SAG-AFTRA Health SPD

Comprehensive Out-of-pocket Maximum

Comprehensive Out-of-pocket Maximum

Plan I (Active Plan)

$8,550/person;
$17,100/family

No maximum

Plan II*

$8,550/person;
$17,100/family

No maximum

The comprehensive out-of-pocket maximum is the maximum amount you could pay in any calendar year — including all Copays, Coinsurance and Deductibles — for Hospital, medical, prescription drugs, mental health and substance abuse services from In-network Providers under the Plan. There is no comprehensive out-of-pocket maximum for out-of-network care. The Plan's comprehensive out-of-pocket maximum is set in accordance with the Affordable Care Act (ACA) and updated annually.

*Note: Plan II runs out September 30, 2021