Sacramento County Bar

Benefits Program

Medical Benefits Provided by Western Health Advantage

Deductible

PC/Specialist 

Co-Insurance

OOP Limit 

Inpatient Hosp

Urgent Care 

Rx Generic 

Rx Preferred 

Rx Non Preferred

Age

0 -14

15 -15

16 -16

17 -17

18 -18

19 -19

20 -20

21 -21

22 -22

23 -23

24 -24

25 -25

26 -26

27 -27

28 -28

29 -29

30 -30

31 -31

32 -32

33 -33

34 -34

35 -35

36 -36

37 -37

38 -38

39 -39

40 -40

41 -41

42 -42

43 -43

44 -44

45 -45

46 -46

47 -47

48 -48

49 -49

50 -50

51 -51

52 -52

53 -53

54 -54

55 -55

56 -56

57 -57

58 -58

59 -59

60 -60

61 -61

62 -62

63 -63

64 -99

$0

$20/$20

0%

$4,000

No Charge

$50

$5

$30

$50

GATEWAY 20

274.37

298.76

308.09

317.41

327.45

337.50

347.90

358.66

358.66

358.66

358.66

360.09

367.26

375.87

389.86

401.34

407.07

415.68

424.29

429.67

435.41

438.28

441.15

444.02

446.89

452.62

458.36

466.97

475.22

486.70

501.04

517.90

537.98

560.58

586.40

611.87

640.56

668.89

700.10

731.66

765.73

799.80

836.74

874.04

913.86

933.58

973.39

1007.82

1030.42

1058.75

1075.97

$0

$20/$20

30%

$4,000

30%

$50

$5

$30

$50

$2,000 ind; $2,700 ind w/ fam

0% after ded

0%

$2,000 medical/$4,000 with RX (incl ded)

0% after ded

0% after ded

0% after ded

$30 after ded

$50 after ded

Age

0 -14

15 -15

16 -16

17 -17

18 -18

19 -19

20 -20

21 -21

22 -22

23 -23

24 -24

25 -25

26 -26

27 -27

28 -28

29 -29

30 -30

31 -31

32 -32

33 -33

34 -34

35 -35

36 -36

37 -37

38 -38

39 -39

40 -40

41 -41

42 -42

43 -43

44 -44

45 -45

46 -46

47 -47

48 -48

49 -49

50 -50

51 -51

52 -52

53 -53

54 -54

55 -55

56 -56

57 -57

58 -58

59 -59

60 -60

61 -61

62 -62

63 -63

64 -99

GATEWAY 70

255.33

278.03

286.70

295.38

304.73

314.07

323.75

333.76

333.76

333.76

333.76

335.10

341.77

349.78

362.80

373.48

378.82

386.83

394.84

399.85

405.19

407.86

410.53

413.20

415.87

421.21

426.55

434.56

442.24

452.92

466.27

481.96

500.65

521.67

545.70

569.40

596.10

622.47

651.51

680.88

712.59

744.29

778.67

813.38

850.43

868.79

905.84

937.88

958.90

985.27

1001.28

Age

0 -14

15 -15

16 -16

17 -17

18 -18

19 -19

20 -20

21 -21

22 -22

23 -23

24 -24

25 -25

26 -26

27 -27

28 -28

29 -29

30 -30

31 -31

32 -32

33 -33

34 -34

35 -35

36 -36

37 -37

38 -38

39 -39

40 -40

41 -41

42 -42

43 -43

44 -44

45 -45

46 -46

47 -47

48 -48

49 -49

50 -50

51 -51

52 -52

53 -53

54 -54

55 -55

56 -56

57 -57

58 -58

59 -59

60 -60

61 -61

62 -62

63 -63

64 -99

GATEWAY 2000 HSA

221.01

240.66

248.17

255.68

263.77

271.86

280.24

288.90

288.90

288.90

288.90

290.06

295.84

302.77

314.04

323.28

327.91

334.84

341.77

346.11

350.73

353.04

355.35

357.66

359.98

364.60

369.22

376.15

382.80

392.04

403.60

417.18

433.36

451.56

472.36

492.87

515.98

538.81

563.94

589.37

616.81

644.26

674.01

704.06

736.13

752.02

784.09

811.82

830.02

852.85

866.70

© 2019 Hutchison Financial Group, All Rights Reserved

HOURS & LOCATION

5 Sierragate Plaza Ste. 340 Roseville CA 95678

support@HFGins.com| p. 916-780-3344 | f. 916-789-0134

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Monday - Thursday

8:30 am to 5:00 pm

 

Friday

8:30 am to 3:30 pm

Saturday 

By Appointment Only