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Great American Health Insurance in GEORGIA – Health Plan Options

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% of eligible charges	CIGNA pays 60% of eligible charges
Office Visit	Primary Care Physician: $25 copay, deductible waived, Specialist: $35 copay, deductible waived	CIGNA pays 60% after deductible is fulfilled
Copay	Primary Care Physician: $25 copay, Specialist: $35 copay	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	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

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 — 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 — $20 Copay POS $500 Ded

A comparison of the $20 Copay POS $500 Ded 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	60% after deductible
Office Visit	Primary Care Physician Visits- $20 Specialist Visits- $55 Includes lab and x-ray when performed in office.	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Copay	Primary Care Physician Visits- $20 Specialist Visits- $55	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Deductible	$500 Individual (3 Maximum per family)	$1,000 Individual (3 Maximum per family)

Great American — $20 Copay POS $1,000 Ded

A comparison of the $20 Copay POS $1,000 Ded 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	60% after deductible
Office Visit	Primary Care Physician Visits- $20 Specialist Visits- $55 Includes lab and x-ray when performed in office.	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Copay	Primary Care Physician Visits- $20 Specialist Visits- $55	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Deductible	$1,000 Individual (3 Maximum per family)	$2,000 Individual (3 Maximum per family)

Great American — $20 Copay POS $2,000 Ded

A comparison of the $20 Copay POS $2,000 Ded 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	60% after deductible
Office Visit	Primary Care Physician Visits- $20 Specialist Visits- $55 Includes lab and x-ray when performed in office.	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Copay	Primary Care Physician Visits- $20 Specialist Visits- $55	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Deductible	$2,000 Individual (3 Maximum per family)	$4,000 Individual (3 Maximum per family)

Great American — $20 Copay POS $3,000 Ded

A comparison of the $20 Copay POS $3,000 Ded 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	60% after deductible
Office Visit	Primary Care Physician Visits- $20 Specialist Visits- $55 Includes lab and x-ray when performed in office	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Copay	Primary Care Physician Visits- $20 Specialist Visits- $55	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible Includes lab and x-ray when performed in office
Deductible	$3,000 Individual (3 Maximum per family)	$6,000 Individual (3 Maximum per family)

Great American — $20 Copay POS $4,000 Ded

A comparison of the $20 Copay POS $4,000 Ded 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	60% after deductible
Office Visit	Primary Care Physician Visits- $20 Specialist Visits- $55 Includes lab and x-ray when performed in office.	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Copay	Primary Care Physician Visits- $20 Specialist Visits- $55	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Deductible	$4,000 Individual (3 Maximum per family)	$8,000 Individual (3 Maximum per family)

Great American — $20 Copay POS $5,000 Ded

A comparison of the $20 Copay POS $5,000 Ded 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	60% after deductible
Office Visit	Primary Care Physician Visits- $20 Specialist Visits- $55 Includes lab and x-ray when performed in office.	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Copay	Primary Care Physician Visits- $20 Specialist Visits- $55	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Deductible	$5,000 Individual (3 Maximum per family)	$10,000 Individual (3 Maximum per family)

Great American — $20 Copay POS $10,000 Ded

A comparison of the $20 Copay POS $10,000 Ded 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	60% after deductible
Office Visit	Primary Care Physician Visits- $20 Specialist Visits- $55 Includes lab and x-ray when performed in office.	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Copay	Primary Care Physician Visits- $20 Specialist Visits- $55	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Deductible	$10,000 Individual (3 Maximum per family)	$20,000 Individual (3 Maximum per family)

Great American — $35 Copay POS $1,000

A comparison of the $35 Copay POS $1,000 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	Primary Care Physician Visits- $35 Specialist Visits- First 2 Visits: $50 3+: $50 after deductible	Primary Care Physician Visits- 50% after deductible Specialist Visits- 50% after deductible
Copay	Primary Care Physician Visits- $35 Specialist Visits- First 2 Visits: $50 3+: $50 after deductible	Primary Care Physician Visits- 50% after deductible Specialist Visits- 50% after deductible
Deductible	$1,000 Individual (2 Maximum per family)	$2,000 Individual (2 Maximum per family)

Great American — $35 Copay POS $2,500

A comparison of the $35 Copay POS $2,500 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	Primary Care Physician Visits- $35 Specialist Visits- First 2 Visits: $50 3+: $50 after deductible	Primary Care Physician Visits- 50% after deductible Specialist Visits- 50% after deductible
Copay	Primary Care Physician Visits- $35 Specialist Visits- First 2 Visits: $50 3+: $50 after deductible	Primary Care Physician Visits- 50% after deductible Specialist Visits- 50% after deductible
Deductible	$2,500 Individual (2 Maximum per family)	$5,000 Individual (2 Maximum per family)

Great American — $35 Copay POS $5,000

A comparison of the $35 Copay POS $5,000 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	Primary Care Physician Visits- $35 Specialist Visits- First 2 Visits: $50 3+: $50 after deductible	Primary Care Physician Visits- 50% after deductible Specialist Visits- 50% after deductible
Copay	Primary Care Physician Visits- $35 Specialist Visits- First 2 Visits: $50 3+: $50 after deductible	Primary Care Physician Visits- 50% after deductible Specialist Visits- 50% after deductible
Deductible	$5,000 Individual (2 Maximum per family)	$10,000 Individual (2 Maximum per family)

Great American — $35 Copay POS $7,500

A comparison of the $35 Copay POS $7,500 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	Primary Care Physician Visits- $35 Specialist Visits- $50 after deductible	Primary Care Physician Visits- 50% after deductible Specialist Visits- 50% after deductible
Copay	Primary Care Physician Visits- $35 Specialist Visits- $50 after deductible	Primary Care Physician Visits- 50% after deductible Specialist Visits- 50% after deductible
Deductible	$7,5000 Individual (2 Maximum per family)	$15,000 Individual (2 Maximum per family)

Great American — $35 Copay POS $10,000

A comparison of the $35 Copay POS $10,000 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	Primary Care Physician Visits- $35 Specialist Visits- $50 after deductible	Primary Care Physician Visits- 50% after deductible Specialist Visits- 50% after deductible
Copay	Primary Care Physician Visits- $35 Specialist Visits- $50 after deductible	Primary Care Physician Visits- 50% after deductible Specialist Visits- 50% after deductible
Deductible	$10,000 Individual (2 Maximum per family)	$20,000 Individual (2 Maximum per family)

Great American — Qualified High Deductible HP POS $1,250 / $2,250 Ded

A comparison of the Qualified High Deductible HP POS $1,250 / $2,250 Ded 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	60% after deductible
Office Visit	Primary Care Physician Visits- 100% after deductible Specialist Visits- 100% after deductible Includes lab and x-ray when performed in office	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Copay	Preventive Screenings for Adults and Children (PCP & Specialist)- $20	Not Covered
Deductible	$1,250 (Family $2,500)	$2,500 (Family $5,500)

Great American — Qualified High Deductible HP POS $3,000 / $5,500 Ded

A comparison of the Qualified High Deductible HP POS $3,000 / $5,500 Ded 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	60% after deductible
Office Visit	Primary Care Physician Visits- 100% after deductible Specialist Visits- 100% after deductible Includes lab and x-ray when performed in office	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Copay	Preventive Screenings for Adults and Children (PCP & Specialist)- $20	Not Covered
Deductible	$3,000 (Family $5,500)	$6,000 (Family $11,000)

Great American — Qualified High Deductible HP POS $5,000 / $10,000 Ded

A comparison of the Qualified High Deductible HP POS $5,000 / $10,000 Ded 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	60% after deductible
Office Visit	Primary Care Physician Visits- 100% after deductible Specialist Visits- 100% after deductible Includes lab and x-ray when performed in office	Primary Care Physician Visits- 60% after deductible Specialist Visits- 60% after deductible
Copay	Preventive Screenings for Adults and Children (PCP & Specialist)- $20	Not Covered
Deductible	$5,000 (Family $10,000)	$10,000 (Family $20,000)

Great American — Fusion 100%/50% POS $3,000 Ded

A comparison of the Fusion 100%/50% POS $3,000 Ded 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	50% after deductible
Office Visit	First 6 Visits: $30 7+ Visits: $60 After Deductible	First 6 Visits: $30 7+ Visits: $60 After Deductible
Copay	First 6 Visits: $30 7+ Visits: $60 After Deductible	First 6 Visits: $30 7+ Visits: $60 After Deductible
Deductible	$3,000 per benefit year (3 Maximum per family)	$3,000 per benefit year (3 Maximum per family)

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 — 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 — Blue Value Select PPO Plan

A comparison of the Blue Value Select PPO 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	Plan pays 80%	Plan pays 60%
Office Visit	$30 copayment	Plan pays 60% after deductible is met
Copay	$30	$30
Deductible	$1,500	$1,500

Great American — Blue Value Select PPO Plan

A comparison of the Blue Value Select PPO 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	Plan pays 80%	Plan pays 60%
Office Visit	$30 copayment	Plan pays 60% after deductible is met
Copay	$30	$30
Deductible	$1,500	$1,500

Great American — Blue Value Select PPO Plan

A comparison of the Blue Value Select PPO 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	Plan pays 80%	Plan pays 60%
Office Visit	$30 copayment	Plan pays 60% after deductible is met
Copay	$30	$30
Deductible	$1,500	$1,500

Great American — Blue Value Select PPO Plan

A comparison of the Blue Value Select PPO 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	Plan pays 80%	Plan pays 60%
Office Visit	$30 copayment	Plan pays 60% after deductible is met
Copay	$30	$30
Deductible	$1,500	$1,500

Great American — Right Plan

A comparison of the Right 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	Plan pays 60%	Plan pays 60%
Office Visit	$40 office visit copay	Plan pays 60%
Copay	$40	$40
Deductible	$0	$0

Great American — Premier

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 80% after deductible	Plan pays 60% after deductible
Office Visit	$35 (Not subject to deductible)	Plan pays 60% after deductible
Copay	$35 (Not subject to deductible)	Plan pays 60% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $1,500, Family: $3,000

Great American — Premier

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 80% after deductible	Plan pays 60% after deductible
Office Visit	$35 (Not subject to deductible)	Plan pays 60% after deductible
Copay	$35 (Not subject to deductible)	Plan pays 60% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $1,500, Family: $3,000

Great American — Premier

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 80% after deductible	Plan pays 60% after deductible
Office Visit	$35 (Not subject to deductible)	Plan pays 60% after deductible
Copay	$35 (Not subject to deductible)	Plan pays 60% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $1,500, Family: $3,000

Great American — Premier

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 80% after deductible	Plan pays 60% after deductible
Office Visit	$35 (Not subject to deductible)	Plan pays 60% after deductible
Copay	$35 (Not subject to deductible)	Plan pays 60% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $1,500, Family: $3,000

Great American — Premier

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 80% after deductible	Plan pays 60% after deductible
Office Visit	$35 (Not subject to deductible)	Plan pays 60% after deductible
Copay	$35 (Not subject to deductible)	Plan pays 60% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $1,500, Family: $3,000

Great American — Premier

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 80% after deductible	Plan pays 60% after deductible
Office Visit	$35 (Not subject to deductible)	Plan pays 60% after deductible
Copay	$35 (Not subject to deductible)	Plan pays 60% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $1,500, Family: $3,000

Great American — SmartSense

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $750, Family: $1,500	Individual: $750, Family: $1,500

Great American — SmartSense

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $1,500, Family: $3,000	Individual: $1,500, Family: $3,000

Great American — SmartSense

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $2,500, Family: $5,000	Individual: $2,500, Family: $5,000

Great American — SmartSense

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $5,000, Family: $10,000	Individual: $5,000, Family: $10,000

Great American — SmartSense

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $10,000, Family: $20,000	Individual: $10,000, Family: $20,000

Great American — SmartSense

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $20,000, Family: $40,000	Individual: $20,000, Family: $40,000

Great American — SmartSense with Comprehensive Rx

A comparison of the SmartSense with Comprehensive 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	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $5,000, Family: $10,000	Individual: $5,000, Family: $10,000

Great American — SmartSense with Comprehensive Rx

A comparison of the SmartSense with Comprehensive 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	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $5,000, Family: $10,000	Individual: $5,000, Family: $10,000

Great American — SmartSense with Comprehensive Rx

A comparison of the SmartSense with Comprehensive 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	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $5,000, Family: $10,000	Individual: $5,000, Family: $10,000

Great American — SmartSense with Comprehensive Rx

A comparison of the SmartSense with Comprehensive 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	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $5,000, Family: $10,000	Individual: $5,000, Family: $10,000

Great American — SmartSense with Comprehensive Rx

A comparison of the SmartSense with Comprehensive 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	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $5,000, Family: $10,000	Individual: $5,000, Family: $10,000

Great American — SmartSense with Comprehensive Rx

A comparison of the SmartSense with Comprehensive 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	Plan pays 70% after deductible (Plan pays 100% after OOP Max is met)	Plan pays 60% after deductible (Plan pays 100% after OOP Max is met)
Office Visit	$30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Copay	Physician Office Visit- $30 Copay for first 3 visits per person per calendar year, then Plan pays 70% after deductible.	Plan pays 60% (subject to deductible except for child wellness)
Deductible	Individual: $5,000, Family: $10,000	Individual: $5,000, Family: $10,000

Great American — Tonik 1500 - Calculated Risk Taker

A comparison of the Tonik 1500 - 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%	70%
Office Visit	$40 Copay (not subject to ded, however, the copayment will continue to be required after the deductible is met)	70% of eligible charges, (not subject to ded)
Copay	$40 Copay (not subject to ded, however, the copayment will continue to be required after the deductible is met)	70% of eligible charges, (not subject to ded)
Deductible	$1,500	$1,500

Great American — Tonik 3000 - Part-Time Daredevil

A comparison of the Tonik 3000 - 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%	70%
Office Visit	$30 Copay for first 4 office visits in a calendar year then member pays negotiated fee rate until the deductible is met at which time benefits are payable at 100% with no copay.	70% of eligible charges for the first 4 visits in a calendar year not subject to deductible. Member pays all charges for subsequent visits until the deductible is met. Once the deductible is met the plan pays 70% of eligible charges.
Copay	$30 Copay for first 4 office visits in a calendar year then member pays negotiated fee rate until the deductible is met at which time benefits are payable at 100% with no copay.	70% of eligible charges for the first 4 visits in a calendar year not subject to deductible. Member pays all charges for subsequent visits until the deductible is met. Once the deductible is met the plan pays 70% of eligible charges.
Deductible	$3,000	$3,000

Great American — Tonik 5000 - Thrill Seeker

A comparison of the Tonik 5000 - 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%	70%
Office Visit	$20 Copay for first 4 office visits in a calendar year then member pays negotiated fee rate until the deductible is met at which time benefits are payable at 100% with no copay.	70% of eligible charges for the first 4 visits in a calendar year not subject to deductible. Member pays all charges for subsequent visits until the deductible is met. Once the deductible is met the plan pays 70% of eligible charges.
Copay	$20 Copay for first 4 office visits in a calendar year then member pays negotiated fee rate until the deductible is met at which time benefits are payable at 100% with no copay.	70% of eligible charges for the first 4 visits in a calendar year not subject to deductible. Member pays all charges for subsequent visits until the deductible is met. Once the deductible is met the plan pays 70% of eligible charges.
Deductible	$5,000	$5,000

Great American — Blue Value 3000

A comparison of the Blue Value 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	Plan pays 70%	Plan pays 60%
Office Visit	$40 copay for first 6 visits; first 6 visits not subject to calendar year deductible. After 6 visits, Plan pays 70% after deductible is met. Includes x-ray/lab work when performed and billed in physician's office.	Plan pays 60% after deductible is met. Includes x-ray/lab work when performed and billed in physician's office.
Copay	$40 copay for first 6 visits; first 6 visits not subject to calendar year deductible. After 6 visits, Plan pays 70% after deductible is met. Includes x-ray/lab work when performed and billed in physician's office.	Plan pays 60% after deductible is met. Includes x-ray/lab work when performed and billed in physician's office.
Deductible	$3,000 (Three deductibles per family)	$6,000 (Three deductibles per family)

Great American — BlueChoice PPO High Deductible HSA Eligible

A comparison of the BlueChoice PPO High Deductible HSA Eligible 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	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,600, Family: $5,150	Individual: $2,600, Family: $5,150

Great American — BlueChoice PPO High Deductible HSA Eligible

A comparison of the BlueChoice PPO High Deductible HSA Eligible 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	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,600, Family: $5,150	Individual: $2,600, Family: $5,150

Great American — BlueChoice PPO High Deductible HSA Eligible

A comparison of the BlueChoice PPO High Deductible HSA Eligible 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	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,600, Family: $5,150	Individual: $2,600, Family: $5,150

Great American — BlueChoice PPO High Deductible HSA Eligible

A comparison of the BlueChoice PPO High Deductible HSA Eligible 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	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,600, Family: $5,150	Individual: $2,600, Family: $5,150

Great American — BlueChoice PPO High Deductible HSA Eligible

A comparison of the BlueChoice PPO High Deductible HSA Eligible 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	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,600, Family: $5,150	Individual: $2,600, Family: $5,150

Great American — BlueChoice PPO High Deductible HSA Eligible

A comparison of the BlueChoice PPO High Deductible HSA Eligible 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	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,600, Family: $5,150	Individual: $2,600, Family: $5,150

Great American — BlueChoice PPO High Deductible HSA Eligible

A comparison of the BlueChoice PPO High Deductible HSA Eligible 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	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,600, Family: $5,150	Individual: $2,600, Family: $5,150

Great American — BlueChoice PPO High Deductible HSA Eligible

A comparison of the BlueChoice PPO High Deductible HSA Eligible 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	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,600, Family: $5,150	Individual: $2,600, Family: $5,150

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 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 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 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 Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by 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	$5,000	$5,000

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	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 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 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 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 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 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 Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

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

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

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 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 — 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 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 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 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 Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by 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	$5,000	$5,000

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 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 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 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 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 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 Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by 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	$5,000	$5,000

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 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 — 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 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	$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

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	$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

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	$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

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	$10,000(Maximum of 3 per family)	$2,000 per person in addition to in-network deductible

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

A comparison of the The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by 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	$5,000	$5,000

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 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 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 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 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 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 HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million

A comparison of the The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $2 Million offered by 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	$5,000	$5,000

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 — 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	80% after deductible	80% after deductible
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

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	80% after deductible	80% after deductible
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

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	80% after deductible	80% after deductible
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	80% after deductible	80% after deductible
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	80% after deductible	80% after deductible
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

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	80% after deductible	80% after deductible
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

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	100% after deductible	100% after deductible
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

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	100% after deductible	100% after deductible
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

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	100% after deductible	100% after deductible
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	100% after deductible	100% after deductible
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	100% after deductible	100% after deductible
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

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	100% after deductible	100% after deductible
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Great American — Saver 80

A comparison of the Saver 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	Not covered	Not covered
Copay	N/A	N/A
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Great American — Saver 80

A comparison of the Saver 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	Not covered	Not covered
Copay	N/A	N/A
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Great American — Saver 80

A comparison of the Saver 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	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Great American — Saver 80

A comparison of the Saver 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	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Great American — Saver 80

A comparison of the Saver 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	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Great American — Saver 80

A comparison of the Saver 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	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Great American — Saver 80

A comparison of the Saver 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	Not covered	Not covered
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Great American — Saver 80

A comparison of the Saver 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	Not covered	Not covered
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Great American — Saver 80

A comparison of the Saver 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	Not covered	Not covered
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 — Saver 80

A comparison of the Saver 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	Not covered	Not covered
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 — Saver 80

A comparison of the Saver 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	Not covered	Not covered
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Great American — Saver 80

A comparison of the Saver 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	Not covered	Not covered
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Great American — Copay Saver

A comparison of the Copay Saver 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	History and exam: $35 copay (maximum 2 visits per person per year)	History and exam: $35 copay (maximum 2 visits per person per year)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Great American — Copay Select

A comparison of the Copay Select 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	History and exam: $25 copay (not subject to deductible)	History and exam: $25 copay (not subject to deductible)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Great American — Copay Select

A comparison of the Copay Select 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	History and exam: $25 copay (not subject to deductible)	History and exam: $25 copay (not subject to deductible)
Copay	see brochure	see brochure
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Great American — Copay Select

A comparison of the Copay Select 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	History and exam: $25 copay (not subject to deductible)	History and exam: $25 copay (not subject to deductible)
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Great American — Copay Select

A comparison of the Copay Select 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	History and exam: $25 copay (not subject to deductible)	History and exam: $25 copay (not subject to deductible)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Great American — Single HSA 100

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Copay	see brochure	see brochure
Deductible	$1,150 (one per family, per calendar year)	$1,150 (one per family, per calendar year)

Great American — Single HSA 100

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Copay	see brochure	see brochure
Deductible	$1,150 (one per family, per calendar year)	$1,150 (one per family, per calendar year)

Great American — Single HSA 100

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Copay	see brochure	see brochure
Deductible	$1,900 (one per family, per calendar year)	$1,900 (one per family, per calendar year)

Great American — Single HSA 100

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Copay	see brochure	see brochure
Deductible	$1,900 (one per family, per calendar year)	$1,900 (one per family, per calendar year)

Great American — Single HSA 100

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Copay	see brochure	see brochure
Deductible	$2,900 (one per family, per calendar year)	$2,900 (one per family, per calendar year)

Great American — Single HSA 100

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Copay	see brochure	see brochure
Deductible	$2,900 (one per family, per calendar year)	$2,900 (one per family, per calendar year)

Great American — Single HSA 100

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Copay	see brochure	see brochure
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Great American — Single HSA 100

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Copay	see brochure	see brochure
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Great American — Single HSA 100

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Copay	see brochure	see brochure
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Great American — Single HSA 100

A comparison of the Single HSA 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	100% after deductible	100% after deductible
Copay	see brochure	see brochure
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Great American — Single HSA Saver

A comparison of the Single HSA Saver 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	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,150 (one per family, per calendar year)	$1,150 (one per family, per calendar year)

Great American — Single HSA Saver

A comparison of the Single HSA Saver 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	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,150 (one per family, per calendar year)	$1,150 (one per family, per calendar year)

Great American — Single HSA Saver

A comparison of the Single HSA Saver 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	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,900 (one per family, per calendar year)	$1,900 (one per family, per calendar year)

Great American — Single HSA Saver

A comparison of the Single HSA Saver 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	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$1,900 (one per family, per calendar year)	$1,900 (one per family, per calendar year)

Great American — Single HSA Saver

A comparison of the Single HSA Saver 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	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$2,900 (one per family, per calendar year)	$2,900 (one per family, per calendar year)

Great American — Single HSA Saver

A comparison of the Single HSA Saver 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	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$2,900 (one per family, per calendar year)	$2,900 (one per family, per calendar year)

Great American — Single HSA Saver

A comparison of the Single HSA Saver 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	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Great American — Single HSA Saver

A comparison of the Single HSA Saver 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	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Great American — Single HSA Saver

A comparison of the Single HSA Saver 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	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Great American — Single HSA Saver

A comparison of the Single HSA Saver 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	100% after deductible
Office Visit	Not covered	Not covered
Copay	N/A	N/A
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Great American — Managed Choice Open Access First Dollar 30

A comparison of the Managed Choice Open Access First Dollar 30 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 up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $0, Family: $0	Individual: $5,000, Family: $10,000

Great American — Managed Choice Open Access First Dollar 40

A comparison of the Managed Choice Open Access First Dollar 40 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% up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-specialist Office Visit: $40 Copay, Specialist Visit: $50 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Copay	Non-specialist Office Visit: $40 Copay, Specialist Visit: $50 Copay	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible
Deductible	Individual: $0, Family: $0	Individual: $7,000, Family: $14,000

Great American — Managed Choice Open Access 1500

A comparison of the Managed Choice Open Access 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	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Great American — Managed Choice Open Access 2500

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

Great American — Managed Choice Open Access 3500

A comparison of the Managed Choice Open Access 3500 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 up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $35 copay, deductible waived (Unlimited visits); Specialist Visit: $45 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $35 copay, deductible waived (Unlimited visits); Specialist Visit: $45 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $3,500, Family: $7,000	Individual: $7,000, Family: $14,000

Great American — Managed Choice Open Access 5000

A comparison of the Managed Choice 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	80% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	60% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $40 copay deductible waived (Unlimited visits), Specialist Visit: $50 copay deductible waived (Unlimited visits)	Non-specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit: $40 copay deductible waived (Unlimited visits), Specialist Visit: $50 copay deductible waived (Unlimited visits)	Non-specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Great American — Managed Choice Open Access Value 2000

A comparison of the Managed Choice Open Access Value 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	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	60% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Visits 1-6 $40 copay, ded. Waived; Visits 7+ 70% after ded. Specialist Visits 1-6 $50 copay, ded. Waived; Visits 7+ 70% after ded. Specialist and Non-Specialist share visit max.	Non-Specialist: 70% after deductible, Specialist: 70% after deductible
Copay	Non-Specialist Visits 1-6 $40 copay, ded. Waived; Visits 7+ 70% after ded. Specialist Visits 1-6 $50 copay, ded. Waived; Visits 7+ 70% after ded. Specialist and Non-Specialist share visit max.	Non-Specialist: 70% after deductible, Specialist: 70% after deductible
Deductible	Individual: $2,000, Family: $4,000	Individual: $4,000, Family: $8,000

Great American — Managed Choice Open Access Value 5000

A comparison of the Managed Choice Open Access Value 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 up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits); Specialist Visit: Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits). Specialist and Non-Specialist share visit max.	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits); Specialist Visit: Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits). Specialist and Non-Specialist share visit max.	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Great American — Managed Choice Open Access Value 10000

A comparison of the Managed Choice Open Access Value 10000 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	60% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist: Visits 1-2 $30 copay, deductible Waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (Unlimited visits), Specialist: Visits 1-2 $30 copay, deductible Waived; Visits 3+ 70% after deductible Specialist and Non-Specialist share visit max (Unlimited visits)	Non-Specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist: Visits 1-2 $30 copay, deductible Waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (Unlimited visits), Specialist: Visits 1-2 $30 copay, deductible Waived; Visits 3+ 70% after deductible Specialist and Non-Specialist share visit max (Unlimited visits)	Non-Specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $10,000, Family: $20,000	Individual: $10,000, Family: $20,000

Great American — Managed Choice Open Access High Deductible 3000 (HSA Compatible)

A comparison of the Managed Choice Open Access High Deductible 3000 (HSA Compatible) 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: 100% after deductible (Unlimited Visits), Specialist Visit: 100% after deductible (Unlimited Visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: 100% after deductible (Unlimited Visits), Specialist Visit: 100% after deductible (Unlimited Visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Great American — Managed Choice Open Access High Deductible 5000 (HSA Compatible)

A comparison of the Managed Choice Open Access High Deductible 5000 (HSA Compatible) 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: 100% after deductible (Unlimited visits), Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: 100% after deductible (Unlimited visits), Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Great American — Preventive and Hospital Care 1250

A comparison of the Preventive and Hospital Care 1250 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 up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Great American — Preventive and Hospital Care 3000 (HSA Compatible)

A comparison of the Preventive and Hospital Care 3000 (HSA Compatible) 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Not covered	Not covered
Copay	Not covered	Not covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Great American — Managed Choice Open Access First Dollar 30 with Dental

A comparison of the Managed Choice Open Access First Dollar 30 with Dental 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 up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $0, Family: $0	Individual: $500, Family: $1,000

Great American — Managed Choice Open Access First Dollar 40 with Dental

A comparison of the Managed Choice Open Access First Dollar 40 with Dental 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% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $0, Family: $0	Individual: $500, Family: $1,000

Great American — Managed Choice Open Access 1500 with Dental

A comparison of the Managed Choice Open Access 1500 with Dental 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 up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Great American — Managed Choice Open Access 2500 with Dental

A comparison of the Managed Choice Open Access 2500 with Dental 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $30 copay deductible waived (Unlimited Visits), Specialist Visit: $40 copay deductible waived (Unlimited Visits)	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.
Copay	Non-Specialist Office Visit: $30 copay deductible waived (Unlimited Visits), Specialist Visit: $40 copay deductible waived (Unlimited Visits)	Non-specialist Office Visit: 50% after deductible, Specialist Visit: 50% after deductible.mited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Great American — Managed Choice Open Access 3500 with Dental

A comparison of the Managed Choice Open Access 3500 with Dental 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	60% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-specialist: $35 copay deductible waived, Specialist: $45 copay deductible waived	Non-specialist Office Visit: 70% after deductible, Specialist Visit: 70% after deductible
Copay	Non-specialist: $35 copay deductible waived, Specialist: $45 copay deductible waived	Non-specialist Office Visit: 70% after deductible, Specialist Visit: 70% after deductible
Deductible	Individual: $3,500, Family: $7,000	Individual: $7,000, Family: $14,000

Great American — Managed Choice Open Access 5000 with Dental

A comparison of the Managed Choice Open Access 5000 with Dental 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	60% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $40 copay deductible waived (Unlimited visits), Specialist Visit: $50 copay deductible waived (Unlimited visits)	Non-specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit: $40 copay deductible waived (Unlimited visits), Specialist Visit: $50 copay deductible waived (Unlimited visits)Unlimited visits)	Non-specialist Office Visit: 70% after deductible (Unlimited visits), Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Great American — Managed Choice Open Access Value 2000 with Dental

A comparison of the Managed Choice Open Access Value 2000 with Dental 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	60% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Visits 1-6 $40 copay, ded. Waived; Visits 7+ 70% after ded. Specialist Visits 1-6 $50 copay, ded. Waived; Visits 7+ 70% after ded. Specialist and Non-Specialist share visit max.	Non-Specialist: 70% after deductible, Specialist: 70% after deductible
Copay	Non-Specialist Visits 1-6 $40 copay, ded. Waived; Visits 7+ 70% after ded. Specialist Visits 1-6 $50 copay, ded. Waived; Visits 7+ 70% after ded. Specialist and Non-Specialist share visit max.	Non-Specialist: 70% after deductible, Specialist: 70% after deductible
Deductible	Individual: $2,000, Family: $4,000	Individual: $4,000, Family: $8,000

Great American — Managed Choice Open Access Value 5000 with Dental

A comparison of the Managed Choice Open Access Value 5000 with Dental 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist: 70% after deductible, Specialist: 70% after deductible	Non-Specialist: 50% after deductible (Unlimited visits), Specialist: 50% after deductible (Unlimited visits)
Copay	Non-Specialist: 70% after deductible, Specialist: 70% after deductible	Non-Specialist: 50% after deductible (Unlimited visits), Specialist: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Great American — Managed Choice Open Access Value 10000 with Dental

A comparison of the Managed Choice Open Access Value 10000 with Dental 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 up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits); Specialist Visit: Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits, Specialist and Non-Specialist share visit max.)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deductible waived, plus 70% coinsurance. Thereafter, 3+ visits 50% coinsurance after deductible (Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deductible waived, plus 70% coinsurance. Thereafter, 3+ visits 50% coinsurance after deductible (Unlimited visits, Specialist and Primary share visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits); Specialist Visit: Visit 1-2 $30 copay, deductible waived. Visit 3+ 70% after deductible (Unlimited visits, Specialist and Non-Specialist share visit max.)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deductible waived, plus 70% coinsurance. Thereafter, 3+ visits 50% coinsurance after deductible (Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deductible waived, plus 70% coinsurance. Thereafter, 3+ visits 50% coinsurance after deductible (Unlimited visits, Specialist and Primary share visits)
Deductible	Individual: $10,000, Family: $20,000	Individual: $10,000, Family: $20,000

Great American — Managed Choice Open Access High Deductible 3000 (HSA Compatible) with Dental

A comparison of the Managed Choice Open Access High Deductible 3000 (HSA Compatible) with Dental 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: 100% after deductible (Unlimited Visits), Specialist Visit: 100% after deductible (Unlimited Visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit: 100% after deductible (Unlimited Visits), Specialist Visit: 100% after deductible (Unlimited Visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited Visits), Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Great American — Managed Choice Open Access High Deductible 5000 (HSA Compatible) with Dental

A comparison of the Managed Choice Open Access High Deductible 5000 (HSA Compatible) with Dental 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: 100% after deductible (Unlimited visits), Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit: 70% after deductible (Unlimited Visits), Specialist Visit: 70% after deductible (Unlimited Visits)Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialis
Copay	Non-Specialist Office Visit: 100% after deductible (Unlimited visits), Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit: 70% after deductible (Unlimited Visits), Specialist Visit: 70% after deductible (Unlimited Visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Great American — Preventive and Hospital Care 1250 with Dental

A comparison of the Preventive and Hospital Care 1250 with Dental 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 up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Not covered	Not covered
Copay	Not covered	Not covered
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Great American — Preventive and Hospital Care 3000 (HSA Compatible) with Dental

A comparison of the Preventive and Hospital Care 3000 (HSA Compatible) with Dental 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 up to out-of-pocket max.	50% after deductible up to out-of-pocket max.
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Great American — Managed Choice Open Access 7500 with Unlimited Primary Care Visits plus Dental

A comparison of the Managed Choice Open Access 7500 with Unlimited Primary Care Visits plus Dental 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 up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	60% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: 80% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 60% after deductible (Unlimited visits); Specialist Visit: 60% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: 80% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 60% after deductible (Unlimited visits); Specialist Visit: 60% after deductible (Unlimited visits)
Deductible	Individual: $7,500, Family: $15,000	Individual: $10,000, Family: $20,000

Great American — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Select PPO Plan

A comparison of the CeltiCare Preferred Select PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred "Any Doc" PPO Plan

A comparison of the CeltiCare Preferred "Any Doc" PPO 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $1,500, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — CeltiCare Preferred Managed Indemnity Plan

A comparison of the CeltiCare Preferred Managed Indemnity 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	see brochure	see brochure
Office Visit	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Copay	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins	Select: $15 copay Any Doc: $35 copay 2 visits per person, per calendar year; 3+ visits subject to ded./coins
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — Celtic Basic - Prescription Drug Card Option

A comparison of the Celtic Basic - Prescription Drug Card Option offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — Celtic Basic - Prescription Drug Card Option

A comparison of the Celtic Basic - Prescription Drug Card Option offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — Celtic Basic - Prescription Drug Card Option

A comparison of the Celtic Basic - Prescription Drug Card Option offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Great American — Celtic Basic

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $1,500, Family: Up to 3 times the individual deductible	Out of Network Deductible is $1500 + Annual Deductible

Great American — Celtic Basic

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $1,500, Family: Up to 3 times the individual deductible	Out of Network Deductible is $1500 + Annual Deductible

Great American — Celtic Basic

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $1,500, Family: Up to 3 times the individual deductible	Out of Network Deductible is $1500 + Annual Deductible

Great American — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health 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	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$5,000	$5,000

Great American — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health 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	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$2,600	$2,600

Great American — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health 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	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$1,500	$1,500

Great American — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health 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	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$2,600	$2,600

Great American — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health 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	see brochure	see brochure
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$1,500	$1,500

Great American — CelticSaver HSA Indemnity Health Plan

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

	Network