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Great American Health Insurance in TEXAS – Health Plan Options

Great American — Patriot Class 1

A comparison of the Patriot Class 1 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	see brochure	see brochure
Deductible	see brochure	see brochure

Great American — Patriot Class 3

A comparison of the Patriot Class 3 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	see brochure	see brochure
Deductible	see brochure	see brochure

Great American — Patriot Class 4

A comparison of the Patriot Class 4 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Copay	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Deductible	N/A	N/A

Great American — Patriot Class 5

A comparison of the Patriot Class 5 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Copay	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Deductible	N/A	N/A

Great American — Open Access 1000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 80% after plan deductible	CIGNA pays 60% after plan deductible
Office Visit	Primary Care Physician - $25 copay (deductible waived), Specialist - $50 copay (deductible waived)	CIGNA pays 60% after plan deductible
Copay	Primary Care Physician - $25, Specialist - $50	CIGNA pays 60% after plan deductible
Deductible	Individual: $1,000, Family: $2,000	Individual: $2,000, Family: $4,000

Great American — Open Access 2000

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

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

Great American — Open Access 3000

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

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

Great American — Open Access 5000

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

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

Great American — Health Savings 1500

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

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

Great American — Health Savings 3000

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 100% after plan deductible	CIGNA pays 60% after plan deductible
Office Visit	Primary Care Physician/Specialist- CIGNA pays 100% after plan deductible	Primary Care Physician/Specialist- CIGNA pays 60% after plan deductible
Copay	N/A	N/A
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family; $12,000

Great American — Health Savings 5000

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

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

Great American — Open Access 7500

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 100% of eligible charges	CIGNA pays 70% of eligible charges
Office Visit	Primary Care Physician: $30 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled, Specialist: CIGNA pays 70% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $7,500, Family: $15,000	Individual: $15,000, Family: $30,000

Great American — Open Access 10000

A comparison of the Open Access 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	CIGNA pays 100% of eligible charges	CIGNA pays 70% of eligible charges
Office Visit	Primary Care Physician: $30 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled, Specialist: CIGNA pays 70% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $10,000, Family: $20,000	Individual: $15,000, Family: $30,000

Great American — Open Access Value 1500

A comparison of the Open Access Value 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 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: $40 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 50% after deductible is fulfilled, Specialist: CIGNA pays 50% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Great American — Open Access Value 2500

A comparison of the Open Access Value 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	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: $40 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 50% after deductible is fulfilled, Specialist: CIGNA pays 50% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Great American — Open Access Value 5000

A comparison of the 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	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: $40 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 50% after deductible is fulfilled, Specialist: CIGNA pays 50% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Great American — Open Access Value 7500

A comparison of the Open Access Value 7500 offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: $40 copay, Specialist: $60 copay	Primary Care Physician: CIGNA pays 50% after deductible is fulfilled, Specialist: CIGNA pays 50% after deductible is fulfilled
Copay	Primary Care Physician: $30; Specialist: $60	CIGNA pays 50% after plan deductible
Deductible	Individual: $7,500, Family: $15,000	Individual: $15,000, Family: $30,000

Great American — Open Access Value 10000

A comparison of the 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	CIGNA pays 70% of eligible charges	CIGNA pays 50% of eligible charges
Office Visit	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled, Specialist: CIGNA pays 70% after deductible is fulfilled	Primary Care Physician: CIGNA pays 50% after deductible is fulfilled, Specialist: CIGNA pays 50% after deductible is fulfilled
Copay	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled; Specialist: CIGNA pays 70% after deductible is fulfilled	Primary Care Physician: CIGNA pays 70% after deductible is fulfilled; Specialist: CIGNA pays 70% after deductible is fulfilled
Deductible	Individual: $10,000, Family: $20,000	Individual: $15,000, Family: $40,000

Great American — Short Term Medical

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

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

Great American — Short Term Medical

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

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

Great American — Short Term Medical

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

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

Great American — Short Term Medical

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

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

Great American — Short Term Medical

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

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

Great American — Short Term Medical

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

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

Great American — Short Term Medical

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

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

Great American — Short Term Medical

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

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

Great American — Short Term Medical

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

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

Great American — Short Term Medical

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

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

Great American — Short Term Medical

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

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

Great American — 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 — MedOne Plus- PPO Benefit Plan

A comparison of the MedOne Plus- PPO Benefit 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	see brochure	Subject to deductible, then coinsurance
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Great American — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% 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	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Great American — MedOne Plus- PPO Benefit Plan

A comparison of the MedOne Plus- PPO Benefit 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	see brochure	Subject to deductible, then coinsurance
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Great American — MedOne- HSAvings Individual

A comparison of the MedOne- HSAvings Individual 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, then coinsurance.	Subject to deductible, then coinsurance.
Copay	N/A	N/A
Deductible	$2,800	$5,600

Great American — MedOne- HSAvings Individual with Wellness

A comparison of the MedOne- HSAvings Individual with Wellness 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 100%	Plan pays 70%
Office Visit	Subject to deductible, then coinsurance.	Subject to deductible, then coinsurance.
Copay	N/A	N/A
Deductible	$2,600	$5,200

Great American — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% 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	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Great American — MedOne Security- PPO Facility Copay Plan

A comparison of the MedOne Security- PPO Facility Copay 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	$30 Copay then 100%	Subject to deductible, then 70% coinsurance.
Copay	$30	N/A
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Great American — MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50% 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	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Great American — MedOne Security- PPO Facility Copay Plan

A comparison of the MedOne Security- PPO Facility Copay 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	$30 Copay then 100%	Subject to deductible, then 70% coinsurance.
Copay	$30	N/A
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Great American — MedOne Plus- PPO Benefit Plan

A comparison of the MedOne Plus- PPO Benefit 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	see brochure	Subject to deductible, then coinsurance
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Great American — MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50% 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	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Great American — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% 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	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 Silver Single Series with 12 Month Rate Guarantee, Lifetime Max $5 Million

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50% after deductible	70% after deductible
Office Visit	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist	Choice of four or unlimited office copays; $15 Primary Care Physician/$60 Specialist
Copay	Unlimited Visits- $15 Primary Care Physician/$60 Specialist	Unlimited Visits- $15 Primary Care Physician/$60 Specialist
Deductible	$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 Gold Series with 24 Month Rate Guarantee, Unlimited Visits, Lifetime Max $2 Million

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Great American — Community Flex 60

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

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

Great American — Community Flex 60

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

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

Great American — Community Flex 80

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

Great American — Community Flex 100

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

Great American — Community Flex 60

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

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

Great American — Community Flex 80

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

Great American — Community Flex 60

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

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

Great American — Community Flex 80

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

Great American — Community Flex 100

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

Great American — Community Flex 60

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

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

Great American — Community Flex 80

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

Great American — Community Flex 60

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

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

Great American — Community Flex 80

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

Great American — Community Flex 100

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

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 80

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

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 60

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

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

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 60

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

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

Great American — Community Flex 100 with Gold Benefits Option

A comparison of the Community Flex 100 with Gold Benefits 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	In-Network: Deductible, then 100%	In-Network: Deductible, then 100%
Copay	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $5,000, Family: $10,000	In-Network:Individual: $5,000, Family: $10,000

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 80

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

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Community Flex 80

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

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 100 with Gold Benefits Option

A comparison of the Community Flex 100 with Gold Benefits 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	In-Network: Deductible, then 100%	In-Network: Deductible, then 100%
Copay	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $5,000, Family: $10,000	In-Network:Individual: $5,000, Family: $10,000

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 100 with Gold Benefits Option

A comparison of the Community Flex 100 with Gold Benefits 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	In-Network: 100% coinsurance	In-Network: 100% coinsurance
Office Visit	In-Network: Deductible, then 100%	In-Network: Deductible, then 100%
Copay	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $5,000, Family: $10,000	In-Network:Individual: $5,000, Family: $10,000

Great American — Community Flex 60

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

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

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 60

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

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

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Community Flex 80

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

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Community Flex 60

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

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

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 80

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

Great American — Community Flex 60

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

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

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 80

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

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 80

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

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 60

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

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

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 60

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

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

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Next Generation HSA

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — Community Flex 80 with Gold Benefits Option

A comparison of the Community Flex 80 with Gold Benefits 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	In-Network: 80% coinsurance	In-Network: 80% coinsurance
Office Visit	In-Network: $30 for Office Visit/$60 for Urgent Care	$30 for Office Visit/$60 for Urgent Care
Copay	In-Network:$30 for Office Visit/$60 for Urgent Care	In-Network:$30 for Office Visit/$60 for Urgent Care
Deductible	In-Network:Individual: $1,500, Family: $3,000	In-Network:Individual: $1,500, Family: $3,000

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — Community Flex 60 with Gold Benefits Option

A comparison of the Community Flex 60 with Gold Benefits 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	In-Network: 60% coinsurance	In-Network: 60% coinsurance
Office Visit	In-Network: $40 for Office Visit/$80 for Urgent Care	In-Network: $40 for Office Visit/$80 for Urgent Care
Copay	In-Network:$40 for Office Visit/$80 for Urgent Care	In-Network:$40 for Office Visit/$80 for Urgent Care
Deductible	In-Network:Individual: $7,500, Family: $15,000	In-Network:Individual: $7,500, Family: $15,000

Great American — PPO Select Value Care - Plan I

A comparison of the PPO Select Value Care - Plan I offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	50% of Allowable Amount	50% of Allowable Amount
Copay	N/A	N/A
Deductible	N/A	N/A

Great American — PPO Select Value Care - Plan II

A comparison of the PPO Select Value Care - Plan II offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	50% of Allowable Amount	50% of Allowable Amount
Copay	N/A	N/A
Deductible	N/A	N/A

Great American — PPO Select Value Care - Plan III

A comparison of the PPO Select Value Care - Plan III offered by Great American is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	50% of Allowable Amount	50% of Allowable Amount
Copay	N/A	N/A
Deductible	N/A	N/A

Great American — Foundation Hospital Care

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	BCBSTX pays 80%, insured pays 20%	BCBSTX pays 60%, insured pays 40%
Office Visit	Not Covered	Not Covered
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000	Individual: $10,000, Family: $30,000

Great American — Select Blue Advantage - Plan I

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$250 Individual/$750 Family	$500 Individual/$1,500 Family

Great American — Select Blue Advantage - Plan II

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Great American — Select Blue Advantage - Plan III

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Great American — Select Blue Advantage - Plan IV

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,500 Individual/$4,500 Family	$3,000 Individual/$9,000 Family

Great American — Select Blue Advantage - Plan V

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Great American — Select Blue Advantage - Plan VI

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$3,500 Individual/$10,500 Family	$7,000 Individual/$21,000 Family

Great American — Select Blue Advantage - Plan VII

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Great American — Select Blue Advantage - Plan VIII

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$10,000 Individual/$30,000 Family	$20,000 Individual/$60,000 Family

Great American — PPO Select Choice - Plan I

A comparison of the PPO Select Choice - Plan I 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$250 Individual/$750 Family	$500 Individual/$1,500 Family

Great American — PPO Select Choice - Plan II

A comparison of the PPO Select Choice - Plan II 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Great American — PPO Select Choice - Plan III

A comparison of the PPO Select Choice - Plan III 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Great American — PPO Select Choice - Plan IV

A comparison of the PPO Select Choice - Plan IV 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,500 Individual/$4,500 Family	$3,000 Individual/$9,000 Family

Great American — PPO Select Choice - Plan V

A comparison of the PPO Select Choice - Plan V 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Great American — PPO Select Choice - Plan VI

A comparison of the PPO Select Choice - Plan VI 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$3,500 Individual/$10,500 Family	$7,000 Individual/$21,000 Family

Great American — PPO Select Choice - Plan VII

A comparison of the PPO Select Choice - Plan VII 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Great American — PPO Select Choice - Plan VIII

A comparison of the PPO Select Choice - Plan VIII 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% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$10,000 Individual/$30,000 Family	$20,000 Individual/$60,000 Family

Great American — PPO Select Saver - Plan I

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Great American — PPO Select Saver - Plan II

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Great American — PPO Select Saver - Plan III

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,500 Individual/$4,500 Family	$3,000 Individual/$9,000 Family

Great American — PPO Select Saver - Plan IV

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Great American — PPO Select Saver - Plan V

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$3,500 Individual/$10,500 Family	$7,000 Individual/$21,000 Family

Great American — PPO Select Saver - Plan VI

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Great American — PPO Select Saver - Plan VII

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$10,000 Individual/$30,000 Family	$20,000 Individual/$60,000 Family

Great American — BlueEdge Individual HSA - Plan I

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% of Allowable Amount after Calendar Year Deductible	70% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	see brochure	see brochure

Great American — BlueEdge Individual HSA - Plan II

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% of Allowable Amount after Calendar Year Deductible	70% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,750, Family: $3,500	Individual: $3,500, Family: $7,000

Great American — BlueEdge Individual HSA - Plan III

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

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% of Allowable Amount after Calendar Year Deductible	70% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Great American — BlueEdge Individual HSA - Plan IV

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

	Network	Non-Network