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OMNIA Bronze HSA

The OMNIA Bronze Health Savings Account (HSA) Plan is our lowest premium Bronze plan and offers our lowest monthly premium and highest out-of-pocket costs when compared to other OMNIA Health Plans. Bronze plans, on average, pay for 60% of the covered medical expenses; you pay 40%. With HSA plans, you make tax-free contributions to your account to cover higher deductible costs in exchange for a significantly lower premium. The OMNIA Bronze HSA Plan is a good option for healthy members who don’t expect to use a lot of medical services but want coverage for unexpected health issues.

Features

  • Plan includes a Health Savings Account (HSA)
  • Coverage for preventive care and unexpected health issues
  • Coming in 2018 one-step easy access on your mobile phone to chat with a nurse, have a video consult with a doctor or make an office appointment.
  • Money back on gym memberships with HorizonbFit—Up to $240 per year*
  • Your premium may be less if you qualify for government financial assistance.—Use our online estimator.

*HorizonbFit is only available to individual consumers.

  OMNIA TIER 1 TIER 2  
Individual Deductible $3,000 $3,000
  • Save with OMNIA Tier 1, including some of NJ’s leading hospitals and 29,000 health care professionals*
  • Enjoy access to our entire Managed Care Network, the largest physician network in NJ*, with Tier 2 doctors and hospitals
  • No primary care physician required
  • No referrals needed
  • Prescription coverage included
  • pdf-form-icon Summary of Benefits and Coverage
Family Deductible $6,000 $6,000
Individual Max Out-of-Pocket $6,550 $6,550
Family Max Out-of-Pocket $13,100 $13,100
Primary Care Physician Visit Deductible then $30 copayment Deductible then 50% coinsurance
Specialist Visit Deductible then $50 copayment Deductible then 50% coinsurance
Outpatient Surgery Deductible then 50% coinsurance Deductible then 50% coinsurance
Inpatient Hospital Stay Deductible then $500 Per Day Copayment Deductible then 50% coinsurance
Emergency Room $100 copayment & deductible, then 50% coinsurance $100 copayment & deductible, then 50% coinsurance

*Based on physician data as of 8/28/17 and is subject to change.

OMNIA Silver

The OMNIA Silver Plan is our lowest premium Silver plan and offers a mid-level monthly premium and out-of-pocket costs when compared to other OMNIA Health Plans. Silver plans, on average, pay for 70% of the covered medical expenses; you pay 30%, and cost-sharing subsidies may be available. The OMNIA Silver Plan is a good choice if you want a balance between monthly premiums and out-of-pocket costs.

Features

  • Our lowest premium, non-HSA, Silver plan
  • A balance between monthly premiums and out-of-pocket costs
  • Coming in 2018 one-step easy access on your mobile phone to chat with a nurse, have a video consult with a doctor or make an office appointment.
  • Money back on gym memberships with HorizonbFit—Up to $240 per year*
  • Your premium may be less if you qualify for government financial assistance.—Use our online estimator

*HorizonbFit is only available to individual consumers.

  OMNIA TIER 1 TIER 2  
Individual Deductible $1,500 $2,500
  • Save with OMNIA Tier 1, including some of NJ’s leading hospitals and 29,000 health care professionals*
  • Enjoy access to our entire Managed Care Network, the largest physician network in NJ*, with Tier 2 doctors and hospitals
  • No primary care physician required
  • No referrals needed
  • Prescription coverage included
  • pdf-form-icon Summary of Benefits and Coverage
Family Deductible $3,000 $5,000
Individual Max Out-of-Pocket $7,350 $7,350
Family Max Out-of-Pocket $14,700 $14,700
Primary Care Physician Visit $30 copayment Deductible then 50% coinsurance
Specialist Visit $50 copayment Deductible then 50% coinsurance
Outpatient Surgery Deductible then $250 copayment Deductible then 50% coinsurance
Inpatient Hospital Stay Deductible then $500 per day copayment Deductible then 50% coinsurance
Emergency Room $100 copayment & deductible $100 copayment & deductible

*Based on physician data as of 8/28/17 and is subject to change.

OMNIA Silver HSA

The OMNIA Silver Health Savings Account (HSA) Plan, like other Silver plans, pays for 70% of your covered medical expenses on average; you pay 30%, and cost-sharing subsidies may be available. With HSA plans, you make tax-free contributions to your account to cover higher deductible costs in exchange for a significantly lower premium. The OMNIA Silver HSA Plan is a good option for healthy members who don’t have ongoing care but want more comprehensive coverage for unexpected health issues.

Features

  • Plan includes a Health Savings Account (HSA)
  • High deductible with a significantly lower premium
  • Coming in 2018 one-step easy access on your mobile phone to chat with a nurse, have a video consult with a doctor or make an office appointment.
  • Money back on gym memberships with HorizonbFit—Up to $240 per year*
  • Your premium may be less if you qualify for government financial assistance.—Use our online estimator

*HorizonbFit is only available to individual consumers.

  OMNIA TIER 1 TIER 2  
Individual Deductible $1,800 $2,500
  • Save with OMNIA Tier 1, including some of NJ’s leading hospitals and 29,000 health care professionals*
  • Enjoy access to our entire Managed Care Network, the largest physician network in NJ*, with Tier 2 doctors and hospitals
  • No primary care physician required
  • No referrals needed
  • Prescription coverage included
  • pdf-form-icon Summary of Benefits and Coverage
Family Deductible $3,600 $5,000
Individual Max Out-of-Pocket $6,000 $6,550
Family Max Out-of-Pocket $12,000 $13,100
Primary Care Physician Visit Deductible then $15 copayment Deductible then $30 copayment
Specialist Visit Deductible then $30 copayment Deductible then $50 copayment
Outpatient Surgery Deductible then 30% coinsurance Deductible then 50% coinsurance
Inpatient Hospital Stay Deductible then 30% coinsurance Deductible then 50% coinsurance
Emergency Room $100 copayment & deductible, then 30% coinsurance $100 copayment & deductible, then 30% coinsurance

*Based on physician data as of 8/28/17 and is subject to change.

OMNIA Gold

The OMNIA Gold Plan is our lowest premium Gold plan and offers a higher monthly premium and lower out-of-pocket costs when compared to other OMNIA Health Plans. Gold plans, on average, pay for 80% of the covered medical expenses; you pay 20%. The OMNIA Gold Plan is a good choice if you expect to use a moderate amount of medical services.

Features

  • Our lowest premium Gold plan
  • Comprehensive coverage for a moderate amount of medical services
  • Coming in 2018 one-step easy access on your mobile phone to chat with a nurse, have a video consult with a doctor or make an office appointment.
  • Money back on gym memberships with HorizonbFit—Up to $240 per year*
  • Your premium may be less if you qualify for government financial assistance.—Use our online estimator

*HorizonbFit is only available to individual consumers.

  OMNIA TIER 1 TIER 2  
Individual Deductible $1,000 $2,500
  • Save with OMNIA Tier 1, including some of NJ’s leading hospitals and 29,000 health care professionals*
  • Enjoy access to our entire Managed Care Network, the largest physician network in NJ*, with Tier 2 doctors and hospitals
  • No primary care physician required
  • No referrals needed
  • Prescription coverage included
  • pdf-form-icon Summary of Benefits and Coverage
Family Deductible $2,000 $5,000
Individual Max Out-of-Pocket $4,500 $6,350
Family Max Out-of-Pocket $9,000 $12,700
Primary Care Physician Visit $10 copayment Deductible then $30 copayment
Specialist Visit $25 copayment Deductible then $50 copayment
Outpatient Surgery Deductible then $250 copayment Deductible then 30% coinsurance
Inpatient Hospital Stay Deductible then $500 per day copayment Deductible then 30% coinsurance
Emergency Room $100 copayment & deductible $100 copayment & deductible

*Based on physician data as of 8/28/17 and is subject to change.

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