Primary Care- 80% coinsurance per office visit after deductible is met Specialist Care- 80% coinsurance per office visit after deductible is met	Primary Care- 80% coinsurance per office visit after deductible is met Specialist Care- 80% coinsurance per office visit after deductible is met
Copay	Primary Care- 80% coinsurance per visit after deductible is met Specialist Care- 80% coinsurance per visit after deductible is met	Primary Care- 80% coinsurance per visit after deductible is met Specialist Care- 80% coinsurance per visit after deductible is met
Deductible	$2,000 Individual / $4,000 Family	$2,000 Individual / $4,000 Family

Great American — 2000 HSA-Qualified Deductible Plan (100%)

A comparison of the 2000 HSA-Qualified Deductible Plan (100%) offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	No Chare per visit after deductible is met	No Chare per visit after deductible is met
Copay	No charge per visit after deductible is met	No charge per visit after deductible is met
Deductible	$2,000 Individual / $4,000 Family	$2,000 Individual / $4,000 Family

Great American — 2500 HSA-Qualified Deductible Plan (100%)

A comparison of the 2500 HSA-Qualified Deductible Plan (100%) offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	No Charge after deductible is met	No Charge after deductible is met
Copay	No Charge per visit after deductible is met	No Charge per visit after deductible is met
Deductible	$2,500 Individual / $5,000 Family	$2,500 Individual / $5,000 Family

Great American — 3000 HSA-Qualified Deductible Plan (100%)

A comparison of the 3000 HSA-Qualified Deductible Plan (100%) offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	No Charge per visit after deductible is met	No Charge per visit after deductible is met
Copay	No Charge per visit after deductible is met	No Charge per visit after deductible is met
Deductible	$3,000 Individual / $6,000 Family	$3,000 Individual / $6,000 Family

Great American — 4000 HSA-Qualified Deductible Plan (100%)

A comparison of the 4000 HSA-Qualified Deductible Plan (100%) offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	No Charge per visit after deductible is met	No Charge per visit after deductible is met
Copay	No Charge per visit after deductible is met	No Charge per visit after deductible is met
Deductible	$4,000 Individual / $8,000 Family	$4,000 Individual / $8,000 Family

Great American — 5000 HSA-Qualified Deductible Plan (100%)

A comparison of the 5000 HSA-Qualified Deductible Plan (100%) offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	No Charge per visit after deductible is met	No Charge per visit after deductible is met
Copay	No Charge per visit after deductible is met	No Charge per visit after deductible is met
Deductible	$5,000 Individual / $10,000 Family	$5,000 Individual / $10,000 Family

Great American — 5000 Deductible Plan (60%) w/Rx Children's Plan

A comparison of the 5000 Deductible Plan (60%) w/Rx Children's Plan offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	60%	60%
Office Visit	Routine medical office visits: Primary Care- $10 per office visit Specialist- $40 per office visit	Routine medical office visits: Primary Care- $10 per office visit Specialist- $40 per office visit
Copay	Primary Care- $10 per office visit Specialist- $40 per office visit	Primary Care- $10 per office visit Specialist- $40 per office visit
Deductible	$5,000 Individual	$5,000 Individual

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Silver Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Gold Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — PPO Platinum Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

Great American — HSA Gold Single Series with 12 Month Rate Guarantee, Lifetime Max $2 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

	Network	Non-Network

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

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

	Network	Non-Network

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

Great American — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

	Network	Non-Network

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

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

	Network	Non-Network

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

Great American — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

	Network	Non-Network

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

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

	Network	Non-Network

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

Great American — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $5 Million

	Network	Non-Network

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

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

	Network	Non-Network

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

Great American — The Edge HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

Great American — The Edge HSA Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

	Network	Non-Network

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

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

	Network	Non-Network

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

Great American — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

	Network	Non-Network

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

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

	Network	Non-Network

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

Great American — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

	Network	Non-Network

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

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

	Network	Non-Network

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

Great American — The Edge PPO Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

	Network	Non-Network

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

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

	Network	Non-Network

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

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

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

	Network	Non-Network

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

Great American — Colorado BluePreferred for Individuals

A comparison of the Colorado BluePreferred for Individuals offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	80% covered after deductible.	60% covered
Copay	N/A	N/A
Deductible	$3,000 per family member.	$6,000 per family member.

Great American — Colorado BluePreferred for Individuals

A comparison of the Colorado BluePreferred for Individuals offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	80% covered after deductible.	60% covered
Copay	N/A	N/A
Deductible	$3,000 per family member.	$6,000 per family member.

Great American — Colorado BluePreferred for Individuals

A comparison of the Colorado BluePreferred for Individuals offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	80% covered after deductible.	60% covered
Copay	N/A	N/A
Deductible	$3,000 per family member.	$6,000 per family member.

Great American — Colorado BluePreferred for Individuals

A comparison of the Colorado BluePreferred for Individuals offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	80% covered after deductible.	60% covered
Copay	N/A	N/A
Deductible	$3,000 per family member.	$6,000 per family member.

Great American — Calculated Risk Taker

A comparison of the Calculated Risk Taker offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	60%
Office Visit	$40 per visit, unlimited vists per year	Covered at 60% (not subject to deductible)
Copay	$40	N/A
Deductible	$1,500	$1,500

Great American — Part-Time Daredevil

A comparison of the Part-Time Daredevil offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	60%
Office Visit	$30 copayment for the first four office visits then 100%	Covered at 60% (not subject to deductible)
Copay	$30	N/A
Deductible	$3,000	$3,000

Great American — Thrill Seeker

A comparison of the Thrill Seeker offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	60%
Office Visit	$20 copayment for the first four office visits then 100%	Covered at 60% (not subject to deductible)
Copay	$20	N/A
Deductible	$5,000	$5,000

Great American — Lumenos HSA

A comparison of the Lumenos HSA offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,500	$3,000

Great American — Lumenos HSA

A comparison of the Lumenos HSA offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500	$5,000

Great American — Lumenos HSA

A comparison of the Lumenos HSA offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000	$10,000

Great American — Lumenos HIA

A comparison of the Lumenos HIA offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Great American — Lumenos HIA

A comparison of the Lumenos HIA offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$10,000 Individual, $20,000 Family

Great American — Lumenos HIA

A comparison of the Lumenos HIA offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,500 Individual, $3,000 Family	$3,000 Individual, $6,000 Family

Great American — Lumenos HIA Plus

A comparison of the Lumenos HIA Plus offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual, $5,000 Family	$5,000 Individual, $10,000 Family

Great American — Lumenos HIA Plus

A comparison of the Lumenos HIA Plus offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	70%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual, $10,000 Family	$10,000 Individual, $20,000 Family

Great American — SmartSense Generic Only Rx 500

A comparison of the SmartSense Generic Only Rx 500 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Copay	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Deductible	$500 Individual, $1,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)	$5,000 Individual, $10,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)

Great American — SmartSense Generic Only Rx 1500

A comparison of the SmartSense Generic Only Rx 1500 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Copay	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Deductible	$1,500 Individual, $3,000 Family (each family member has an individual deductible, family deductible can be satisfied by 2 or more people)	$5,000 Individual, $10,000 Family (each family member has an individual deductible, family deductible can be satisfied by 2 or more people)

Great American — SmartSense Generic Only Rx 2500

A comparison of the SmartSense Generic Only Rx 2500 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% after deductible is met	50% after deductible
Copay	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Deductible	$2,500 Individual, $5,000 Family (each family member has an individual deductible, family deductible can be satisfied by 2 or more people)	$5,000 Individual, $10,000 Family (each family member has an individual deductible, family deductible can be satisfied by 2 or more people)

Great American — SmartSense Generic Only Rx 5000

A comparison of the SmartSense Generic Only Rx 5000 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Copay	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Deductible	$5,000 Individual, $10,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)	$5,000 Individual, $10,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)

Great American — SmartSense Generic Only Rx 7500

A comparison of the SmartSense Generic Only Rx 7500 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Copay	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Deductible	$7,500 Individual, $15,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)	$7,500 Individual, $15,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)

Great American — SmartSense Full Rx 500

A comparison of the SmartSense Full Rx 500 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Copay	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Deductible	$500 Individual, $1,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)	$5,000 Individual, $10,000 Family (each family member has an individual deductible, family deductible can be satisfied by 2 or more people)

Great American — SmartSense Full Rx 1500

A comparison of the SmartSense Full Rx 1500 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Copay	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Deductible	$1,500 Individual, $3,000 Family (each family member has an individual deductible, family deductible can be satisfied by 2 or more people)	$5,000 Individual, $10,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)

Great American — SmartSense Full Rx 2500

A comparison of the SmartSense Full Rx 2500 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Copay	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Deductible	$2,500 Individual, $5,000 Family (each family member has an individual deductible, family deductible can be satisfied by 2 or more people)	$5,000 Individual, $10,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)

Great American — SmartSense Full Rx 5000

A comparison of the SmartSense Full Rx 5000 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Copay	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Deductible	$5,000 Individual, $10,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)	$5,000 Individual, $10,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)

Great American — SmartSense Full Rx 7500

A comparison of the SmartSense Full Rx 7500 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	70% after deductible	50% after deductible
Office Visit	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Copay	$30 copay for first 3 visits per member per year (deductible waived); after 3 visits, 70% once deductible is met	50% after deductible
Deductible	$7,500 Individual, $15,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)	$7,500 Individual, $15,000 Family(each family member has an individual deductible, family deductible can be satisfied by 2 or more people)

Great American — Plan 80

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Great American — Plan 80

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Great American — Plan 80

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

	Network	Non-Network

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

Great American — Plan 80

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

	Network	Non-Network

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

Great American — Plan 80

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

	Network	Non-Network

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

Great American — Plan 80

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

	Network	Non-Network

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

Great American — Plan 80

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Great American — Plan 80

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Doctor Office Visit - Illness and Injury: 80%	Doctor Office Visit - Illness and Injury: 80%
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Great American — Plan 100

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Doctor Office Visit - Illness and Injury: 100%	Doctor Office Visit - Illness and Injury: 100%
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Great American — Plan 100

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Doctor Office Visit - Illness and Injury: 100%	Doctor Office Visit - Illness and Injury: 100%
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Great American — Plan 100

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Doctor Office Visit - Illness and Injury: 100%	Doctor Office Visit - Illness and Injury: 100%
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Great American — Plan 100

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Doctor Office Visit - Illness and Injury: 100%	Doctor Office Visit - Illness and Injury: 100%
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Great American — Plan 100

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Doctor Office Visit - Illness and Injury: 100%	Doctor Office Visit - Illness and Injury: 100%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Great American — Plan 100

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Doctor Office Visit - Illness and Injury: 100%	Doctor Office Visit - Illness and Injury: 100%
Copay	N/A	N/A
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Great American — Plan 100

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Doctor Office Visit - Illness and Injury: 100%	Doctor Office Visit - Illness and Injury: 100%
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Great American — Plan 100

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

	Network	Non-Network

Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Doctor Office Visit - Illness and Injury: 100%	Doctor Office Visit - Illness and Injury: 100%
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)