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Plans	Basic HMO				Value HMO			Premium HMO
Plans	HNE Wise^Plus HDHP M HMO	HNE Wise^Max HDHP H HMO	HNE Essential²⁰⁰⁰ HDHP H HMO	HNE Essential¹⁵⁰⁰	HNE Essential¹⁰⁰⁰	HNE Essential⁵⁰⁰	HNE Focus Option 8H	HNE Choice^PlusOption 7M	HNE Complete^Max Option 5	HNE Complete^PlusOption 7H	HNE Principle Option 4
Up-front deductible	$2,000 per individual $4,000 per family per policy OR calendar year	$2,000 per individual $4,000 per family per policy OR calendar year	$2,000 per individual $4,000 per family per policy OR calendar year	$1,500 per individual $3,000 per family per policy OR calendar year	$1,000 per individual $2,000 per family per policy OR calendar year	$500 per individual $1,000 per family per policy OR calendar year	N/A	N/A	N/A	N/A	N/A
Doctor’s Office	$0 Preventive Services $25 after deductible for all other office visits	$0 Preventive Services $25 after deductible for all other office visits	$0 Preventive Services $20 All other office visits	$0 Preventive Services $20 All other office visits	$0 Preventive Services $20 All other office visits	$0 Preventive Services $20 All other office visits	$0 Preventive Services $20 All other office visits	$0 Preventive Services $20 PCP $40 Specialist	$0 Preventive Services $20 All other office visits	$0 Preventive Services $10 PCP $25 Specialist	$0 Preventive Services $15
Emergency (waived if admitted directly from ER)	$100 after deductible	$0 after deductible	$150 per visit	$150 per visit	$150 per visit	$150 per visit	$150 per visit	$100 per visit	$100 per visit	$100 per visit	$100 per visit
High Cost Diagnostics: Diagnostic Imaging: CT Scans, MRI, PET Scans	$75 after deductible	$0 after deductible	$100 after deductible	$100 after deductible	$75 after deductible	$75 after deductible	$150	$75	$75	$75	$75
Sleep Studies	$75 after deductible	$0 after deductible	$100 after deductible	$100 after deductible	$75 after deductible	$75 after deductible	$150	$75	$75	$75	$75
Genetic Testing: BRCA & Colaris	$75 after deductible	$0 after deductible	$100 after deductible	$100 after deductible	$75 after deductible	$75 after deductible	$150	$75	$75	$75	$75
Outpatient Surgical	$250 after deductible	$0 after deductible	$0 after deductible	$0 after deductible	$0 after deductible	$0 after deductible	$500	$250	$250	$250	$150
Hospital Stay	$500 after deductible	$0 after deductible	$0 after deductible	$0 after deductible	$0 after deductible	$0 after deductible	$1,000	$500	$500	$500	$250
Out-of-Pocket Maximum	$5,000 per individual $10,000 per family	$5,000 per individual $10,000 per family	$4,000 per individual $8,000 per family	$3,000 per individual $6,000 per family	$2,000 per individual $4,000 per family	$2,000 per individual $4,000 per family	$2,000 per individual $4,000 per family	$1,000 per individual $2,000 per family	$1,000 per individual $2,000 per family	$1,000 per individual $2,000 per family	$500 per individual $1,000 per family
Out-of-Pocket Maximum Includes:	Deductible and copayments	Deductible and copayments	Deductible and services with a copayment of $100 or greater	Deductible and services with a copayment of $100 or greater	Deductible and services with a copayment of $100 or greater	Deductible and services with a copayment of $100 or greater	Services with a copayment of $100 or greater	Services with a copayment of $250 or greater	Services with a copayment of $250 or greater	Services with a copayment of $250 or greater	Services with copayment of $150 or greater
Prescription Drugs	Pharmacy Riders are available for all plans.								*HNE offers a PHCS PPO version of these plans. PHCS is a national PPO network of over 450,000 providers and 4,000 facilities to choose from.