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Navigator PPO

Navigator PPO Plans

With three tiers of benefits, employees get the flexibility to choose care that best fits their health and financial needs.

Large provider network with low copays and zero coinsurance for most physicians and ancillary care.

In-Network 3500 Plan 4000 Plan 4500 Plan 6000 Plan
Deductible (Single / Family) $3,500 / $7,000 $4,000 / $8,000 $4,500 / $9,000 $6,000 / $12,000
Out-of-Pocket Limit (Single / Family) $8,700 / $17,400 $8,700 / $17,400 $8,700 / $17,400 $8,700 / $17,400

Lowest annual deductible options with low coinsurance for most physicians and ancillary care.

In-Network 1000 Plan 1500 Plan 2000 Plan 2500 Plan
Deductible (Single / Family) $1,000 / $2,000 $1,500 / $3,000 $2,000 / $4,000 $2,500 / $5,000
Out-of-Pocket Limit (Single / Family) $8,700 / $17,400 $8,700 / $17,400 $8,700 / $17,400 $8,700 / $17,400

Affordable annual deductibles with zero coinsurance benefits after deductibles are met.

In-Network 4000 Plan 4500 Plan 6000 Plan 6500 Plan
Deductible (Single / Family) $4,000 / $8,000 $4,500 / $9,000 $6,000 / $12,000 $6,500 / $13,000
Out-of-Pocket Limit (Single / Family) $7,050 / $14,100 $7,050 / $14,100 $7,050 / $14,100 $7,050 / $14,100

Low annual deductibles with coinsurance benefits after deductibles are met.

In-Network 2500 Plan 3500 Plan 6850 Plan
Deductible (Single / Family) $2,500 / $5,000 $3,500 / $7,000 $6,850 / $13,700
Out-of-Pocket Limit (Single / Family) $8,700 / $17,400 $8,700 / $17,400 $8,700 / $17,400
Navigator VBP

Navigator VBP Plans

Navigator Value-Based Pricing (VBP) Plans use negotiated pricing to reduce the cost of benefits up to 40% when compared to traditional PPO networks.

Value-based pricing (VBP) allows patients the ability to select any hospital or facility they choose by connecting with a Care Advocate to find a provider that will conduct the desired procedure.

In-Network 1000 Plan 2000 Plan 3000 Plan 5000 Plan
Deductible (Single / Family) $1,000 / $3,000 $2,000 / $6,000 $3,000 / $6,000 $5,000 / $10,000
Out-of-Pocket Limit (Single / Family) $8,700 / $17,400 $8,700 / $17,400 $8,700 / $17,400 $8,700 / $17,400

VBP HDHP Plans offer the same features as Navigator VBP but with a lower premium equivalent and higher deductible. Coverage and costs vary by plan.

In-Network 3000 Plan 5000 Plan
Deductible (Single / Family) $3,000 / $6,000 $5,000 / $10,000
Out-of-Pocket Limit (Single / Family) $7,050 / $14,100 $7,050 / $14,100
Essential

Essential Plans

Essential plans are affordable for employers and employees, while helping them avoid potential tax penalties.

There are several Essential Plans to fit your needs. All groups are eligible for Simple Plans and Basic Plans. Some groups may not be eligible for Edge Plans, Care 1 Plans, Plus Plans, or Premier Plans. Eligibility will be determined during a review of a group's claims experience data or employee health applications.

The premium equivalent is the shared monthly cost for the employer and employee.
In-Network Simple Basic Edge Care 1 Plus Premier
Deductible (Single/Family) None None None None None None
Out-of-Pocket Limit (Single/Family) None None None None None None
60+ Preventive and Wellness Services
Telehealth
Primary Care Office Visit Copay Not covered
Specialist Care Office Visit Copay Not covered Not covered
Outpatient Services Not covered Not covered
Emergency Services Not covered Not covered
Inpatient Services Not covered Not covered
Non-Preventive Prescription Services Not Covered Not Covered Not Covered
Preventive Prescription Services

Dental

Vision

Dental and Vision Plans

Small businesses can choose from a suite of affordable Dental and Vision Plans with low annual deductibles that include 100% coverage for preventive care, eyeglasses, and contact lenses.

View Dental and Vision Plans
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