Health & Dental Plans > 2-50 Employees

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Health Plans for 2-50 Employees

Compare 2018 Plans

Health Plans | Dental Plans

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Blue Choice® Platinum
for Business




Blue
Access® Gold
for Business




Blue
HSA Gold
for Business




Blue
Secure Silver
for Business




Blue
Saver® Bronze
for Business




Blue
HSA Bronze
for Business


Materials

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View Coverage Summary (SBC)

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Rates
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Dental

With three plans to choose from, Essential Dental for Business, Total Dental for Business, and Premier Dental for Business plans will provide you with coverage options sure to fit your needs. All plans cover Diagnostic and Preventive Services at 100% with NO deductible or waiting period. These plans offer minimal participation requirements, flexible employer contribution, and annual open enrollment.

For more information and a comparison of our dental plans click here.

Calendar Year Deductible

SELF-ONLY

FAMILY



$100

$200



$600

$1,200



$1,600

$3,200



$2,600

$5,200



$7,150

$14,300



$6,450

$12,900

Out-of-Pocket

SELF-ONLY

FAMILY

Includes deductible, copays, and coinsurance for
in-network services.

$4,000

$8,000


$6,000

$12,000


$4,000

$8,000


$7,350

$14,700


$7,150

$14,300


$6,450

$12,900

Office Visit Copay

$20 Primary Care/
$30 Specialist

$35 Primary Care/
$50 Specialist

Plan pays 90%
after Deductible

$40 Primary Care/
$65 Specialist

$40 copay for 1st two illness related office visits; thereafter plan pays 100% after Deductible

Plan pays 100% after Deductible

Inpatient

Plan pays 100% after $150 daily copay days 1 - 5 for each admission

Lower Member Cost Share: Plan pays 100% after $240 daily copay days 1-5 for each admission

Higher Member Cost Share: Plan pays 100% after $500 daily copay days 1-5 for each admission

Plan pays 90%
after Deductible

Lower Member Cost Share: Plan pays 100% after $390 daily copay days 1-5 for each admission

Higher Member Cost Share: Plan pays 100% after $800 daily copay days 1-5 for each admission

Plan pays 100%
after Deductible

Plan pays 100%
after Deductible

Outpatient
Surgery

Plan pays 100% after $150 hospital copay

Lower Member Cost Share: Plan pays 100% after $240 hospital copay

Higher Member Cost Share: Plan pays 100% after $500 hospital copay

Plan pays 90%
after Deductible

Lower Member Cost Share: Plan pays 100% after $390 hospital copay

Higher Member Cost Share: Plan pays 100% after $800 hospital copay

Plan pays 100%
after Deductible

Plan pays 100%
after Deductible

ER Visit

Plan pays 100% after $150 hospital copay

Plan pays 100% after $250 hospital copay

Plan pays 90%
after Deductible

Plan pays 100% after $400 hospital copay

Plan pays 100%
after Deductible

Plan pays 100%
after Deductible

Prescription Drugs (per 30-day supply)

Tier 1
$10 copay

Tier 2
$20 copay

Tier 3
$35 copay

Tier 4
$75 copay

Tier 5
$100 copay

Tier 6
$200 copay

Tier 1
$10 copay

Tier 2
$20 copay

Tier 3
$40 copay

Tier 4
$80 copay

Tier 5
$125 copay

Tier 6
$250 copay

Plan pays at 90%
after Deductible

Tier 1
$15 copay

Tier 2
$25 copay

Tier 3
$65 copay

Tier 4
$100 copay

Tier 5
$250 copay

Tier 6
Plan pays 60%

Tier 1
$20 copay

Tier 2
$35 copay

Tier 3 - Tier 6
Plan pays 100% after Deductible

Plan pays 100%
after Deductible
Mail Order Pharmacy
(90 day supply)

Tier 1
$25 copay

Tier 2
$50 copay

Tier 3
$87.50 copay

Tier 4
$187.50 copay

Tier 5
not covered

Tier 6
not covered

Tier 1
$25 copay

Tier 2
$50 copay

Tier 3
$100 copay

Tier 4
$200 copay

Tier 5
not covered

Tier 6
not covered

N/A

Tier 1
$37.50 copay

Tier 2
$62.50 copay

Tier 3
$162.50 copay

Tier 4
$250 copay

Tier 5
not covered

Tier 6
not covered

N/A

N/A
ValueONE Pharmacy Network

x

x

x

x

x

x

Source+Rx 2.0 Formulary

x

x

x

Source+Rx 1.0 formulary

x

x

x

Select Lab Network

x

x

Pediatric Vision

Plan pays 80%
after Deductible

Plan pays 80%
after Deductible

Plan pays 90%
after Deductible

Plan pays 80%
after Deductible

Plan pays 100%
after Deductible

Plan pays 100%
after Deductible

Pediatric Dental
(members up to
age 19)

DIAGNOSTIC & PREVENTIVE

BASIC SERVICES


MAJOR SERVICES


MEDICALLY NECESSARY ORTHODONTIA




Plan pays 100%


Plan pays 80%


Plan pays 50%
after Deductible

Plan pays 50%
after Deductible




Plan pays 100%


Plan pays 80%


Plan pays 50%
after Deductible

Plan pays 50%
after Deductible




Plan pays 100%
after Deductible

Plan pays 80%
after Deductible

Plan pays 50%
after Deductible

Plan pays 50%
after Deductible




Plan pays 100%


Plan pays 80%


Plan pays 50%
after Deductible

Plan pays 50%
after Deductible




Plan pays 100%


Plan pays 100%


Plan pays 100%
after Deductible

Plan pays 100%
after Deductible




Plan pays 100%
after Deductible

Plan pays 100%
after Deductible

Plan pays 100%
after Deductible

Plan pays 100%
after Deductible