Summary of Coverage Plans
The table below summarizes the applicable deductibles, co-insurance rates and out-of-pocket limits for each plan offered under the DGA-Producer Health Plan. Additional details on each plan are available in the March 2025 Health Plan Summary Plan Description, which is available at www.dgaplans.org. For questions, please call Participant Services, Monday through Friday from 8:30 a.m. to 5:00 p.m. Pacific Time, at (877) 866-2200, Ext. 401.
|
Premier Choice/ |
Choice/ |
Silver |
Bronze |
||
|---|---|---|---|---|---|
|
Deductibles |
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|
Individual |
$325 |
$325 |
$325 |
$750 |
|
|
Family |
$975 |
$975 |
$975 |
$2,250 |
|
|
Co-Insurance Rates |
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|
Network Network co-insurance rate is based on amount of Covered Expenses |
90% |
90% |
90% |
70% |
|
|
Non-Network Non-Network co-insurance rate is based on Reasonable and Customary amount of Covered Expenses1 |
70% |
60% |
60% |
50% |
|
|
1If you use a Non-Network provider, other than for Emergency Services, Emergency or Non-Emergency Services received from a Non-Network provider at certain Network facilities, or air ambulance services by a Non-Network provider, you will be responsible for either 30% or 40% (or 50% under the DGA Bronze Plan) of the remaining Covered Expenses depending on your plan of coverage, as well as any amount above the Reasonable and Customary amount. |
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|
Out-of-Pocket Limits |
|||||
|
Individual Network |
$1,000 |
$1,000 |
$1,000 |
$9,200 |
|
|
Individual Non-Network |
$12,500 |
$20,000 |
$20,000 |
No limit |
|
