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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 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 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.
| 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 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.
