Admission Benefit | Low Plan | High Plan | ||
4 Times per Calendar Year | ||||
Admission | $500 | $1,000 | ||
ICU Supplemental Admission | $500 | $1,000 | ||
ICU Supplemental Admission Benefit is paid concurrently with the Admission Benefit when a covered person is admitted to ICU | ||||
Confinement Benefit | Low Plan | High Plan | ||
31-Days per Confinement | ||||
ICU Supplemental Confinement will pay an Additional Benefit for each of those 31-Days | ||||
Confinement | $100 | $200 | ||
ICU Supplemental Confinement | $100 | $200 | ||
ICU Supplement Confinement Benefit is paid concurrently with the Confinement benefit when a covered person is admitted to ICU | ||||
Inpatient Rehabilitation Benefit | Low Plan | High Plan | ||
15-Days per Calendar Year | ||||
Inpatient Rehabilitation | $100 | $200 | ||
(For Injury or Sickness) | ||||
Confinement Benefit | Low Plan | High Plan | ||
for Newborn Nursery Care | ||||
3-Days per Confinement | ||||
Confinement | $100 | $200 |
Coverage & Rates shown are for the 2025/26 Plan Year, effective 7/1/2025 through 6/30/2026. |
Type | Low Plan | High Plan | ||
Employee Only | 9.91 | 19.43 | ||
Employee & Spouse | 21.60 | 42.34 | ||
Employee & Child(ren) | 15.27 | 29.93 | ||
Employee, Spouse & Child(ren) | 26.96 | 52.85 |
Eligibility: |
For eligible active employee members only. |
Only available if Employer group allows this coverage to be offered. |
Opportunities: |
OPEH&W Initial Enrollment. |
OPEH&W Annual Open Enrollment. |
First Offering from OPEH&W. |