Summaries of Benefits for large group plans — 2018
HMO Plus plans
- HMO Plus $20 $40 $1,000 Ded 80% Coins Option 1
- HMO Plus $25 $50 $1,000 Ded 80% Coins Option 2
- HMO Plus $30 $50 $1,500 Ded 70% Coins Option 3
POS plans
- POS $20 $40 $300 Day
- POS $30 $50 $400 Day
- POS $20 $40 $1,000 Ded 90% Coins
- POS $30 $50 $1,500 Ded 80% Coins
- POS $30 $50 $2,000 Ded 70% Coins
POS Plus plans
- POS Plus $10 $20 $0 Day
- POS Plus $20 $40 $0 Day
- POS Plus $20 $40 $250 Day
- POS Plus $30 $40 $300 Day
- POS Plus $20 $40 $1,000 Ded 90% Coins
- POS Plus $30 $50 $1,500 Ded 80% Coins
- POS Plus $30 $50 $2,000 Ded 70% Coins
EPO plans
- EPO $20 $40 $250
- EPO $30 $50 $500
- EPO $20 $40 $1,500 Ded 80% Coins
- EPO $30 $50 $1,500 Ded 70% Coins
- EPO $30 $50 $2,500 Ded 80% Coins $100 ER
- EPO $2,000 Ded 100% Coins
- EPO $50 $75 $2,500 Ded 50% Coins
- EPO HSA $1,350 Ded 50% Coins w/ Int Rx $7 50% $125
- EPO HSA $1,500 Ded 70% Coins w/ Int Rx $7 50% $125
- EPO HSA $1,500 Ded 70% Coins w/ Int Rx $10 $40 $60
- EPO HSA $2,500 Ded 100% Coins w/ Int Rx $25 $50 $75
EPO Advantage plans
- AmeriHealth Advantage High Option $1,000 Ded
- AmeriHealth Advantage $15 $25 $1,500 Ded
- AmeriHealth Advantage Medium Option $2,000 Ded
- AmeriHealth Advantage Low Option $2,500 Ded
- AmeriHealth Advantage Economy Option $2,500 Ded
- AmeriHealth Advantage Economy HSA Option $2,500 Ded w/ Int Rx
Tier 1 Advantage plans
- Tier 1 Advantage High Option $1,500 Ded
- Tier 1 Advantage Low Option $2,500 Ded
- Tier 1 Advantage Low HSA Option $2,500 Ded w/ Int Rx
PPO plans
- PPO HDHP $1,350 Ded 100% Coins w/Int Rx $10 $40 $60
- PPO HDHP HSA $2,000 Ded 90% Coins w/ Int Rx $7 $35 $50
- PPO HDHP HSA $2,500 Ded 70% Coins w/ Int Rx $7 $35 $50
Vision
- Vision Care 100: 12/12/12*
- Vision Care 100: 12/12/24*
- Vision Care 100: 24/24/24
- Vision Care 100: 12/12/12 $25 Copay — Voluntary
- Vision Care 130: 12/12/12*
- Vision Care 130: 12/12/24*
- Vision Care 130: 12/12/24 $25 Copay*
- Vision Care 150: 12/12/12*
- Vision Care 150: 12/12/24 — Voluntary
- $35 Vision Program
Benefits Available Every Two Calendar Years
- $100 Vision Program
Benefits Available Once Every Calendar Year
- $100 Vision Program
Benefits Available Every Two Calendar Years
- $200 Vision Program
Benefits Available Once Every Calendar Year
- $200 Vision Program
Benefits Available Every Two Calendar Years
- $35 Corrective Eyewear
Benefits Available Every Two Calendar Years
- $100 Corrective Eyewear
Benefits Available Every Two Calendar Years
