HDHP $4,000 $500 $16 $1,000 $2,484 $1,000 $80 $3,960 HIGH CLAIMS YEAR PLAN Specialist (2x) Prescription Drugs (4x) ER Visit Surgery: $15,000 SWIA HSA Contributions Monthly Premium Total Cost | YEAR Includes your monthly premium C l a i m S c e n a ri o - M e d i c a l