2015 Dean Health Plan Individual & Family Plan Book

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Metal Tiers refer to plans of varying cost and coverage. These are indicated by
four metal levels (or tiers): bronze, silver, gold, and platinum (Dean Health Plan does
not offer platinum plans on the Marketplace). These plans will all offer coverage of
the same Essential Health Benefits but with different out-of-pocket costs for things
like doctor or hospital visits. The level you buy determines 1) your monthly premium,
2) your cost-sharing amounts, and 3) your maximum out-of-pocket limit. In addition
to the metal tier options, there is an option called the Catastrophic Plan. It is only for
people under age 30 or who qualify through financial hardship. See the plan details
for more information on metal tiers and catastrophic coverage.
Preventive Care Benefits are services such as child immunizations and certain
cancer screenings. These benefits are covered with zero out-of-pocket cost to you
when you use in-network providers and all other criteria are met.
Health Insurance Marketplace (also referred to as the Exchange or
is a website where individuals can compare plans and purchase
health insurance. Individuals who qualify for federal assistance or tax breaks must
purchase through the Marketplace to take advantage of any cost sharing or
tax credits.
Essential Health Benefits are a set of benefits individual plans must now
cover. These Essential Health Benefits include things like preventive and wellness
services, maternity and newborn coverage, prescription drugs, doctor visits and
coverage for hospital stays. Most of these benefits were already covered by Dean
Health Plan long before this law came into effect, as we have always provided
comprehensive health services and valuable benefits through our health plans.