Bronze Plan


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
In-Network:  
     Deductible (single/family) $3,500 / $7,000
     Coinsurance 20%
     Out-of-Pocket Maximum (single/family) $6,350 / $12,700
Medical Services:  
     PCP/Specialist Visit 20% after deductible
Hospital Services:  
     Inpatient Hospital 25% after deductible
     Outpatient Surgery 25% after deductible
     Emergency Room Visit 20% after deductible
     Urgent Care 20% after deductible
Prescription Drugs*  
     Generic/Formulary/Non-Formulary $15 / $50 / 50% after deductible
Rates (Single/Family):  
     Single $329.89
     Employee/Child $560.81
     Employee/Spouse $659.78
     Family $940.19
     Pediatric Dental Rate   $14.61
   

*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.