Health & Dental Plans > up to 50 Employees

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Health Plans for up to 50 Employees

Compare 2019 Plans

Health Plans | Dental Plans

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Blue Choice® Platinum
for Business




Blue
Access® Gold
for Business




Blue
Secure Gold
for Business




Blue
Secure Silver
for Business




Blue
HSA Silver
for Business




Blue
Saver® Bronze
for Business


Materials

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View Coverage Summary (SBC)

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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, our dental plans will provide you with coverage options sure to fit your needs. All plans cover Diagnostic and Preventive Services at 100% with NO deductible and most plans have NO waiting periods for services such as fillings, oral surgery and crowns. 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



$1,200

$2,400



$3,250

$6,500



$4,000

$8,000



$7,150

$14,300

Out-of-Pocket

SELF-ONLY

FAMILY

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

$4,000

$8,000


$6,000

$12,000


$6,750

$13,000


$7,900

$15,800


$6,000

$12,000


$7,150

$14,300

Office Visit Copay

$20 Primary Care/
$30 Specialist

$30 Primary Care/
$50 Specialist

$35 Primary Care/
$60 Specialist

$40 Primary Care/
$65 Specialist

Plan pays 80% after Deductible

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

Telephone and Online Video Consultation
Available though Teledoc

$45 per consultation

$45 per consultation

$45 per consultation

$45 per consultation

$45 per consultation

$45 per consultation

Inpatient
Hospital

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

Lower Member Cost Share: Plan pays 100% after $250 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

Lower Member Cost Share: Plan pays 100% after $300 daily copay days 1-5 for each admission

Higher Member Cost Share: Plan pays 100% after $600 daily copay days 1-5 for each admission

Lower Member Cost Share: Plan pays 100% after $400 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 80%
after Deductible

Plan pays 100%
after Deductible

Outpatient
Surgery

Plan pays 100% after $150 hospital copay

Lower Member Cost Share: Plan pays 100% after $250 hospital copay

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

Lower Member Cost Share: Plan pays 100% after $300 hospital copay

Higher Member Cost Share: Plan pays 100% after $600 hospital copay

Lower Member Cost Share: Plan pays 100% after $400 hospital copay

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

Plan pays 80%
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 100% after $300 hospital copay

Plan pays 100% after $400 hospital copay

Plan pays 80%
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

Tier 1
$10 copay

Tier 2
$20 copay

Tier 3
$50 copay

Tier 4
$90 copay

Tier 5
$200 copay

Tier 6
$300 copay

Tier 1
$15 copay

Tier 2
$30 copay

Tier 3
$75 copay

Tier 4
$100 copay

Tier 5
$250 copay

Tier 6
Plan pays 60%

Plan pays 80%
after Deductible

Tier 1
$20 copay

Tier 2
$35 copay

Tier 3 - Tier 6
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

Tier 1
$25 copay

Tier 2
$50 copay

Tier 3
$125 copay

Tier 4
$225 copay

Tier 5
not covered

Tier 6
not covered

Tier 1
$37.50 copay

Tier 2
$75 copay

Tier 3
$187.50 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

Pediatric Vision

Plan pays 80%
after Deductible

Plan pays 80%
after Deductible

Plan pays 80%
after Deductible

Plan pays 80%
after Deductible

Plan pays 80%
after Deductible

Plan pays 100%
after Deductible

Pediatric Dental

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%


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 100%


Plan pays 100%
after Deductible

Plan pays 100%
after Deductible