Find the Plan that’s Right for You!
Program highlights:
• National PPO Network In-Network coverage in all 50 states, plus DC & Puerto Rico
• 4 tier rates nationwide - No age rating, no census needed subject to actively at work rules.
• Available to all group sizes, including sole proprietors and 1099 contractors.
• Participants benefit from large group rates nationwide.
• Fully funded, first dollar coverage • Coverage cannot be denied (no pre-existing limitations)
• Additional Ancillary and Supplemental Programs Available Plan Pays 100% $10 Child/$25 Adult Preventative Services
• Account information, customer service support available with the click of a button through a dedicated concierge team
Plan Tier: All
Coverage: Starts on the 1st of the month
Enroll by the 15th of the month for the plan to be effective on the 1st.
Network By
Base Plan
Member Only
Your Monthly Premium:
Employee Rate $883.00
Employee & (1) Child Rate $1,415.25
Employee & Spouse Rate $1,672.00
Employee & Family Rate $2,092.25
Individual Deductible
$3,000
Individual Out-of-Pocket Max
$5,350
Family Deductible
$6,000
Family Out-of-Pocket Max
$10,700
Office Visit
Deductible and 50% coinsurance
Specialist Visit
Deductible and 50% coinsurance
Plan Summary Details
View Rx Formulary
Find a Provider
How-To Guide for Finding a Provider
Bronze 4000 Plan
Member Only
Your Monthly Premium:
Employee Rate $985.00
Employee & (1) Child Rate $1,531.25
Employee & Spouse Rate $2,030.00
Employee & Family Rate $2,362.25
Individual Deductible
$4,000
Individual Out-of-Pocket Max
$9,100
Family Deductible
$10,000
Family Out-of-Pocket Max
$18,200
Office Visit
$45 copay
Specialist Visit
$45 copay
Plan Summary Details
View Rx Formulary
Find a Provider
How-To Guide for Finding a Provider
Bronze Plan
Member Only
Your Monthly Premium:
Employee Rate $1,032.00
Employee & (1) Child Rate $1,683.25
Employee & Spouse Rate $1,954.00
Employee & Family Rate $2,360.25
Individual Deductible
$None
Individual Out-of-Pocket Max
$7,350
Family Deductible
$None
Family Out-of-Pocket Max
$14,700
Office Visit
40% Coinsurance
Specialist Visit
40% Coinsurance
Plan Summary Details
View Rx Formulary
Find a Provider
How-To Guide for Finding a Provider
Silver 2500 Plan
Member Only
Your Monthly Premium:
Employee Rate $1,130.00
Employee & (1) Child Rate $1,601.25
Employee & Spouse Rate $2,063.00
Employee & Family Rate $2,512.25
Individual Deductible
$2,500
Individual Out-of-Pocket Max
$9,100
Family Deductible
$7,500
Family Out-of-Pocket Max
$18,200
Office Visit
$30 copay
Specialist Visit
$30 copay
Plan Summary Details
View Rx Formulary
Find a Provider
How-To Guide for Finding a Provider
Liberty 1500 Plan
Member Only
Your Monthly Premium:
Employee Rate $1,150.00
Employee & (1) Child Rate $1,821.25
Employee & Spouse Rate $2,229.00
Employee & Family Rate $2,701.25
Individual Deductible
$1,500
Individual Out-of-Pocket Max
$5,350
Family Deductible
$3,000
Family Out-of-Pocket Max
$10,700
Office Visit
$30 copay
Specialist Visit
$50 copay
Plan Summary Details
View Rx Formulary
Find a Provider
How-To Guide for Finding a Provider
Gold 1000 Plan
Member Only
Your Monthly Premium:
Employee Rate $1,244.00
Employee & (1) Child Rate $1,823.25
Employee & Spouse Rate $2,358.00
Employee & Family Rate $2,940.25
Individual Deductible
$1,000
Individual Out-of-Pocket Max
$7,550
Family Deductible
$2,000
Family Out-of-Pocket Max
$15,000
Office Visit
$40 copay
Specialist Visit
$40 copay
Plan Summary Details
View Rx Formulary
Find a Provider
How-To Guide for Finding a Provider
Liberty Plan
Member Only
Your Monthly Premium:
Employee Rate $1,259.00
Employee & (1) Child Rate $2,096.25
Employee & Spouse Rate $2,511.00
Employee & Family Rate $3,016.25
Individual Deductible
$None
Individual Out-of-Pocket Max
$5,350
Family Deductible
$None
Family Out-of-Pocket Max
$10,700
Office Visit
$30 copay
Specialist Visit
$50 copay
Plan Summary Details
View Rx Formulary
Find a Provider
How-To Guide for Finding a Provider
Gold Plan
Member Only
Your Monthly Premium:
Employee Rate $1,347.00
Employee & (1) Child Rate $2,339.25
Employee & Spouse Rate $2,608.00
Employee & Family Rate $3,034.25
Individual Deductible
$None
Individual Out-of-Pocket Max
$7,350
Family Deductible
$None
Family Out-of-Pocket Max
$14,700
Office Visit
$10 copay & 20% Coinsurance
Specialist Visit
$10 copay & 20% Coinsurance
Plan Summary Details
View Rx Formulary
Find a Provider
How-To Guide for Finding a Provider
ASO Plan
Member Only
Your Monthly Premium:
Employee Rate $1,426.00
Employee & (1) Child Rate $2,476.25
Employee & Spouse Rate $2,740.00
Employee & Family Rate $3,297.25
Individual Deductible
$None
Individual Out-of-Pocket Max
$None
Family Deductible
$None
Family Out-of-Pocket Max
$None
Office Visit
$25 copay
Specialist Visit
$25 copay
Plan Summary Details
View Rx Formulary
Find a Provider
How-To Guide for Finding a Provider
HSA 6000 Plan
Member Only
Your Monthly Premium:
Employee Rate $864.00
Employee & (1) Child Rate $1,354.25
Employee & Spouse Rate $1,651.00
Employee & Family Rate $2,089.25
Individual Deductible
$6,000
Individual Out-of-Pocket Max
$8,300
Family Deductible
$12,000
Family Out-of-Pocket Max
$16,600
Office Visit
Deductible & 30% Coinsurance
Specialist Visit
Deductible & 30% Coinsurance
Plan Summary Details
View Rx Formulary
Find a Provider
How-To Guide for Finding a Provider