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Group Health Cooperative
and Group Health Options, Inc.
Group Health Cooperative and Group Health
Options, Inc., an affiliated company of Group Health Cooperative,
offer comprehensive and catastrophic individual and family health care plans,
including an HSA-qualified plan, available to people living
in 18 western and
eastern Washington state counties (click
here
for the counties and zip codes where Group Health is offered).
The plan offered by Group Health Cooperative (Welcome plan) is
an
HMO plan that requires you to use doctors, clinics and facilities
of Group Health Cooperative.
Click
here
for the provider directory (in the drop-down box choose "Group
Health").
The plans offered by Group Health Options, Inc. (Balance and HealthPays
plans) are
Point of Service
(POS)
plans in which you
can use Group Health
Cooperative providers along with Virginia Mason and Everett Clinic for
in-network services, and any other provider for out-of-network
services. Discounts are available using out-of-network providers
participating with First Choice Health and Beech Street networks (click
here for
provider directory; in the drop-down box choose "Alliant Plus" and
then click on "Out-of-network providers" on the right side).
Click on the green
"Welcome Plan", "Balance Plan" or "HealthPays HSA" titles below
or the links at the left to jump to
pages describing the plans in detail.
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Welcome Plan (offered by Group
Health Cooperative) |
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Welcome 500
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Welcome
1750
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Welcome
3500
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In-network benefits
only
(except in an emergency) using Group
Health Cooperative providers
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Annual deductible: $500, $1,750 or
$3,500
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Hospital inpatient copay (Welcome 500 only): $500 copay per day with 5-day copay maximum
($2,500 total) per inpatient admission
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Office
visits:
no deductible for 1st 5 office visits
per year (Welcome 500
pays 100% after $30 copay for the 1st 5 visits)
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Outpatient lab & x-ray: Welcome 500 (only) includes no deductible & 100%
coverage for the first $500 per year
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Other expenses: 80% (Welcome 500), 60% (Welcome 1750) or
50% (Welcome 3500) benefit
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Annual
coinsurance maximum: $4,000 (Welcome 500), $6,000 (Welcome
1750) or
$10,000 (Welcome 3500)
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Preventive care: covered
(no deductible)
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Prescription drugs: covered (Welcome
500 only)
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Maternity: covered (Welcome 500 only)
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Vision exam, lenses and frames:
covered
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Balance Plan
(offered by Group Health Options, Inc.) |
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Balance
1000
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Balance
1500
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Balance
2500
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Balance
5000
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In-network benefits (using
Group Health Cooperative, Virginia Mason & Everett Clinic
providers) and out-of-network benefits
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Annual deductible: $500, $1,500,
$2,500 or $5,000
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Office
visits:
100% coverage after $30 copay; in-network not subject to
deductible; out-of-network after deductible is satisfied
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Outpatient lab & x-ray:
100% coverage; in-network not subject to deductible;
out-of-network after deductible
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Other expenses: 80% (Balance 1000),
70% (Balance 1500), 60% (Balance 2500) or
50% (Balance 5000)
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Annual coinsurance maximum: $4,000, $6,000,
$8,000 or $10,000
corresponding to the plans shown above
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Preventive care: covered
(no deductible); no maximum for in-network benefits;
out-of-network benefits limited to $300 per person/$600 per family
per calendar year
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Prescription drugs: covered
(Balance 1000 and 1500 only)
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Maternity: covered
(Balance 1000 and 1500 only)
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Vision exam, lenses and frames:
covered
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HealthPays HSA (offered by Group
Health Options, Inc.) |
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Individual Plan
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Family
Plan
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In-network benefits (using
Group Health Cooperative, Virginia Mason & Everett Clinic
providers) and out-of-network benefits
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Annual deductible:
Individual Plan - $2,000; Family Plan - $4,000
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Benefit: 90% in-network; 80%
out-of-network
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Annual coinsurance maximum:
Individual Plan - $3,100; Family Plan - $6,200
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Preventive care: covered
(no deductible); no maximum for in-network benefits;
out-of-network benefits limited to $300 per person/$600 per family
per calendar year
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Not covered: prescription
drugs, maternity, vision
exam, lenses and frames
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