Plan Comparison

Plan Comparison  

Overview

  Basic HSA Plan HSA Plus Plan PPO Plan
HSA-eligible Yes Yes No
Company contribution to HSA $350 for employee-only coverage; $700 for family coverage $600 for employee-only coverage; $1,200 for family coverage None
In-network care: Your costs
Individual/
family deductible
$2,000/$4,000 $1,500/$3,000 $700/$1,400
Individual/
family out-of-pocket maximum
$5,000/$10,000 $4,500/$9,000 $4,500/$9,000
Coinsurance (applies after meeting deductible)
You pay 20%, plan pays 80%
Office visit — Preventive care
Covered at 100% in-network, so you pay nothing*
Office visit — Primary care You pay 20% after deductible
You pay 20% after deductible
You pay $30 copay
Office visit — Specialist 
You pay 20% after deductible You pay 20% after deductible You pay $60 copay
Office visit – Chiropractor
(60 visits per year)
You pay 20% after deductible You pay 20% after deductible You pay $60 copay (services requiring adjustments/manipulation subject to deductible and coinsurance)
Telemedicine Physical Health You pay 20% after deductible up to $59 You pay 20% after deductible up to $59 You pay $15 copay
Telemedicine (Behavioral Health) You pay 20% after deductible You pay 20% after deductible $30
Urgent care visit You pay 20% after deductible You pay 20% after deductible You pay $60 copay
Emergency room visit You pay 20% after deductible You pay 20% after deductible You pay $200 copay
Hospital (inpatient or outpatient) You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Mental health and substance abuse (inpatient) You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Mental health and substance abuse (outpatient) You pay 20% after deductible You pay 20% after deductible You pay $30 copay

 

*There is no cost if only a preventive exam is performed. If any other services are provided during the visit for new or ongoing health concerns, the visit may be billed as diagnostic and subject to the applicable charge for your plan.

 

  • Working spouse/domestic partner program

    If your spouse/domestic partner has group medical insurance coverage available elsewhere but chooses our program, $20 will be added to your biweekly premiums each pay period. This helps Masonite to continue to offer comprehensive and affordable coverage for our employees.

    This does not apply to dependent children. You will have to attest to the fact that your spouse/domestic partner is not eligible for group health coverage through his/her own employer. 

  • Non-tobacco rate for all medical plans

    If you and your dependent have been tobacco free for the past six months, you will be able to participate in the medical plan at the lower non-tobacco rate. Once you have been tobacco free for six consecutive months you may contact OSV at 1-855.65.MASON or send an email to MployeeCentralBenefits@onesourcevirtual.com.