OXFORD GOLD PLANS

OXFORD GOLD PLANS

Oxford partners with more than 1.3 million physicians and care professionals, and 6,500 hospitals and other care facilities nationwide . Together with health care professionals, they help people access the right care at the right time.

OXFORD LIBERTY GOLD EPO 25/50 ZD

Rates are for new and renewing groups effective 10/1/2024 — 12/1/2024

PLAN RATES (MONTHLY)

Employee
$1,395.13
Employee/Spouse (DP)
$2,784.31
Employee/Child(ren)
$2,367.56
Family (DP)
$3,965.12

PLAN HIGHLIGHTS

  • PCP/Specialist: $25/$50
  • Deductible, Coinsurance: $0, 0%
  • Max OOP: $7,000/$14,000
  • Rx: $10/$50/$90 after $200/member Rx deductible (n/a Tier 1)

OXFORD LIBERTY GOLD EPO 30/60 G

Rates are for new and renewing groups effective 10/1/2024 — 12/1/2024

PLAN RATES (MONTHLY)

Employee
$1,264.79
Employee/Spouse (DP)
$2,523.62
Employee/Child(ren)
$2,145.97
Family (DP)
$3,593.64

PLAN HIGHLIGHTS

  • PCP/Specialist: $30/$60  
  • Deductible, Coinsurance: $1,250/$2,500, 0%
  • Max OOP: $7,000/$14,000
  • Rx: $10/$50/$90 after $200/member Rx deductible (n/a Tier 1)

OXFORD LIBERTY GOLD HSA 1600 M

Rates are for new and renewing groups effective 10/1/2024 — 12/1/2024

PLAN RATES (MONTHLY)

Employee
$1,210.25
Employee/Spouse (DP)
$2,414.55
Employee/Child(ren)
$2,053.26
Family (DP)
$3,438.21

PLAN HIGHLIGHTS

  • PCP/Specialist: Deductible then 10% coinsurance
  • Deductible, Coinsurance: $1,600/$3,200, 10%
  • Max OOP: $5,750/$11,500
  • Rx: Deductible then $10/$50/$90

OXFORD LIBERTY GOLD EPO 30/60

Rates are for new and renewing groups effective 10/1/2024 — 12/1/2024

PLAN RATES (MONTHLY)

Employee
$1,247.72
Employee/Spouse (DP)
$2,489.48
Employee/Child(ren)
$2,116.95
Family (DP)
$3,544.98

PLAN HIGHLIGHTS

  • PCP/Specialist: $30/$60 
  • Deductible, Coinsurance: $1,800/$3,600, 30%
  • Max OOP: $8,000/$16,000
  • Rx: $10/$50/$90 after $200/member Rx deductible (n/a Tier 1)

OXFORD METRO GOLD EPO 25/40

Rates are for new and renewing groups effective 10/1/2024 — 12/1/2024

PLAN RATES (MONTHLY)

Employee
$1,184.93
Employee/Spouse (DP)
$2,363.90
Employee/Child(ren)
$2,010.22
Family (DP)
$3,366.04

PLAN HIGHLIGHTS

  • PCP/Specialist: $25/$40                                    
  • Deductible, Coinsurance: $1,250/$2,500, 20%
  • Max OOP: $6,500/$13,000
  • Rx: $10/$65/$95 after $150/member Rx deductible (n/a Tier 1)

OXFORD METRO GOLD EPO 25/40 G

Rates are for new and renewing groups effective 10/1/2024 — 12/1/2024

PLAN RATES (MONTHLY)

Employee
$1,143.99
Employee/Spouse (DP)
$2,282.04
Employee/Child(ren)
$1,940.62
Family (DP)
$3,249.37

PLAN HIGHLIGHTS

  • PCP/Specialist: $25/$40
  • Deductible, Coinsurance: $1,250/$2,500, 20%
  • Max OOP: $6,500/$13,000
  • Rx: $10/$65/$95 after $150/member Rx deductible (n/a Tier 1)

Carrier rates are subject to NYS Department of Financial Services approval and final verification at enrollment.
All plans above include $5.95 for HealthPass Program Benefits (non-carrier/agent services) and a 2.9% billing and administrative fee.