Premier $1,500 - 25%Premier $3,500 - 30%Premier $4,100 HDHPPremier $5,000 - 40%Premier $6,200 HDHPPremier $7,500Premier $9,200Premier HMO $1,500 - 30%Premier HMO $2,500 - 20% CopayPremier HMO $3,300 - 30% HDHPPremier HMO $3,500 - 30%Premier HMO $3,500 HDHPPremier HMO $4,000 - 20% HDHPPremier HMO $5,000 - 20% HDHPPremier HMO $5,500 - 30% CopayPremier HMO $7,050 HDHPPremier HMO $750 - 10%Premier HMO $9,100Premier POS $1,500 - 30%Premier POS $2,500 - 20% CopayPremier POS $3,300 - 30% HDHPPremier POS $3,500 - 30%Premier POS $3,500 HDHPPremier POS $4,000 - 20% HDHPPremier POS $5,000 - 20% HDHPPremier POS $5,500 - 30% CopayPremier POS $7,050 HDHPPremier POS $750 - 10%Premier POS $9,100Premier ProtectionReliance $1,500 - 30%Reliance $2,500 - 20% CopayReliance $3,300 - 30% HDHPReliance $3,500 - 30%Reliance $3,500 HDHPReliance $4,000 - 20% HDHPReliance $5,000 - 20% HDHPReliance $5,500 - 30% CopayReliance $7,050 HDHPReliance $750 - 10%Reliance $9,100Select $1,500 - 25%Select $3,500 - 30%Select $4,100 HDHPSelect $5,000 - 40%Select $6,200 HDHPSelect $7,500Select $9,200Select ProtectionEnrich $1,500 - 25%Enrich $1,500 - 30%Enrich $2,500 - 20% CopayEnrich $3,300 - 30% HDHPEnrich $3,500 - 30%Enrich $3,500 HDHPEnrich $4,000 - 20% HDHPEnrich $4,100 HDHPEnrich $5,000 - 20% HDHPEnrich $5,000 - 40%Enrich $5,500 - 30% CopayEnrich $6,200 HDHPEnrich $7,050 HDHPEnrich $7,500Enrich $750 - 10%Enrich $9,100Enrich $9,200Enrich ProtectionSimplyOne $1,500 - 25%SimplyOne $1,500 - 30%SimplyOne $2,500 - 20% CopaySimplyOne $3,300 - 30% HDHPSimplyOne $3,500 - 30%SimplyOne $3,500 HDHPSimplyOne $4,000 - 20% HDHPSimplyOne $4,100 HDHPSimplyOne $5,000 - 20% HDHPSimplyOne $5,000 - 40%SimplyOne $5,500 - 30% CopaySimplyOne $6,200 HDHPSimplyOne $7,050 HDHPSimplyOne $7,500SimplyOne $750 - 10%SimplyOne $9,100SimplyOne $9,200SimplyOne Protection