|  | | |
| Plan | Value Alliance HMO BR-TW 40%/7200 ded | Value Alliance HMO BR-T2 0%/6900 ded | Value Alliance HMO BR-TU 0%/6900 ded |
| Metal | Bronze | Bronze | Silver |
| Network | Value Alliance HMO | Value Alliance HMO | Value Alliance HMO |
| Deductible | $7200/$14,400 family | $6900/$13,800 family | $6900/$13,800 family |
| Coinsurance | 60% coverage (after deductible) | 100% coverage for most services | 100% coverage for most services |
| Out of Pocket Mzx | $8150 ($16,300 family) | $6900 ($13,800 family) | $6900 ($13,800 family) |
| Ambulance | 60% coverage (after deductible) | 100% after ded | 100% after ded |
| Chiropractor | Not covered | Not covered | Not covered |
| Durable Med Equip | 60% coverage (after deductible) | 100% after ded | 100% after ded |
| Emergency Room | 60% coverage (after deductible) | 100% coverage after ded | 100% after ded |
| Hospital | 60% coverage (after deductible) | 100% coverage after ded | 100% after ded |
| Infertility | Optional | Optional | Optional |
| Lab & X-Ray | 60% coverage (after deductible) | 100% coverage after ded | 100% after ded |
| Office Visit | 60% coverage (after deductible) | 100% coverage after ded | 100% after ded |
| Specialist | 60% coverage (after deductible) | 100% coverage after ded | 100% after ded |
| Outpatient Surgery | 60% coverage (after deductible) | 100% coverage after ded | 100% after ded |
| Physical Therapy | 60% coverage (after deductible) | 100% coverage after ded | 100% after ded |
| Inpatient Psych | 60% coverage (after deductible) | 100% coverage after ded | 100% after ded |
| Outpatient Psych | 60% coverage (after deductible) | 100% coverage after ded | 100% after ded |
| Rx Tier 1 | 60% coverage after med ded (max $500) | 100% coverage after ded | 100% after ded |
| Rx Tier 2 | 60% coverage after med ded (max $500) | 100% coverage after ded | 100% after ded |
| Rx Tier 3 | 60% coverage after med ded (max $500) | 100% coverage after ded | 100% after ded |
| Rx Tier 4 | 60% coverage after med ded (max $500) | 100% coverage after ded | 100% after ded |
| Links | Brochure Formulary Providers | Brochure Formulary Providers | Brochure Formulary Providers |
| Addie Joss | 264.64 | 276.83 | 276.83 |
| Alec Bailey | 602.47 fam 1171.6 | 630.22 fam 1225.56 | 630.22 fam 1225.56 |
| Allisan Porter | 273.03 | 285.61 | 285.61 |
| Anne Murray | 234.65 | 245.46 | 245.46 |
| Barbara Mamdrell | 210.54 fam 370.96 | 220.24 fam 388.05 | 220.24 fam 388.05 |
| Barbi Benton | 238.01 | 248.97 | 248.97 |
| Billie Ry Cyrus | 327.76 | 342.86 | 342.86 |
| Blaze Foley | 234.65 | 245.46 | 245.46 |
| Bob Feller | 214.73 fam 745.27 | 224.62 fam 779.6 | 224.62 fam 779.6 |
| Brantley Gilbert | 447.71 | 468.33 | 468.33 |
| Carl Hubbell | 209.7 | 219.36 | 219.36 |
| Carrie Underwood | 210.54 | 220.24 | 220.24 |
| Conway Twitty | 210.54 fam 370.96 | 220.24 fam 388.05 | 220.24 fam 388.05 |
| David Valdez | 257.93 | 269.81 | 269.81 |
| Debbie Boone | 467.63 fam 1001.95 | 489.17 fam 1048.1 | 489.17 fam 1048.1 |
| Dolly Parton | 342.86 | 358.65 | 358.65 |
| Donna Douglas | 264.64 | 276.83 | 276.83 |
| Eddie Collins | 257.93 | 269.81 | 269.81 |
| Elizabeth Lyons | 292.95 fam 1071.77 | 306.45 fam 1121.15 | 306.45 fam 1121.15 |
| Elvis Presley | 273.03 | 285.61 | 285.61 |
| Emi Sunshine | 254.58 | 266.3 | 266.3 |
| Ernie Banks | 264.64 | 276.83 | 276.83 |
| Evan Felker | 569.13 | 595.34 | 595.34 |
| Faith Hill | 357.75 | 374.23 | 374.23 |
| Fergie Jenkins | 327.76 | 342.86 | 342.86 |
| Gary Allen | 302.81 | 316.76 | 316.76 |
| Geogia Holt | 302.81 | 316.76 | 316.76 |
| George Brett | 602.47 | 630.22 | 630.22 |
| Greg Maddux | 257.93 | 269.81 | 269.81 |
| Hank Greenberg | 256.25 | 268.06 | 268.06 |
| Helen Carter | 264.64 | 276.83 | 276.83 |
| Hunter Hayes | 210.54 fam 741.92 | 220.24 fam 776.1 | 220.24 fam 776.1 |
| Jackie Robinson | 273.03 | 285.61 | 285.61 |
| Jane Doe | 256.25 | 268.06 | 268.06 |
| Jerry Smith | 251.22 fam 828.31 | 262.79 fam 866.47 | 262.79 fam 866.47 |
| Jimmy Buffet | 214.73 | 224.62 | 224.62 |
| Joe Medwick | 259.61 | 271.57 | 271.57 |
| Joe Morgan | 227.94 | 238.44 | 238.44 |
| Joe Namath | 409.33 fam 767.08 | 428.19 fam 802.42 | 428.19 fam 802.42 |
| John Denver | 210.54 | 220.24 | 220.24 |
| John Williamson | 357.75 | 374.23 | 374.23 |
| Johnny Cash | 569.13 | 595.34 | 595.34 |
| Jsssi Colter | 273.03 | 285.61 | 285.61 |
| Katie Stevens | 545.85 | 570.99 | 570.99 |
| Kayne Brown | 264.64 | 276.83 | 276.83 |
| Keith Urban | 619.03 fam 1208.29 | 647.55 fam 1263.95 | 647.55 fam 1263.95 |
| Keithh Wlhitley | 248.08 | 259.5 | 259.5 |
| Kenny Rogers | 619.03 fam 1188.16 | 647.55 fam 1242.89 | 647.55 fam 1242.89 |
| Kinky Friedman | 342.86 fam 683.41 | 358.65 fam 714.89 | 358.65 fam 714.89 |
| Kirby Buckett | 314.55 | 329.04 | 329.04 |
| Lann Kifflin | 467.63 fam 915.34 | 489.17 fam 957.5 | 489.17 fam 957.5 |
| Larry Fine | 302.81 | 316.76 | 316.76 |
| Lean Rimes | 447.71 | 468.33 | 468.33 |
| Lefty Grove | 327.76 | 342.86 | 342.86 |
| Leon Spinks | 327.76 | 342.86 | 342.86 |
| Linda Rondstat | 314.55 | 329.04 | 329.04 |
| Lionel Richie | 447.71 | 468.33 | 468.33 |
| Loretta Lynn | 248.08 | 259.5 | 259.5 |
| Lorrie Morgan | 219.77 fam 594.92 | 229.89 fam 622.32 | 229.89 fam 622.32 |
| Luke Benward | 427.79 | 447.49 | 447.49 |
| Maren Morris | 342.86 | 358.65 | 358.65 |
| Marty Robins | 619.03 | 647.55 | 647.55 |
| Mel Ott | 447.71 | 468.33 | 468.33 |
| Mickey Cochrane | 409.33 | 428.19 | 428.19 |
| Mickie James | 257.93 | 269.81 | 269.81 |
| Miley Cyrus | 327.76 fam 1183.75 | 342.86 fam 1238.29 | 342.86 fam 1238.29 |
| Miranda Lambert | 209.7 | 219.36 | 219.36 |
| Moe Howard | 391.09 | 409.11 | 409.11 |
| Nap Lajoie | 234.65 | 245.46 | 245.46 |
| Nolan Ryan | 302.81 fam 595.76 | 316.76 fam 623.21 | 316.76 fam 623.21 |
| Olivia Newton John | 534.32 fam 962.11 | 558.93 fam 1006.42 | 558.93 fam 1006.42 |
| Patsy Cline | 257.93 | 269.81 | 269.81 |
| Pebe Sebert | 243.04 fam 452.74 | 254.24 fam 473.6 | 254.24 fam 473.6 |
| Pete Rose | 545.85 | 570.99 | 570.99 |
| Randy Travis | 545.85 | 570.99 | 570.99 |
| Rhyne Sandberg | 292.95 fam 1134.9 | 306.45 fam 1187.18 | 306.45 fam 1187.18 |
| Riba McEntire | 209.7 fam 370.12 | 219.36 fam 387.17 | 219.36 fam 387.17 |
| Roger Clemens | 273.03 | 285.61 | 285.61 |
| Ron Settles | 209.7 | 219.36 | 219.36 |
| Ronnie Milsap | 302.81 | 316.76 | 316.76 |
| Rory Feek | 257.93 | 269.81 | 269.81 |
| Rube Waddell | 489.23 | 511.77 | 511.77 |
| Ruston Kelly | 210.54 | 220.24 | 220.24 |
| Sam Hunt | 489.23 | 511.77 | 511.77 |
| Scotty McReary | 234.65 | 245.46 | 245.46 |
| Shawnee Smith | 210.54 | 220.24 | 220.24 |
| Sheryl Crow | 342.86 | 358.65 | 358.65 |
| Steve Carlton | 534.32 fam 943.65 | 558.93 fam 987.12 | 558.93 fam 987.12 |
| Sturgill Simpson | 327.76 fam 941.55 | 342.86 fam 984.93 | 342.86 fam 984.93 |
| Tammy Wynette | 257.93 | 269.81 | 269.81 |
| Taylor Die | 327.76 | 342.86 | 342.86 |
| Taylor Swift | 248.08 | 259.5 | 259.5 |
| Thomas Rhett | 409.33 fam 783.85 | 428.19 fam 819.97 | 428.19 fam 819.97 |
| Tom Seaver | 302.81 | 316.76 | 316.76 |
| Tony Gwynn | 447.71 fam 667.48 | 468.33 fam 698.22 | 468.33 fam 698.22 |
| Trace Adloms | 292.95 | 306.45 | 306.45 |
| Tris Speaker | 342.86 | 358.65 | 358.65 |
| Warren Spahn | 256.25 | 268.06 | 268.06 |
| Willie Jones | 409.33 | 428.19 | 428.19 |
| Yogi Berra | 302.81 | 316.76 | 316.76 |
| Total | 33248.35 w deps 44176.23 | 34779.92 w deps 46211.20 | 34779.92 w deps 46211.20 |