ACA Eligible Medical Plan

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Coverage That Checks The Box — And Covers Your Basics

Welcome to our dedicated space for ACA Eligible Team Members who are exploring or navigating their health insurance options under the Affordable Care Act (ACA).

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What Does ACA Eligible Mean?

Being ACA Eligible simply means that you meet certain criteria set by the Affordable Care Act (ACA), making you qualified to enroll in health insurance plans offered through the ACA marketplace. These criteria include aspects like your income level, your citizenship, or legal residency status, and not having access to affordable health insurance through an employer or a government program like Medicare or Medicaid.

Plan Features
TAG Essential
In-Network
You pay: (after deductible)
Annual Deductible
Individual/Family
$6,000 / $12,000
Annual Out-of-Pocket Maximum
Individual/Family
$9,100 / $18,200
Preventive Care Visit
Covered in full*
Telehealth
$20 copay*
Primary Care
$20 copay*
Specialist
$50 copay*
Urgent Care
$50 copay*
Emergency Room**
$300 copay**
Hospital
20%
Prescription Drugs: Retail (up to a 30-day supply) / Mail Order (up to a 90-day supply)
Generic
$15 copay* / $30 copay*
Preferred Brand
$30 copay* / $60 copay*
Non-Preferred Brand
$45 copay* / $90 copay*

* Deductible waived.

** Copay waived if admitted.

Digital Wellness Resource Center

Learn the Lingo

In-Network Care: In-network providers offer services at negotiated rates, resulting in cost savings for you.

Out-of-Network Care: When you receive care outside the plan's network, you may experience higher costs and balance billing.

Copay: A fixed dollar amount you pay at the time of service.

Deductible: The amount you pay each year before the plan begins paying benefits.

Out-of-Pocket Maximum: This is the most you'll pay for covered expenses in the plan year. Once you reach this limit, the plan covers the rest. This cap ensures you're protected from excessive costs.