Cost of Coverage The cost you pay to be enrolled in insurance coverage. You and your employer share this cost. Your portion is paid through pre-tax payroll deductions each period. HEALTHCARE COSTS - EXPLAINED You share the cost of services with the insurance plans you select. As you review your plan options you should consider the different types of costs associated with insurance coverage. The amounts below are examples only, please refer to your specific plan for the exact amounts. Premium A flat fee you pay up front at the time you receive a service. For example, you need to see a Primary Care Physician, you may have a set copay for each visit. Copay The % of a covered service's cost that a patient pays after meeting their deductible. You and the insurance company each pay a share of the cost, with the percentages adding up to 100%. For example, if your plan has an 80%/20% coinsurance structure, you pay the first 20% of the cost and the insurance company pays the remaining 80%. Coinsurance The maximum amount of money you pay for covered services in a plan year. Once you reach your out-of-pocket maximum, the insurance company pays 100% of covered costs for the rest of the plan year. For example, if your plan has a $30 copay for a visit to the primary care doctor, that $30 would count toward your out-of-pocket maximum for the year. Out-of-Pocket Maximum A fixed amount you must pay for covered services each plan year before the insurance company will pay their portion. For example, if you have a $2,000 deductible and receive a medical bill for $3,500, you pay the first $2,000 and the insurance company pays their portion of the remaining $1,500. Deductible 5