National Medical Plans
Program Highlights
- Seamless enrollment through our secure online portal
- Experienced benefits professionals to assist with strategy, contributions, onboarding and enrollment
- Composite (tiered) medical rates, regardless of group size (no age-banding)
- No participation minimums on ancillary plans
- Custom employee benefit guide tailored to your plan offering
Managed Choice® POS (Open Access) Plans
Plan Name | OA MC 0/100% 25/50 | OA MC 500/80% | OA MC 1,000/80% | OA MC 1,500/90% | OA MC 2,000/80% | OA MC 4,000/80% |
|---|---|---|---|---|---|---|
Plan Type | POS | POS | POS | POS | POS | POS |
Provider Network | Managed Choice® POS (Open Access) | Managed Choice® POS (Open Access) | Managed Choice® POS (Open Access) | Managed Choice® POS (Open Access) | Managed Choice® POS (Open Access) | Managed Choice® POS (Open Access) |
Deductible | In Network | In Network | In Network | In Network | In Network | In Network |
Individual | $0 | $500 | $1,000 | $1,500 | $2,000 | $4,000 |
Family | $0 | $1,000 | $2,000 | $3,000 | $4,000 | $8,000 |
Coinsurance | ||||||
Your Percentage | 0% | 20% | 20% | 10% | 20% | 20% |
Out of Pocket Max | ||||||
Individual | $4,000 | $3,500 | $4,500 | $5,500 | $6,850 | $6,850 |
Family | $8,000 | $7,000 | $9,000 | $11,000 | $13,700 | $13,700 |
Office Visits | ||||||
Preventive | $0 | $0 | $0 | $0 | $0 | $0 |
Primary Care | $25 | $25 | $25 | $25 | $30 | $30 |
Specialist | $50 | $50 | $50 | $50 | $60 | $60 |
Lab & X-Ray | $0 | Ded & 20% | Ded & 20% | Ded & 10% | Ded & 20% | Ded & 20% |
Urgent Care | $85 | $85 | $85 | $85 | $85 | $85 |
Hospital | ||||||
Inpatient | $300 per day (Max 5 days) | Ded & 20% | Ded & 20% | Ded & 10% | Ded & 20% | Ded & 20% |
Outpatient Surgery | $300 | Ded & 20% | Ded & 20% | Ded & 10% | Ded & 20% | Ded & 20% |
Emergency Room | $350 | $350 | $350 | $350 | $350 | $350 |
Prescriptions | ||||||
Rx Deductible | None | None | None | None | None | None |
Generic | $10 | $10 | $10 | $10 | $10 | $10 |
Formulary | $45 | $45 | $45 | $45 | $45 | $45 |
Non-Formulary | $70 | $70 | $70 | $70 | $70 | $70 |
Specialty | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 |
Plans: Managed Choice® POS (Open Access) - Page 2
Plan Name | OA MC 5,000/70% | OA MC Value 6,350/100% | OA MC 7,150/100% | OA MC HDHP 3,400/90% | OA MC HDHP 4,000/80% | OA MC HDHP 6,350/100% |
|---|---|---|---|---|---|---|
Plan Type | POS | POS | POS | HDHP POS | HDHP POS | HDHP POS |
Provider Network | Managed Choice® POS (Open Access) | Managed Choice® POS (Open Access) | Managed Choice® POS (Open Access) | Managed Choice® POS (Open Access) | Managed Choice® POS (Open Access) | Managed Choice® POS (Open Access) |
Deductible | In Network | In Network | In Network | In Network | In Network | In Network |
Individual | $5,000 | $6,350 | $7,150 | $3400/2x | $4,000 | $6,350 |
Family | $10,000 | $12,700 | $14,300 | $6,800 | $8,000 | $12,700 |
Coinsurance | ||||||
Your Percentage | 30% | 0% | 0% | 10% | 20% | 0% |
Out of Pocket Max | ||||||
Individual | $7,600/2x | $7,500/2x | $7,600 | $5,500 | $6,850 | $6,350 |
Family | $15,200 | $15,000 | $15,200 | $11,000 | $13,700 | $12,700 |
Office Visits | ||||||
Preventive | $0 | $0 | $0 | $0 | $0 | $0 |
Primary Care | $40 | $25 | $40 | Ded & 10% | Ded & 20% | Ded & 0% |
Specialist | $80 | Ded & 0% | Ded & 0% | Ded & 10% | Ded & 20% | Ded & 0% |
Lab & X-Ray | Ded & 30% | 0% after ded | 0% after ded | Ded & 10% | Ded & 20% | 0% after ded |
Urgent Care | $85 | Ded & 0% | Ded & 0% | Ded & 10% | Ded & 20% | Ded & 0% |
Hospital | ||||||
Inpatient | Ded & 30% | 0% after ded | 0% after ded | Ded & 10% | Ded & 20% | Ded & 0% |
Outpatient Surgery | Ded & 30% | 0% after ded | 0% after ded | Ded & 10% | Ded & 20% | Ded & 0% |
Emergency Room | $500 | 0% after ded | 0% after ded | Ded & 10% | Ded & 20% | Ded & 0% |
Prescriptions | ||||||
Rx Deductible | None | None | None | Combined with Medical, Waived for Preventive | Combined with Medical, Waived for Preventive | Combined with Medical, Waived for Preventive |
Generic | $10 | $10 | $10 | $10 | $10 | Ded & 0% |
Formulary | $45 | $45 | $45 | $45 | $45 | Ded & 0% |
Non-Formulary | $70 | $70 | $70 | $70 | $70 | Ded & 0% |
Specialty | $15/55/90/30% ($300 Max) / 50% ($500 Max) | $15/55/90/30% ($300 Max) / 50% ($500 Max) | $15/55/90/30% ($300 Max) / 50% ($500 Max) | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | Ded & 0% |
Elect Choice® EPO (Open Access) Plans
Plan Name | OA EPO 1,000/70% | OA EPO 2,000/70% | OA EPO 3,000/70% | OA EPO 4,000/70% | OA EPO 5,000/70% | OA EPO Value 7,150/100% | OA EPO Value 8,700/100% |
|---|---|---|---|---|---|---|---|
Plan Type | EPO | EPO | EPO | EPO | EPO | EPO | EPO |
Provider Network | Elect Choice® EPO (Open Access) | Elect Choice® EPO (Open Access) | Elect Choice® EPO (Open Access) | Elect Choice® EPO (Open Access) | Elect Choice® EPO (Open Access) | Elect Choice® EPO (Open Access) | Elect Choice® EPO (Open Access) |
Deductible | In Network | In Network | In Network | In Network | In Network | In Network | In Network |
Individual | $1,000 | $2,000 | $3,000 | $4,000 | $5,000 | $7,150 | $8,700 |
Family | $2,000 | $4,000 | $6,000 | $8,000 | $10,000 | $14,300 | $17,400 |
Coinsurance | |||||||
Your Percentage | 30% | 30% | 30% | 30% | 30% | 0% | 0% |
Out of Pocket Max | |||||||
Individual | $5,000 | $6,500/2x | $6,850 | $6,900 | $7,600 | $7,600 | $8,700 |
Family | $10,000 | $13,000 | $13,700 | $13,800 | $15,200 | $15,200 | $17,400 |
Office Visits | |||||||
Preventive | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
Primary Care | $30 | $35 | $40 | $40 | $40 | $15 | $10 |
Specialist | $60 | $70 | $80 | $80 | $80 | Ded & 0% | $95 |
Lab & X-Ray | $0/Ded & 30% | $0/Ded & 30% | $0/Ded & 30% | $0/Ded & 30% | $0/Ded & 30% | $0/Ded & 30% | $20/0% after ded |
Urgent Care | $85 | $85 | $85 | $85 | $85 | Ded & 0% | Ded & 0% |
Hospital | |||||||
Inpatient | Ded & 30% | Ded & 30% | Ded & 30% | Ded & 30% | Ded & 30% | Ded & 0% | Ded & 0% |
Outpatient Surgery | Ded & 30% | Ded & 30% | Ded & 30% | Ded & 30% | Ded & 30% | Ded & 0% | Ded & 0% |
Emergency Room | $350 | $350 | $350 | $500 | $500 | Ded & 0% | Ded & 0% |
Prescriptions | |||||||
Rx Deductible | None | None | None | None | None | None | None |
Generic | $10 | $10 | $10 | $10 | $10 | $10 | $10 |
Formulary | $45 | $45 | $45 | $45 | $45 | $45 | $55 |
Non-Formulary | $70 | $70 | $70 | $70 | $70 | $70 | $100 |
Specialty | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | $15/55/90 30% ($300 Max) / 50% ($500 Max) | $15/55/90 30% ($300 Max) / 50% ($500 Max) | $15/55/90 30% ($300 Max) / 50% ($500 Max) |
Plans: Elect Choice® EPO (Open Access) - Page 2
Plan Name | OA EPO HDHP 2,000/100% | OA EPO HDHP 3,500/80% | OA EPO HDHP 5,000/80% |
|---|---|---|---|
Plan Type | HDHP EPO | HDHP EPO | HDHP EPO |
Provider Network | Elect Choice® EPO (Open Access) | Elect Choice® EPO (Open Access) | Elect Choice® EPO (Open Access) |
Deductible | In Network | In Network | In Network |
Individual | $2,000 | $3,500 | $5,000 |
Family | $4,000 | $7,000 | $10,000 |
Coinsurance | |||
Your Percentage | 0% | 20% | 20% |
Out of Pocket Max | |||
Individual | $3,500 | $6,500 | $6,850 |
Family | $7,000 | $13,000 | $13,700 |
Office Visits | |||
Preventive | $0 | $0 | $0 |
Primary Care | Ded & $30 | Ded & 20% | Ded & 20% |
Specialist | Ded & $60 | Ded & 20% | Ded & 20% |
Lab & X-Ray | 0% after ded | Ded & 20% | Ded & 20% |
Urgent Care | Ded & $85 | Ded & 20% | Ded & 20% |
Hospital | |||
Inpatient | Ded & $500/day x3 | Ded & 20% | Ded & 20% |
Outpatient Surgery | Ded & $300 | Ded & 20% | Ded & 20% |
Emergency Room | Ded & $350 | Ded & 20% | Ded & 20% |
Prescriptions | |||
Rx Deductible | Combined with Medical, Waived for Preventive | Combined with Medical, Waived for Preventive | Combined with Medical, Waived for Preventive |
Generic | $10 | $10 | $10 |
Formulary | $45 | $45 | $45 |
Non-Formulary | $70 | $70 | $70 |
Specialty | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 |
Plans: Open Choice PPO
Plan Name | PPO 1,000/80% | PPO 2,000/80% | PPO HDHP 3400/90% | OA MC HDHP 5950/100% Copay | PPO 4,000/70% |
|---|---|---|---|---|---|
Plan Type | PPO | PPO | HDHP PPO | HDHP PPO | PPO |
Provider Network | Open Choice PPO | Open Choice PPO | Open Choice PPO | Open Choice PPO | Open Choice PPO |
Deductible | In Network | In Network | In Network | In Network | In Network |
Individual | $1,000 | $2,000 | $3400/2x | $5,950/2x | $4,000 |
Family | $2,000 | $4,000 | $6,800 | $11,900 | $8,000 |
Coinsurance | |||||
Your Percentage | 20% | 20% | 10% | 0% | 30% |
Out of Pocket Max | |||||
Individual | $4,500 | $6,850 | $5,500 | $6,750 | $6,850 |
Family | $9,000 | $13,700 | $11,000 | $13,500 | $13,700 |
Office Visits | |||||
Preventive | $0 | $0 | $0 | $0 | $0 |
Primary Care | $25 | $30 | Ded & 10% | Ded & $30 | $40 |
Specialist | $50 | $60 | Ded & 10% | Ded & $60 | $80 |
Lab & X-Ray | Ded & 20% | Ded & 20% | Ded & 10% | 0% after ded | Ded & 30% |
Urgent Care | $85 | $85 | Ded & 10% | Ded & $85 | $85 |
Hospital | |||||
Inpatient | Ded & 20% | Ded & 20% | Ded & 10% | Ded & $500 | Ded & 30% |
Outpatient Surgery | Ded & 20% | Ded & 20% | Ded & 10% | Ded & $300 | Ded & 30% |
Emergency Room | $350 | $350 | Ded & 10% | $350 | $500 |
Prescriptions | |||||
Rx Deductible | None | None | Combined with Medical, Waived for Preventive | Combined with Medical, Waived for Preventive | None |
Generic | $10 | $10 | $10 | $10 | $10 |
Formulary | $45 | $45 | $45 | $45 | $45 |
Non-Formulary | $70 | $70 | $70 | $70 | $70 |
Specialty | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 | 30% Max $300 / 50% Max $500 |
Disclaimer: Carrier & Medical plan(s) availability subject to Employer location, minimum contributions, participation and employee location(s). Select plans and plan details effective as of 1/1/2026.