MEDICAL PLAN DESIGN BCBS Insurance with Participating Funding Arrangement (PFA) administered by RSI HMO Individual Two-Party & Family Full BCBS $4,500 Full BCBS $9,000 BCBS HMO Member Deductible Deductible Responsibility: - Your $500 - Your $1,000 Per Member $500 Deductible Deductible =BB&N Pays $4,000 = BB&N Pays $8,000 Family Maximum $1,000 HMO High Deductible Plan (HDP) Individual Two-Party & Family Full BCBS $4,500 Full BCBS $9,000 BCBS HMO HDP Member Deductible Deductible Responsibility: - Your $750 - Your $1,500 Per Member $750 Deductible Deductible =BB&N Pays $3,750 = BB&N Pays $7,500 Family Maximum $1,500