Bronze Plans have the lowest monthly premiums and the highest member cost-sharing.
For more information, contact us at 1-888-249-2583.
|Healthy Balance POS 8100 Pkg 2|
|Deductible (single/family)||$3,500 / $7,000|
|Out-of-Pocket Maximum (single/family)||$6,350 / $12,700|
|PCP/Specialist Visit||20% after deductible|
|Inpatient Hospital||25% after deductible|
|Outpatient Surgery||25% after deductible|
|Emergency Room Visit||20% after deductible|
|Urgent Care||20% after deductible|
|Generic/Formulary/Non-Formulary||$15 / $50 / 50% after deductible|
|Pediatric Dental Rate||$19|
*Generic oral contraceptives are covered in full.
*Mail order drugs are 2.5 copays / 90 day supply.
*Pediatric Dental is an essential health benefit required for independents under the age of 19.Optional coverage is available with all plans.